Remembering Albert Sabin and the vaccine that changed the world

Medicine and public health lost a luminary 25 years ago this week with the death of Dr. Albert Sabin. During his life, Sabin became a household name, famous the world over for his development of the oral polio vaccine. He was also a role model for many clinicians and researchers because he refused to patent the vaccine.

I recall a conversation with Sabin at a medical conference in Miami in the early 1960s. My wife and I had come down to the hotel restaurant for breakfast. Sabin, sitting alone having his toast and coffee, motioned us over and invited us to join him. He had something he wanted to talk about that he thought I might find interesting, as we were both involved in work on vaccines. What he described went far beyond interesting.

In those days, children in the United States were immunized much the same way they are now: individually, on a schedule determined by a child’s age. But in Cuba, Sabin told me, they’d done it differently. In a country without reliable refrigeration, it didn’t make sense to try to store perishable vaccine in every hospital and clinic. Instead, the health authorities had decided to vaccinate the entire country in one fell swoop — all of the children in a matter of just a few days. Six months later, they came back and did it again.

The results were as spectacular as they were unexpected. By vaccinating all the children simultaneously, Cuba had not only protected each vaccinated child but deprived the virus of all of its potential carriers. Cuba, he told me, had eliminated polio.

The words were electrifying. We were only a few years out from the era of unstoppable polio epidemics in the United States and elsewhere. At that time, no disease had ever been eradicated. But there before me was Albert Sabin, sipping his coffee, saying that if it had been done in one country, “we might be able to do it everywhere.”

For the next 30 years, Sabin pursued this possibility as single-mindedly as he had once pursued the vaccine itself. He traveled the world, conferring with governments and experts, and wrote paper after paper that meticulously explored the mechanisms by which polio might be defeated. Two elements, he said, were the keys to success: the use of the oral vaccine, and the need to administer it to an entire population at once.

The obstacles, however, were enormous. The cost, the logistics, the army of workers needed to vaccinate millions of children at a time — who would ever take it on?

In 1979, the president of Rotary International, a global humanitarian service organization, called me at the National Institutes of Health, where I was then working. He wanted to know what large-scale humanitarian effort might be accomplished by an organization with, at that time, just under a million members in most of the world’s countries. My mind immediately flashed back to that morning in Miami, and I said, “Eradicate polio.”

Rotary committed to doing just that, going on to become a spearheading partner of  what is today the Global Polio Eradication Initiative. With the support of national governments and using the technique of mass immunization, this initiative — now made up of Rotary, the World Health Organization, the Centers for Disease Control and Prevention, UNICEF, and the Bill and Melinda Gates Foundation — has reduced the number of children paralyzed by wild poliovirus from 350,000 in 1988 to just 22 cases last year. We have every expectation that the number will soon drop to zero.

Through this extensive partnership, Sabin’s spark of breathtaking ambition flamed into a beacon of cooperation, professionalism, and hope. When its work is done, and the world is free of polio, the achievement will be a testament not only to the vision and determination of one man, but also to the ability of a world united in compassion to determine its own future.

John Sever, M.D., is vice chair of Rotary’s International PolioPlus Committee, and former chief of infectious diseases at the National Institute of Neurological Disorders and Stroke.