Thursday, September 17, 2020

Meredith Wadman's "The Vaccine Race"

Meredith Wadman is a reporter at Science magazine in Washington, D.C. Her gripping book, The Vaccine Race: Science, Politics and the Human Costs of Defeating Disease, tells the tale of WI-38, a fascinating cell line with a colorful and controversial history and a huge public health impact.

The Vaccine Race was shortlisted for the 2018 Wellcome Book Prize, named a Washington Post Notable Nonfiction Book of 2017, and was longlisted for the Andrew Carnegie 2018 Medal for Excellence in Nonfiction. The Guardian named it the second-best science book of 2017.

Wadman applied the “Page 99 Test” to The Vaccine Race and reported the following:
Page 99 of the Vaccine Race: Science, Politics and the Human Costs of Defeating Disease, comes in Chapter Seven, which is entitled “Polio Vaccine `Passengers.’” Page 99 situates the reader at a 1960 conference where scientists are holding their collective breath in anticipation that a new, improved polio vaccine will be delivered any day. Instead, Merck’s venerated vaccine czar, Maurice Hilleman, stands up and delivers a blow that calls into question the safety of every polio vaccine made in the U.S. since the much-hailed launch of the Salk vaccine in 1955. Merck researchers, Hilleman announced, had discovered a silent monkey virus lurking in the monkey kidney cells that were then used as miniature “factories” to pump out the Salk vaccine.. And this wasn’t just any monkey virus: when it got into certain cells it went on a rampage, tearing holes that left them looking like Swiss cheese. The Salk vaccine had already been given to 70 million Americans, many of them children Soon, researchers would demonstrate that the virus caused cancer-like changes in human cells in lab dishes – cells from people’s skin, and the inside of their cheeks. Cells from three-month-olds and adults.

By and large, the assembled scientists, and the regulators who approved US vaccines, presumed that formaldehyde that was used in producing the Salk vaccine killed the silent monkey virus before it found its way into people’s arms. But this couldn’t be known for sure. (Hilleman was so worried that he soon shut down Merck’s production of the Salk vaccine, never to resume it.)

Just as worrisome was the fact that the same monkey kidney cells that were susceptible to the silent virus were being used to produce the nearly-ready Sabin vaccine, which would be licensed in 1961 and delivered to tens of millions more Americans. And because the Sabin vaccine used a live, weakened version of the polio virus, it didn’t contain formaldehyde, unlike Salk’s killed-virus vaccine. So, any live monkey virus in Sabin’s vaccine would be swallowed along with the sugar cube that delivered it.

The page 99 test turns out to be an excellent one for The Vaccine Race: page 99 touches on so many of my book’s themes and preoccupations. These range from the difficulty of vaccine development and the unexpected obstacles that scientists encounter in that process to the fierce competition to license longed-for vaccines, to the part that politics and personalities play in such approvals.

The reader wouldn’t know it from reading page 99 alone, but the fact is that scientists listened to Merck’s Hilleman and respected him because he was not only an excellent scientist but a prototypical hard-charging male: a tough-talking, no-nonsense Montanan who in his career would develop more commercially successful vaccines than any scientist to this day.

Yet, a quiet, unsung woman from Auburn, West Virginia, population 199, had warned of a cancer-causing substance in the monkey kidney cells even before Hilleman. She worked at the National Institutes of Health and her name was Bernice Eddy. She had injected fluid from the monkey kidney cells being used to make the Salk vaccine into 154 laboratory hamsters. Seventy percent of them developed lethal tumors. (She later proved that the cancer-causing “substance” was the same virus, dubbed SV-40, that Hilleman had described.) But when she warned her boss – another hard-charging, tough-talking man -- about the danger, she got stripped of most of her lab staff, removed from her duties policing polio vaccine safety and relocated to a former storage closet.

Page 99 also sets up a series of events which reveal the power – and potential damage – caused by obdurate regulators. The chief of U.S. vaccine approvals would take fully three years after that 1960 conference to require polio vaccine makers to stop using the species of monkeys whose cells housed the silent virus. He preferred, as one aggrieved character put it, the devil he knew to the one that he didn’t.

There is another big theme of my book that is not apparent on page 99. It is the abuse of captive populations of human beings --- from the babies of prisoners to intellectually disabled children --- to test medicines and vaccines in the mid-20th century. This appropriation of the bodies of powerless people was widely approved by the medical establishment, from funding agencies to research universities to medical journals. My book brings some of the people who suffered into clear focus, like premature babies at Philadelphia General Hospital, nearly all of them African American, and orphans in the care of the Archdiocese of Philadelphia.

Also not present on page 99 is Mrs. X, the anonymous Swedish woman whose fetus was taken by researchers without her knowledge or consent after her 1962 abortion, and used to develop cells that have led to the production of billions of doses of vaccines, from rubella to chicken pox to rabies to shingles.

Finally, to state the obvious, page 99 centers on a theme that is hugely relevant today: vaccine safety at a time of intense public pressure to fend off a horrifying disease. Perhaps not surprisingly, regulators are again on the hot seat: Will senior FDA brass bow to pressure to approve a COVID-19 vaccine before it has been proven safe and effective?
Visit Meredith Wadman's website.

--Marshal Zeringue