The Polio End Game

There is a medically seismic event erupting. We are soon to witness the eradication of polio. While the details are fascinating, they may be confusing. I think I can simplify things for you and do so briefly.

The basics are that there are two vaccine types and three virus types.

The killed Salk vaccine is injected. The live Sabin vaccine is oral.

In nature, all three virus types cause the same heartbreaking disease. Very rarely, polio vaccine can actually cause the polio syndrome, but only the live type 2 vaccine does this.

The oral vaccine has been the mainstay of the eradication campaign. (It is logistically impossible to get an injection to every child born around the world.) But the live vaccine will never eradicate polio virus from nature; this is because some persons continue to excrete vaccine virus into the environment.

For now, the WHO will continue to recommend oral vaccine, but without type 2. Type 2 live virus is not needed because all the naturally occurring cases have been due to types 1 and 3. And if type 2 is taken out of the oral vaccine, there should be no more vaccine-induced polio.

The true end-game will commence when there are no polio cases any longer. Then there will be a switch back to the killed vaccine until the virus can no longer be detected in the environment.

I think it is sweet in a way that Jonas Salk began the control of polio and we will be returning to the Salk vaccine for the final End Game.

[I will mention as an afterthought that Jonas Salk and my father attended the NYU College of Medicine at the same time.]

Winkler G. Weinberg, MD

I have been an Infectious Disease physician for over 3 decades. I am the author of No Germs Allowed!. If you liked this article, check out the book on Amazon.