Dr. Salk, the Polio Vaccine, and Us
By Michael Hodin
Dr. Jonas Salk changed history 70 years ago this month, when the first child received the polio vaccine, which ultimately prevented tens of millions from contracting the disease. It was part of the wider childhood immunization effort in the fifties that prevented multiple communicable diseases, now recognized as a public health triumph and one of the pillars that has led to our 21st century longevity. This milestone underscores that prevention is the best of our health system and central to healthy aging and health systems sustainability. Re-learning basic truth about prevention for the third decade of our 21st century — The Decade of Healthy Ageing — is imperative.
It’s also fitting that the anniversary directly precedes Shingles Awareness Week — reminding us that Salk’s innovation is not a dusty chapter for the history books, but a living lesson that is highly relevant for aging societies. Countries must treat spending on life-course immunization, and prevention more broadly, as an investment rather than a cost, saving massively on hospitalization, doctors’ visits, care, and health costs generally, as well as contributing to productivity and, therefore, a central, if often overlooked, component of economic growth.
However, ageism and our late 20th century focus on acute treatment can obscure those facts and lead societies to underutilize one of the most cost-effective public health tools in their arsenal. In the case of shingles, one-in-three people will have the disease in their lifetime, but a recent global study from GSK finds that many have a few common misperceptions about the disease. Far more than a nuisance, shingles can be very painful and debilitating for the individual, with 10–18% of people developing nerve pain that can last for months or years, while generating billions in care costs and lost productivity for society overall.
The same holds true for a range of vaccine-preventable diseases, including influenza, RSV, COVID, and pneumococcal pneumonia. While we have the vaccines, what we still need is a full-on embrace of these tools as incredible, life-saving innovations, public health no-brainers and smart, ready-to-go policy solutions for fiscal sustainability, economic productivity, and the future of work and society in an ever rapidly aging world.
Doing for adults what we did for the children nearly a century ago ought to be a no-brainer — not least because using innovations will be the incentive for even more innovation: Can there be a vaccine to address AMR? Will the vaccine be one of the tools used against Alzheimer’s? Only in a hospitable environment for these innovations will we see the continued investment for future innovation.
As we celebrate the Salk vaccine, let’s take a stand in 2024 with respect to the added value of adult vaccines profoundly linked to the needs of our 21st century aging society.
· Embrace healthy aging. For the individual and society, vaccination is one of the easiest, most effective steps to support healthy aging. And yet, still, around one-third of all disability-adjusted life years globally for those 55+ are caused by vaccine-preventable lower respiratory infections. These diseases can be lethal; tragically, influenza still causes 3–5 million severe cases and as many as 650,00 deaths each year. While we have the tools, we need greater societal and policy focus, systems and data, and investment, through national immunization programs and other measures.
· Strengthen health infrastructure. Vaccination keeps people out of the hospital, helping strained health systems to manage the burden of influenza, COVID, RSV, and shingles, especially during peaks in cold and flu season. This means that prioritizing adult immunization is effectively an investment in health system capacity and long-term sustainability, as we enter an era with both an ongoing “tripledemic” and older, higher-risk populations.
· Spend on prevention as an investment versus a cost. The U.S. already saves $185 billion each year from adult immunization coverage, but increasing coverage could save an additional $96 billion — money that, right now, we’re leaving on the table. The same holds true around the world, but OECD countries currently spend less than 10% of their preventative healthcare budgets on immunization. There is an immense opportunity to do more and to save more.
· Enhance worker productivity and economic value. Adult immunization can also be a huge win for employers, as vaccine-preventable diseases drain productivity and generate business risks. A recent study estimates that productivity losses account for nearly 90% of the total societal costs of influenza; in Italy, for example, it’s estimated higher levels of vaccination could save hundreds of millions of Euros in productivity. Stepping up adult vaccination efforts can reduce these losses, while aligning with employers’ growing contributions to all aspects of health — another major societal shift since 1954.
In short, it’s time to extend the incredible value of prevention and vaccination across the entire life course. That’s the lasting legacy of Dr. Salk and the polio vaccine, which show us that transformative innovations must go hand-in-hand with society-wide focus and action.
