“Dr Bertram McCloskey no doubt saved many lives, maybe even Norbury’s own. But it wasn’t until the adult Norbury dug up a report McCloskey published in a medical journal that he heard of a likely link between the 1950s polio epidemic and inoculation against whooping cough and the deadly disease diphtheria, which once killed tens of thousands of children a year. His report in The Lancet makes disturbing reading, even today,” Norbury begins. McCloskey had noticed that 211 of 340 polio cases in Victoria in six months were children who had been inoculated — and that the more recent the injection, the more likely it was they had developed polio. Even more pointedly, the polio paralysis was more severe in whichever arm the child had recently had injected. This rang alarm bells with Norbury. Because of problems with the primitive syringes then used, he’d been given a double dose of diphtheria vaccine, he says, only weeks before the paralysis hit him. The veteran journalist would ferret out facts hidden from his parents and others when he was a child. He discovered that McCloskey had reported his misgivings to the Victorian chief health officer, the heads of the Commonwealth Serum Laboratories and the head of the Infectious Diseases Hospital. They agreed there was a link between school injections and polio. In fact, the Medical Journal of Australia advised against injecting school-aged children in areas where polio was breaking out. Experts apparently suspected that children’s immune systems were temporarily weakened by the vaccines, making them vulnerable to polio. So what happened? Because of fears of a backlash against immunisation, the authorities buried McCloskey’s report. People in high places thought that the increased risk of hundreds of children getting polio was better than postponing diphtheria vaccinations.”
… it was not until the end of World War II that injection-induced polio emerged as a public health concern. The application of epidemiological surveillance and statistical methods enabled researchers to trace the steady rise in polio incidence along with the expansion of immunisation programmes for diphtheria, pertussis, and tetanus. A report that emerged from Guy’s and Evelina Hospitals, London, in 1950, found that 17 cases of polio paralysis developed in the limb injected with pertussis or tetanus inoculations. Results published by Australian doctor Bertram McCloskey also showed a strong association between injections and polio paralysis. Meanwhile, in the USA, public health researchers in New York and Pennsylvania reached similar conclusions. Clinical evidence, derived from across three continents, had established a theory that required attention.
The impressive volume of literature on polio provocation by the 1950s fuelled changes in health policy. US health organisations and charities, including the National Foundation for Infantile Paralysis, the American Academy of Pediatrics, and the American Public Health Association, accommodated the possibility of polio provocation and encouraged health professionals to avoid “indiscriminate” injections and “booster shots” during epidemics. In New York City, child health stations were closed and laws mandating paediatric vaccinations before school attendance were relaxed. Most health professionals reformed their immunisation practices and accepted that seasonal factors and cycles of disease were important to consider before immunising children.
Skeletal muscle injury is known to predispose its sufferers to neurological complications of concurrent poliovirus infections. This phenomenon, labeled “provocation poliomyelitis,” continues to cause numerous cases of childhood paralysis due to the administration of unnecessary injections to children in areas where poliovirus is endemic. Recently, it has been reported that intramuscular injections may also increase the likelihood of vaccine-associated paralytic poliomyelitis in recipients of live attenuated poliovirus vaccines. We have studied this important risk factor for paralytic polio in an animal system for poliomyelitis and have determined the pathogenic mechanism linking intramuscular injections and provocation poliomyelitis. Skeletal muscle injury induces retrograde axonal transport of poliovirus and thereby facilitates viral invasion of the central nervous system and the progression of spinal cord damage. The pathogenic mechanism of provocation poliomyelitis may differ from that of polio acquired in the absence of predisposing factors.
Since August 2, 2014 our Centers for Disease Control has received reports of 107 cases of ‘acute flaccid myelitis’ (AFM), a polio-like illness in children in 34 states. During the same interval there have been 1153 cases of respiratory illnesses associated with enterovirus D-68 (CIDRAP News 1/16/15. CDC update 1/15/15. Catherine Saint Louis, NY Times 1/13/15). AFM affects motor neurons in spinal cord gray matter, resulting in asymmetrical limb weakness; 34% of patients have cranial nerve motor dysfunction. Median age of patients is 7.6 years/range: 5 months-20 years (MMWR 63: 1243–January 9, 2015). So far only one child has fully recovered. EV-D68 is a suspected cause but, thus far, no viruses have been found in the spinal fluid of patients, and only a minority have had an antecedent illness associated with EV-D68. Case-control studies are planned to look for clues, but presently AFM is a mystery disease of unknown cause.It is taboo to suggest a role for vaccines, but some old-timers remember “provocation poliomyelitis” or “provocation paralysis.” This is paralytic polio following intramuscular injections, typically with vaccines. PP was most convincingly documented by Austin Bradford Hill and J. Knowelden during the 1949 British polio epidemic when the risk of paralytic polio was increased 20-fold among children who had received the DPT injection (BMJ 2:1–July 1, 1950). Similar observations were made by Greenberg and colleagues in New York City; their literature review cited suspected cases as far back as 1921 (Am J Public Health 42:142–Feb.1952). I first became aware of PP 10 years ago while browsing through “Krugman’s Infectious Disease of Children” (page 128 of the 2004 edition).AFM may result from a direct virus attack on the spinal cord, or by an immune attack triggered by a virus, or by something else.If a polio-like virus is circulating in the U.S., the possibility of its provocation by one or more vaccines has to be considered.
…any possible doubts, whether or not well founded, about the safety of the vaccine cannot be allowed to exist in view of the need to assure that the vaccine will continue to be used to the maximum extent consistent with the nation’s public health objectives.