Vaccinating young children – against Polio — has been a difficult and frustrating process.


The virus was polio, and the year was 1961. It had been six years since Jonas Salk’s much-heralded vaccine had been authorized, and disease cases had dropped dramatically as a result of amazingly successful vaccination campaigns.

Despite this, some outbreaks continued, particularly in impoverished urban areas. Only about half of the American population had been vaccinated, and President John F. Kennedy was particularly worried that 4.8 million children — the majority of whom were under the age of five — had not received their vaccinations.

“I hope that every parent in America will fully support the reinvigorated effort this spring and summer to provide vaccination for all Americans, particularly the young,” Kennedy remarked at a press conference in April 1961.

Despite the fact that many parents supported the vaccine, the nation’s experience with polio demonstrated the difficulty of immunizing the smallest children – a challenge that the coronavirus epidemic is repeating today.

The Food and Drug Administration approved vaccines for children under the age of five on Friday, after more than two years of the pandemic, with injections anticipated to be available next week. According to research released last month by the Kaiser Family Foundation, only 1 in 5 parents said they’ll get their young children immunized as soon as feasible. In November, children aged 5 to 11 became eligible for the vaccine, but only 4 out of 10 parents claimed their children in that age group had received it, according to the research.

Unlike the coronavirus, however, polio primarily affected children. That’s why Kennedy and public health officials were concerned about the vaccine gap among children.

Since the first recorded polio epidemic in the United States in 1894, parents had been counting on a vaccine as horrific stories of paralysis and death among children had built up. According to David Oshinsky’s book “Polio: An American Story,” about 1.5 million youngsters took part in the huge Salk experiments. Volunteering for the study was considered a privilege, and the typical wording “I offer my permission” was replaced with “I hereby request” on parental consent forms, according to Oshinsky.

However, while schools functioned as a “safety net” and later assisted in the administration of a large number of vaccines, uptake for babies and preschoolers slowed, according to James Colgrove, a Columbia University professor of sociomedical sciences.

According to Elena Conis, author of “Vaccine Nation: America’s Changing Relationship with Immunization,” children aged 5 to 9 were at the greatest risk of contracting polio before 1955. However, by the end of the decade, the paralytic cases had shifted to children under the age of five.

This was especially noticeable in urban poorer families. When polio struck Providence, R.I., in 1960, for example, epidemiologists discovered that the cases were almost entirely limited to children living in the city’s poorest neighborhoods, said Conis, a journalism professor at the University of California at Berkeley.

She explained that one of the key reasons for the polio vaccine inequities was that children’s appointments had transferred from public clinics to private doctor offices, which were becoming “increasingly the realm of the middle class.” Three shots plus a booster were required for the Salk vaccination, which entailed several visits to the doctor.


With the Vaccination Assistance Act of 1962, Kennedy hoped to close the vaccine gap by providing funds to states to implement mass immunization campaigns for polio, diphtheria, tetanus, and pertussis. It also established the federal government’s leading role in coordinating immunization policies, which has proven especially crucial, and contentious, during the coronavirus pandemic.

“With Kennedy’s idea, the story of vaccination and society in modern times begins,” Conis wrote.

Public health programs were also launched by the federal government. “Babies and Breadwinners,” for example, was created with the goal of bringing immunizations to babies and men who, while not as vulnerable as children, were nevertheless at risk. (The most notable case was Franklin D. Roosevelt, who was paralyzed from the waist down after being diagnosed with polio at the age of 39.)

The government approved Albert Sabin’s oral polio vaccine months after Kennedy’s press address. According to Colgrove, the relative simplicity of administering oral doses ushered in a reinvigorated vaccination effort. On “Sabin Sundays,” millions of children and adults flocked to churches and schools to receive their free doses, which were often provided in the form of sugar cubes. Wellbeing, a cartoon bee who encouraged kids to “drink the free polio vaccine,” was included in a government public health campaign.

Despite extensive use of the vaccine, the United States was not proclaimed polio-free until 1979.

Polio vaccines changed the epidemiology of the disease, concentrating cases mostly in poor metropolitan areas with low vaccination rates, a pattern that was repeated when vaccines became available for other diseases. Conis stated that fresh outbreaks were centered in low-income urban districts, where vaccination rates were lower, just a few years after the first measles vaccine was released in 1963.

In the 1960s, several middle-class parents, many of whom were affected by the social movements of the time, developed a fresh wave of vaccine apprehension. They began to question the need for vaccines, especially for diseases like measles, which, despite being potentially fatal, had seemed to be a normal part of childhood, according to Conis.

When it came to children, ongoing epidemics of preventable diseases pushed a move away from persuasion and toward compulsion.

Immunizations were mandatory for school enrollment in half of the states in 1968. According to “Vaccine Nation,” one CDC official observed, “It’s challenging to reach the single preschool child in the slum, but mounting a campaign to achieve really high levels of immunization in kindergarteners, and the 1st, 2nd graders in school should be pretty easy.”

The federal government gave money to states in 1977 to help them implement mandated immunization programs, which included tracking progress and reviewing student records. According to Colgrove, as a result, all states had required school immunization mandates by 1981.

The most efficient method to assure immunization for the youngest children is to demand it before they can enter school, according to Colgrove, citing the country’s experiences with polio and other transmissible diseases.

But it’s unclear if that lesson applies to Covid. Children are not as badly affected as adults. According to a Kaiser analysis published last month, coronavirus vaccinations were created and rolled out at breakneck speed, and more than half of parents with children under the age of five say they don’t have enough information about the vaccine’s safety or effectiveness.

Furthermore, there is a significant level of distrust in institutions, especially the government. “It’s just a more difficult vaccine to sell in schools,” Colgrove explained. “We’re not in that atmosphere anymore,” he said, referring to successful polio vaccination programs in schools.

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Author: Muhammad Asim

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