073 - Vaccination Against Acute Anterior Poliomyelitis

I've talked about John A. Kolmer and his polio vaccine before (047, 048, and 063), but I wanted to touch on it once more.¹

Kolmer's vaccine was a "live" but partially inactivated virus. He took infected monkey spinal cords, treated them with sodium ricinoleate, added some phenyl-mercuri-nitrate as a preservative to prevent bacterial contamination, and injected them subcutaneously. These things should prevent infectivity in humans, he thought. And it seemed to work well in monkeys, though it could still paralyze if injected into the brain. The reason he wanted it partially "alive" was that he thought completely inactivated virus was unable to immunize, for some reason.

By this point, more than 12,000 people had received Kolmer's vaccine. None seemed to have severe reactions, like encephalomyelitis, though some that received the version without preservative had abscesses temporarily.

However, there were 10 cases Kolmer knew of in which the subject seemed to get sick with polio soon after receiving the vaccine (soon meaning 1-6 days later). Usually it was after the second dose, never after the third, but five of the 10 (50%) actually died from their illness, from paralysis.

In this paper, Kolmer thought it unlikely that the polio had come from his vaccine, considering the many that received the same lot without getting sick, and how no one receiving all three doses got sick. However, he was unable to explain where the virus had come from for some of the cases, since there wasn't an outbreak in their areas. It was a mystery.

It seems like later, though, he does conclude that the vaccine is not safe enough to use in people, especially because he hadn't been able to establish its efficacy in preventing any disease.

"It was my hope that this strain of virus had lost infectivity for human beings by reason of its long adaptation to the monkey, and especially after treatment with sodium ricinoleate and when given by subcutaneous injection, but the occurrence of nine cases of poliomyelitis among 10,725 individuals given the vaccine in 1935 has indicated that the virus apparently possesses infectivity for human beings and that this vaccine as well as the formalized vaccine of Park and Brodie is too dangerous for use."²

So, I'm not sure whether it was the correct decision or not, but that's why we don't use Kolmer's vaccine these days.

References:
1. Kolmer, J. A. Vaccination Against Acute Anterior Poliomyelitis. Am J Public Health Nations Health 26, 126–135 (1936).
2. Kolmer, J. A. The Present Status of Methods for the Prophylaxis of Acute Anterior Poliomyelitis. Ann Intern Med 12, 95–105 (1938).