The Polish-American physician and virologist Albert Bruce Sabin (1906-1993) developed the first effective and widely used live virus polio vaccine.
Born in Poland, Sabin emigrated to the United States with his parents in 1921 in order to avoid persecutions directed against Jews. After attending New York University as a pre-dental student he switched to medical school and to an interest in microbiology. Upon receiving his medical degree in 1931, Sabin immediately began research on the nature and cause of polio, an acute viral infection that could result in death or paralysis. This disease had reached epidemic proportions affecting people around the world. During his internship at Bellevue Hospital in New York City, Sabin successfully isolated the B virus from a colleague who had died after a bite from a monkey. Sabin was soon able to prove the B virus's relation to the herpes simplex virus, the cause of herpes in humans.
Sabin joined the staff of the Rockefeller Institute in New York City in 1935 and four years later left for a post at the Children's Hospital Research Foundation in Cincinnati, Ohio. It was there that he proved that polio viruses not only grew in nervous tissue, as was generally assumed, but that they lived in the small intestines. By introducing the idea of enteroviruses —viruses that lived in the gut—Sabin established that poliomyelitis was essentially an infection of the alimentary tract. This discovery indicated that poliomyelitis might be vulnerable to a vaccine taken orally.
Sabin's work on a poliomyelitis vaccine was interrupted by World War II. In 1941 he joined the U.S. Army Epidemiological Board's Virus Committee and accepted assignments in Europe, Africa, the Middle East, and the Pacific. During this phase of his career Sabin developed vaccines for encephalitis (sleeping sickness), sand-fly fever, and dengue fever. At the war's end Sabin returned to Cincinnati and to his research on the polio virus.
Convinced that the polio virus in nature lived primarily in the intestines, Sabin resolved to make the human gut a hostile environment for it. This he intended to accomplish by isolating a mutant form of the polio virus that was incapable of producing the disease. The avirulent virus would then be propagated and introduced into the intestines, where it would reproduce rapidly, displacing the lethal virulent forms of the polio virus and protecting the human host from the disease. Sabin's goal from the outset was to find a live and safe variant polio virus that could be administered orally to combat poliomyelitis.
After an intensive investigation during which he discovered a number of new enteroviruses, Sabin managed to isolate the viruses he sought. Sabin and his research associates first ingested the live avirulent viruses themselves before they experimented on other human subjects. For two years (1955-1957) he gave the vaccine to hundreds of prison inmates with no harmful effects. At this point Sabin was ready for large-scale tests, but he could not carry them out in the United States. A rival polio vaccine developed by Dr. Jonas Salk in 1954 was then being tested for its efficacy in preventing the disease among American school children.
Whereas Sabin thought an attenuated live virus diluted and weakened would be effective, Salk was determined to create a vaccine using a killed form of the virus.
Some foreign virologists, especially those from the U.S.S.R., were convinced of the superiority of the Sabin vaccine, and hence it was first subjected to widespread tests outside the United States from 1957 to 1959. Millions of Russians, and millions more living in Latvia, Estonia, Czechoslovakia, Poland, Hungary, and East Germany, gained protection from poliomyelitis with Sabin's vaccine. A much smaller group of persons living in Sweden, England, Singapore, and the United States received Sabin's vaccine by the end of 1959.
In the meantime the Salk vaccine experienced some problems that made the American medical community more receptive to the solution proposed by Sabin. Salk's vaccine, which utilized killed virulent polioviruses, was accidently contaminated with some live virulent polioviruses which subsequently brought death or severe illness to several hundred school children. In addition, the Salk vaccine was somewhat difficult to administer (it was necessary to inject it into the body) and it was effective for a relatively short time (less than a year).
Sabin took advantage of this situation by vigorously promoting his vaccine. It was, he said, free of virulent viruses, easily administered orally, and effective over a long period of time. The battle that ensued between the supporters of the Salk and Sabin vaccines was finally won by the Sabin forces and hence it was a live virus vaccine that was used in the United States and the rest of the world to eradicate poliomyelitis. The battle between Salk and Sabin went on for years. Salk denounced Sabin's vaccine in 1973 as being unsafe and tried to persuade the public to use his vaccine again. But he was ignored by many, and by 1993 health organizations reported the near-extinction of the polio disease in the Western Hemisphere.
The success of his polio vaccine brought Sabin many honors at home and abroad. Always a tireless researcher, Sabin did not rest upon his laurels but moved on to a new field of study—the viral origins of human cancer. After more than a decade of work he was forced in 1977 to conclude that cancers were not caused by viruses as he had first assumed. During this time he served as research professor at the University of South Carolina until taking an emeritus status in 1982. In 1980 he traveled to Brazil to deal with a new outbreak of polio, and retired from medicine in 1986. Until his death on March 3, 1993, of heart failure, Sabin continued to add wood to the fire, speaking out against many ideals, including his doubts that a vaccine should be developed to fight the human immunodeficiency virus, or HIV, which causes AIDS.
Sabin's life and scientific achievements are treated in chapter 5 of Theodore Berland, The Scientific Life (1962) and in chapter 14 of Roger Rapoport, The Superdoctors (1975). The Salk-Sabin controversy is covered in Richard Carter, Breakthrough: The Saga of Jonas Salk (1966). The Miracle Finders by Donald Robinson and The Health Century by Edward Shorter are encouraged reading for learning of many other contributors to the world of virology. □