Untitled
Abstract
In 1955, a vaccine emerged in America for the severe disease, polio. In 2021, a vaccine was approved to treat the viral infection, covid-19. Many doctors and studies compare these two diseases when studying the vaccination responses from America at these two very different times in modern history due to similarities between the disease transmission and societal effects such as city closures and quarantines. America faced drastically different social and political contexts between 1955 and 2021, as well as differing in the ways that the country responded to these health crises. A successful polio campaign leaves many takeaways for how the covid vaccination campaign could have been handled and executed more effectively. It urges a careful analysis of these contexts, which this article provides. Results of the study showed that most prominently, different presiding presidents created this vaccination divide most strongly, through molding the country’s views and attitudes and dealing with polarization. Polio vaccination campaigns were also more expansive than covid. Still in the midst of the coronavirus, it is important for the country to look back on history and ask, what can we change to keep the virus under control? And most of all, how can we prevent this from happening again in the future?
Introduction
In early 2020, the rapid spread of the coronavirus left the entire world scrambling, the United States included. From the onset of the virus to November 2022, there have been over one million deaths from the virus and nearly 100 million confirmed cases total in America alone (CDC). The virus is transmitted through close contact with infected individuals through droplets, making the disease easy to spread and difficult to detect until the symptoms begin emerging.
The United States has faced large-scale viral infections before–in the past, one particular epidemic stands out bearing resemblance to the covid pandemic: polio. The virus hit America in two waves: 1916 and 1952. The worst outbreak in 1952 had over 57,000 cases, 21,000 of those resulting in paralysis and 3,000 deaths. Similarities polio bears to covid includes how it is easily transmitted through the respiratory system (Larsen). One stark difference between the two diseases, however, is that resistance against the polio vaccine was not as strong as the resistance against the covid vaccine. The covid pandemic in America has been notorious for the debate over vaccinations. From the emergence of the vaccine to November 2022, 80.4% of individuals have received at least one dose of the vaccine. 68.6% of individuals have received all doses of the vaccine (CDC). However, there was a lot of pushback against vaccinations. Surveys conducted in 2020 showed that between May and November 2020, the percentage of respondents who were willing to be vaccinated shifted from 72% to 51% to 60% (Wood). In contrast, 92.5% of children before the age of two have received the full polio vaccine dosage today (“Immunization”). Through comparisons between the recent covid pandemic to the historical polio epidemics in America, this article aims to show how sociopolitical contexts and vaccination responses affected polio and covid vaccination rates in America. Vaccine resistance and lower vaccination rates are dangerous because it leaves a community more exposed to diseases that could be fatal. Both polio and covid have shown to be severe and potentially fatal–but it is ultimately their outcomes that differ.
Social Contexts of Covid and Polio
The main social contexts that shaped the population’s attitude towards polio were the anti-vaccination sentiments and the at-risk population, which counter-balanced the anti-vaccination sentiments. This type of misinformation surrounding the vaccine was spread, most notably, from Walter Winchell, the modern day equivalent of a Fox News broadcaster and most popular columnist at the time. In an article published in the Chicago Sun Times, author Neil Steinberg quotes Winchell’s booming words to America on the morning of April 4, 1954. Winchell reported that there was “‘a new polio vaccine claimed to be a cure. It may be a killer.’ The vaccine hadn’t even been tested yet. Authorities, Winchell claimed, wrongly, were stockpiling “little white coffins” to handle the vaccine’s victims. That week, 150,000 children were yanked out of the vaccine trial” (Steinberg). The American peoples’ response to Winchell’s baseless claims demonstrate the power that misinformation and vaccine fears hold. Winchell’s claims were proven to be false by the National Foundation for Infantile Paralysis (NFIP), the organization founded by Franklin Delano Roosevelt that conducted vaccine trials. A 1954 issue of the Scientific American journal reported that the NFIP pointed out that of over 4,000 children who had received Jonas Salk’s live virus vaccine, none of them showed any effects (Scientific American). Despite claims about the dangers of the polio vaccine, parents rushed to vaccinate their children anyways, most likely due to the at-risk population target of polio. Children had the highest chance of contracting polio, and parents were so desperate to protect their children that many parents were very willing to get their children vaccinated, according to Emory University historian Elena Conis (Conis). As a result of this desperation, it was much less likely that parents would listen to the voices of anti-vaccine movement leaders such as Winchell. Regardless of the desperation, it was also important that parents would feel reassured about the vaccine, and the NFIP did just that–particularly during vaccine trials which recruited 1.8 million children to participate in (Larsen). In David Oshinksky’s book Polio: An American Story, he elaborated that the NFIP explained to parents how the vaccine had already been proved to be safe on over 5,000 volunteers, with none-to-minimal side effects (Oshinsky). Thus, from efforts to calm questioning parents to the parental desire to protect their children, the social environment guided the population towards vaccinations, muffling the anti-vaccination cries and vaccinations proceeded forward.
For the covid pandemic, Americans faced similar social contexts as polio: anti-vaccination movements and an at-risk population. However, instead of counterbalancing each other, both factors worked together to become a strong competitor towards vaccination rates. An article published in the Microbes and Infection journal articulates some of the outrageous claims that anti-vaccine movements have created, including ones such as Bill Gates created the virus, covid viruses contain microchips to track individuals, 5G networks in China weakened immune systems so that citizens would become infected. Other protests include lobbying against social distancing, contact tracing, and wearing masks (Hotez). In comparison to the polio social context, the amount of conspiracy theories that have emerged and spread from covid are greater than polio. One reason for this abundance is due to the internet and the availability of misinformation. Professors at the University of Iowa explain in an article published in the Wiley Public Health Emergency Collection how in the spring of 2020, covid-related Google searches spiked and tweets related to the virus hit over 500 million. However, around 50% of the American population encountered false information about covid, and many people unsurprisingly bought into it (Wang). Out of the abundance of misinformation, anti-vaccination sentiments and conspiracies were certainly shared among people, only fueling the movements against vaccines. Another factor that the population faces in terms of becoming vaccinated is the at-risk group for the covid virus. The majority of deaths from covid fall under people age 50 and older, according to data from the CDC. As a result, vaccination rates are among the lowest in young adults ages 24 and under (CDC). In one abcnews article, Johns Hopkins Center for Health Security scholar Dr. Monica Schoch-Spana states that the reason for the low rates among young adults is because of their “‘lingering perception that 'I am young, I am strong, I can fight this thing off…So there's that youthful sense of invincibility that was reinforced early on when we had less vaccine available’” (Deliso). The result of the low vaccination rates emerges among social pressures: if less teenagers and young adults feel the need to get vaccinated, they are less likely to encourage their peers to vaccinate as well, or even pressure their friends against getting vaccinated because of their sense of invincibility. These opinions, combined with misinformation and conspiracy theories created by anti-vaxxers, result in strong reasons to not get vaccinated for those who believe it.
Political Contexts of Polio
The other important area of context that should be understood when analyzing polio and covid are the political contexts. Political leaders of a country are often looked to during times of crisis, and it is their responses and actions that can unite its citizens, or divide them. For polio, the political contexts largely aimed to unite the people of America and encourage them. One of America’s presidents himself was diagnosed with polio in 1921: Franklin Delano Roosevelt. As a victim to the disease and thus able to empathize with other adults and children who contracted the disease, Roosevelt focused on the chase to find a treatment for polio when he became president in 1933. According to Robert Dorfman, a surgeon at Northwestern, and his article published in the Canadian Bulletin of Medical History, Roosevelt was the “first American president to make a disease "his disease." His advisors made much of his transformation from polio victim to polio patron and featured his name, voice, and body in fundraising” (Dorfman). This framing of polio that Roosevelt presented was a key attitude in shaping the public’s views towards polio. Not only did Roosevelt start a rehabilitation foundation center in Warm Springs, Georgia, but he also founded the NFIP to fund research for a polio cure (Dorfman). Roosevelt’s efforts to spread awareness and actively battle the disease showed the public not only that he took polio and the safety of American citizens very seriously, but that polio could be treated and overcome. Roosevelt served to be a beacon of hope for the American public in this way. By the time the Salk vaccine emerged, Dwight D. Eisenhower was in charge of the country and debates within the government arose on how to best distribute the vaccine. The idea of ‘socialized medicine’ arose, the phrase appearing in an article by Government Executive featuring Harvard historian Jill Lepore, is best described as a refusal of the federal government to mandate and distribute medicine over the fear of the government becoming authoritarian with such powers (Abramson). In a statement released by Eisenhower himself at the end of May 1955, he announced that vaccine distribution powers would be given to individual states. In addition, his statement also explained the safety of the vaccine, encouraged children to receive all three doses of the vaccine, method of distribution of vaccines to the most susceptible first, legislation to allocate funds to the states to provide free vaccinations, and his personal hope for polio eradication (Eisenhower). As a result, by July 1955, just two months after Eisenhower’s statement, four million children received their vaccinations (Abramson). Both Eisenhower and Roosevelt set examples of compassionate presidents that took care in addressing the national crisis beginning with action from the government. Their encouragement united the American people more than it divided them.
The political context of covid, on the other hand, was (and still is) filled with division. Based on a survey from March 2021, according to an article published in The Lancet, spearheaded by Yale School of Medicine Professor Saad Omer, 49% of males affiliated with the Republican party said they would not vaccinate, while only 6% of males affiliated with the Democratic party would choose not to vaccinate. Other research studies, the article writes, have concluded that political polarization has damaged the potential of America’s response to the health crisis (Omer). What is contributing to this divide? An article by The Atlantic holds some of the answers: President Donald Trump’s dishonesty about the virus. Starting from the beginning of 2020 up to November 2020, the article tracks each false claim that Trump made about the coronavirus. These include instances and quotes such as on February 27, he claimed “It’s going to disappear. One day, it’s like a miracle–it will disappear.” He made other similar claims downplaying the severity and increasing daily covid cases, making general statements about covid cases dropping extremely low when they were, in fact, either surging or plateauing, and how 99% of covid cases were harmless, which was disproved by the director of the National Institute of Allergy and Infectious Diseases, Anthony Fauci. Trump also falsely cited a CDC study and claimed that 85% of mask-wearers would still catch the virus. The list goes on (Paz). Trump’s continuous neglect to treat covid as a national health crisis and hailing the virus to be less severe than it was in reality, led to many of his supporters echoing his attitude and refusing to vaccinate. Stacy Wood, in her journal article in the New England Journal of Medicine, explains how a main factor in choosing to wear facemasks was associated with political affiliation (Wood). Given the earlier-mentioned false claims that Trump made about masks, it supports Wood’s claim about political association because those who were less likely to vaccinate were more likely in support of not wearing masks, from the social contexts in the previous section (Hotez). Other political explanations for the division surrounding covid vaccinations is the mistrust that Americans have in their government. Senior scientist Frank Newport with data company Gallup writes that the low levels of trust in the government could have impacted the effects of covid, backed up by a CNBC poll and Census Bureau data that showed low levels of trust in the government was one of the top reasons to refuse a vaccine. “It is plausible to assume,” Newport writes, “that Americans' trust in government is at least partially related to their willingness to adhere to government vaccine recommendations.” The choice of many states run by democratic governors to lift their state mask mandate is an example of distrust of the federal government, which still recommends masks according to the CDC guidelines, Newport also claims (Newport). The federal government must have earned this low trust, through failing to meet demands or respond quickly to different emergencies and responsibilities. As a result, the public is less inclined to trust the government, and some people may even actively go against their recommendations. Regarding covid, this means that recommendations to social distance, wear masks, and get vaccinated will be met with resistance from citizens who don’t trust the government’s capacity to make the right decisions. The distrust, paired with flawed administration, creates a general negative attitude for its citizens and dissuades them from wanting to be vaccinated.
Vaccines and Vaccination Responses to Polio and Covid
The development of the first successful polio vaccine began in 1952 when Jonas Salk received funding to begin working on his vaccine, although research had begun since the 1930s. In 1954, Salk ran a double blind vaccine trial that utilized the help of over 1.8 million children, 50 thousand teachers, 60 thousand doctors and nurses, and 200 thousand volunteers (Larsen). The trial snowballed into a nationwide vaccination campaign. The NFIP was heavily involved in promoting the trial to parents, passing out flyers and consent forms that framed the trial efforts as a sense of obligation to the community (Ujifusa). Within two years of Salk’s vaccine being approved in 1955, polio rates dropped by 80% (Larsen). People were lined up to receive the vaccine.
Organizations had been promoting polio awareness and treatments for years before the Salk vaccine came to light. FDR founded the NFIP in 1938, which has now become one of the largest voluntary nonprofit organizations in history, with the goals of treating polio victims, raising awareness, and sponsoring research to discover a cure. Because of the organization’s infamous dime-sized donations, the NFIP became better known as the March for Dimes (Larsen). While the vaccination of children was greatly successful, vaccinations fell short among teenagers, who held promising cultural influences whose support could lead to great positive shifts in vaccinations. Ann Johnston Research Fellow Steven Mawdsley dove into teen health activism in his article published in The Journal of the Social History Society with the NFIP’s creation of its youth chapter in 1954, called Teens Against Polio (TAP). TAP reached out to schools, boys and girls clubs, YMCA, sporting teams, and more in an attempt to recruit teenagers to help fundraise and promote vaccinations for polio. Teens in TAP hosted car washes, block parties, bake sales, ticket parties, and went door to door to fundraise. They appeared on television programs to talk about the vaccine, helped create print materials and pamphlets to distribute, because the best way to target teenagers was to create material “by teens, for teens, with teen language”. TAP’s efforts were ultimately successful in reducing the vaccination gap (Mawdsley). Another campaign to increase vaccination among youth was using popular figures, such as Elvis Presley. Scientific American article states how Presley was vaccinated for polio on live television, and vaccination rates among the youth increased to 80% within six months. His campaign held three key components: he held significant social influence, changed social norms by vaccinating, and his vaccination came across as more personal and impactful to young American viewers (Hershfield). The polio vaccination effort was truly a community effort. The March for Dimes played an enormous role in this battle from the beginning, but it was also the willingness of parents, teachers, and teenagers to support the vaccine.
While the polio vaccine took over 20 years of research to develop, the advanced technology around the emergence of covid resulted in vaccine production and distribution within 12 to 18 months. According to Claire Klobucista’s article in the Council on Foreign Relations, In May 2020, Trump launched Operation Warp Speed to push for fast development of a vaccine through funding around $4 billion dollars total to Moderna, Pfizer, and BioNTech. After President Biden took office, the federal government has purchased over 1 billion more doses to distribute to Americans and donate to the rest of the world as well (Klobucista).
Despite the government’s fast action towards developing a vaccine, the public was still hesitant to vaccinate. Executive director Georges C. Benjamin of the American Public Health Association said in Klobucista’s article regarding vaccinations, that “‘We’ve not done a really good job of saying, ‘Here’s what happens if you get this vaccination and here’s what happens if you don’t,’. We’ve not married those two stories in a compelling way for a lot of people who are fundamentally hesitant’” (Klobucista). The cause of vaccine hesitancy, according to Benjamin, is that the government or other organizations have not convinced enough people of the importance of vaccinations. Polio had the March for Dimes, empowering the American people–covid has no such organization. Dr. Rahul Gupta with USAToday suggests that this pandemic needs a March for Dimes of its own: non-partisan, direct communication to the public[3] , and most of all–no political influence (Gupta). Other suggestions for how to promote vaccinations have included creating more on-site vaccination locations such as at work or school, increasing observability through making vaccinated people into ‘walking vaccination advertisements’ with stickers, buttons, or pins, or offering free incentives to get vaccinated such as food, work days off, tax benefits, etc (Omer, Wood). From personal experience, many schools and workplaces have implemented mandatory vaccinations, stores and supermarkets require masks for unvaccinated customers, and college campuses are plastered with posters and signs encouraging vaccinations and masks. According to the CDC, countless volunteers, smaller organizations, companies, schools, have successfully reached members in their communities to increase vaccinations through vaccine outreach strategy programs, Zoom panels, flyers, community conversations, on-site vaccination clinics, and social media. The CDC even provides a guide for how to promote vaccinations in different community spaces (CDC). While small-scale efforts have been successful, larger organizations such as the World Health Organization (WHO) face criticism on a global scale for their response to covid. An article by Lidia Kuznetsova, faculty of medicine at University of Barcelona, published in Frontiers of Medical Health explains that the most popular criticisms of the WHO include both the over and underestimation of the threat of covid, allowing political biases to conflict with interests and agenda, lacking preparedness and responding too slowly. To add to the conflicts, Trump pulled the United States out of the WHO and suspended America’s financing of the organization (Kuznetsova). America’s struggle with vaccine hesitancy has been more supported locally than it has nationally. Lacking a strong, nationwide, organized effort to promote vaccinations and battle the vaccine hesitancy, the country lags behind.
Analysis and Conclusion
Despite this paper’s differentiation between sociopolitical contexts and vaccination responses, the reality of a society’s actions towards vaccinations is the deep intertwining of all three components, and even more. Thus, overlaps between these three sections exist, for both covid and polio. In the context of polio, for example, FDR’s presidency set the tone for attitudes towards polio because he was a victim of the disease himself. FDR cared deeply about treating polio and aiding victims, leading to the American people taking more urgency to vaccinate their children. His founding of the NFIP/March for Dimes meant that the organization would be able to reach people on a national scale and have significant funding and resources to produce and promote vaccines to the public. The organization had also been around for over a decade before the vaccine was released, thus had been gaining traction and gathering support for many years. America’s leadership during the start of covid, in contrast, made it difficult for a vaccination campaign to lift off the ground. Trump’s initial downplaying of the severity of the virus aimed to put the public more at ease and prevent panic, but according to news published by the Harvard T.H. Chan School of Public Health, numerous experts have criticized Trump’s decision to downplay the facts and say that if he was straightforward, it would be the best way to minimize panic (Harvard). His reaction to the virus was reflected on a national level, and conspiracy theories and anti-covid protection movements arose because there was no perceived urgency to accompany the rising pandemic until later on. The disorganization from the federal government meant that preventative measures were left up to the states and local cities, while they pushed urgently towards developing a vaccine at an extremely accelerated rate. Although the vaccine was quickly developed, the government was left with an unwilling crowd.
The American covid era did not have the same luxury as the polio era of having an organization to raise over a decade of awareness before the emergence of the vaccine, thanks to developments in immunology today–perhaps both a blessing and a curse. A covid-geared organization similar to the NFIP would certainly have benefited the nation, but it may be more unrealistic to have a new national organization for each new pandemic/epidemic. However, a solution would be to have a nonpartisan, nonpolitical organization as Dr. Rahul Gupta suggested, geared more generally towards vaccine promotion for all different kinds of viruses and offering a variety of vaccination programs. Most of all however, the country needs a compassionate leader to take action and rally the public together against the enemy of the disease, not each other.
In 1955, a vaccine emerged in America for the severe disease, polio. In 2021, a vaccine was approved to treat the viral infection, covid-19. Many doctors and studies compare these two diseases when studying the vaccination responses from America at these two very different times in modern history due to similarities between the disease transmission and societal effects such as city closures and quarantines. America faced drastically different social and political contexts between 1955 and 2021, as well as differing in the ways that the country responded to these health crises. A successful polio campaign leaves many takeaways for how the covid vaccination campaign could have been handled and executed more effectively. It urges a careful analysis of these contexts, which this article provides. Results of the study showed that most prominently, different presiding presidents created this vaccination divide most strongly, through molding the country’s views and attitudes and dealing with polarization. Polio vaccination campaigns were also more expansive than covid. Still in the midst of the coronavirus, it is important for the country to look back on history and ask, what can we change to keep the virus under control? And most of all, how can we prevent this from happening again in the future?
Introduction
In early 2020, the rapid spread of the coronavirus left the entire world scrambling, the United States included. From the onset of the virus to November 2022, there have been over one million deaths from the virus and nearly 100 million confirmed cases total in America alone (CDC). The virus is transmitted through close contact with infected individuals through droplets, making the disease easy to spread and difficult to detect until the symptoms begin emerging.
The United States has faced large-scale viral infections before–in the past, one particular epidemic stands out bearing resemblance to the covid pandemic: polio. The virus hit America in two waves: 1916 and 1952. The worst outbreak in 1952 had over 57,000 cases, 21,000 of those resulting in paralysis and 3,000 deaths. Similarities polio bears to covid includes how it is easily transmitted through the respiratory system (Larsen). One stark difference between the two diseases, however, is that resistance against the polio vaccine was not as strong as the resistance against the covid vaccine. The covid pandemic in America has been notorious for the debate over vaccinations. From the emergence of the vaccine to November 2022, 80.4% of individuals have received at least one dose of the vaccine. 68.6% of individuals have received all doses of the vaccine (CDC). However, there was a lot of pushback against vaccinations. Surveys conducted in 2020 showed that between May and November 2020, the percentage of respondents who were willing to be vaccinated shifted from 72% to 51% to 60% (Wood). In contrast, 92.5% of children before the age of two have received the full polio vaccine dosage today (“Immunization”). Through comparisons between the recent covid pandemic to the historical polio epidemics in America, this article aims to show how sociopolitical contexts and vaccination responses affected polio and covid vaccination rates in America. Vaccine resistance and lower vaccination rates are dangerous because it leaves a community more exposed to diseases that could be fatal. Both polio and covid have shown to be severe and potentially fatal–but it is ultimately their outcomes that differ.
Social Contexts of Covid and Polio
The main social contexts that shaped the population’s attitude towards polio were the anti-vaccination sentiments and the at-risk population, which counter-balanced the anti-vaccination sentiments. This type of misinformation surrounding the vaccine was spread, most notably, from Walter Winchell, the modern day equivalent of a Fox News broadcaster and most popular columnist at the time. In an article published in the Chicago Sun Times, author Neil Steinberg quotes Winchell’s booming words to America on the morning of April 4, 1954. Winchell reported that there was “‘a new polio vaccine claimed to be a cure. It may be a killer.’ The vaccine hadn’t even been tested yet. Authorities, Winchell claimed, wrongly, were stockpiling “little white coffins” to handle the vaccine’s victims. That week, 150,000 children were yanked out of the vaccine trial” (Steinberg). The American peoples’ response to Winchell’s baseless claims demonstrate the power that misinformation and vaccine fears hold. Winchell’s claims were proven to be false by the National Foundation for Infantile Paralysis (NFIP), the organization founded by Franklin Delano Roosevelt that conducted vaccine trials. A 1954 issue of the Scientific American journal reported that the NFIP pointed out that of over 4,000 children who had received Jonas Salk’s live virus vaccine, none of them showed any effects (Scientific American). Despite claims about the dangers of the polio vaccine, parents rushed to vaccinate their children anyways, most likely due to the at-risk population target of polio. Children had the highest chance of contracting polio, and parents were so desperate to protect their children that many parents were very willing to get their children vaccinated, according to Emory University historian Elena Conis (Conis). As a result of this desperation, it was much less likely that parents would listen to the voices of anti-vaccine movement leaders such as Winchell. Regardless of the desperation, it was also important that parents would feel reassured about the vaccine, and the NFIP did just that–particularly during vaccine trials which recruited 1.8 million children to participate in (Larsen). In David Oshinksky’s book Polio: An American Story, he elaborated that the NFIP explained to parents how the vaccine had already been proved to be safe on over 5,000 volunteers, with none-to-minimal side effects (Oshinsky). Thus, from efforts to calm questioning parents to the parental desire to protect their children, the social environment guided the population towards vaccinations, muffling the anti-vaccination cries and vaccinations proceeded forward.
For the covid pandemic, Americans faced similar social contexts as polio: anti-vaccination movements and an at-risk population. However, instead of counterbalancing each other, both factors worked together to become a strong competitor towards vaccination rates. An article published in the Microbes and Infection journal articulates some of the outrageous claims that anti-vaccine movements have created, including ones such as Bill Gates created the virus, covid viruses contain microchips to track individuals, 5G networks in China weakened immune systems so that citizens would become infected. Other protests include lobbying against social distancing, contact tracing, and wearing masks (Hotez). In comparison to the polio social context, the amount of conspiracy theories that have emerged and spread from covid are greater than polio. One reason for this abundance is due to the internet and the availability of misinformation. Professors at the University of Iowa explain in an article published in the Wiley Public Health Emergency Collection how in the spring of 2020, covid-related Google searches spiked and tweets related to the virus hit over 500 million. However, around 50% of the American population encountered false information about covid, and many people unsurprisingly bought into it (Wang). Out of the abundance of misinformation, anti-vaccination sentiments and conspiracies were certainly shared among people, only fueling the movements against vaccines. Another factor that the population faces in terms of becoming vaccinated is the at-risk group for the covid virus. The majority of deaths from covid fall under people age 50 and older, according to data from the CDC. As a result, vaccination rates are among the lowest in young adults ages 24 and under (CDC). In one abcnews article, Johns Hopkins Center for Health Security scholar Dr. Monica Schoch-Spana states that the reason for the low rates among young adults is because of their “‘lingering perception that 'I am young, I am strong, I can fight this thing off…So there's that youthful sense of invincibility that was reinforced early on when we had less vaccine available’” (Deliso). The result of the low vaccination rates emerges among social pressures: if less teenagers and young adults feel the need to get vaccinated, they are less likely to encourage their peers to vaccinate as well, or even pressure their friends against getting vaccinated because of their sense of invincibility. These opinions, combined with misinformation and conspiracy theories created by anti-vaxxers, result in strong reasons to not get vaccinated for those who believe it.
Political Contexts of Polio
The other important area of context that should be understood when analyzing polio and covid are the political contexts. Political leaders of a country are often looked to during times of crisis, and it is their responses and actions that can unite its citizens, or divide them. For polio, the political contexts largely aimed to unite the people of America and encourage them. One of America’s presidents himself was diagnosed with polio in 1921: Franklin Delano Roosevelt. As a victim to the disease and thus able to empathize with other adults and children who contracted the disease, Roosevelt focused on the chase to find a treatment for polio when he became president in 1933. According to Robert Dorfman, a surgeon at Northwestern, and his article published in the Canadian Bulletin of Medical History, Roosevelt was the “first American president to make a disease "his disease." His advisors made much of his transformation from polio victim to polio patron and featured his name, voice, and body in fundraising” (Dorfman). This framing of polio that Roosevelt presented was a key attitude in shaping the public’s views towards polio. Not only did Roosevelt start a rehabilitation foundation center in Warm Springs, Georgia, but he also founded the NFIP to fund research for a polio cure (Dorfman). Roosevelt’s efforts to spread awareness and actively battle the disease showed the public not only that he took polio and the safety of American citizens very seriously, but that polio could be treated and overcome. Roosevelt served to be a beacon of hope for the American public in this way. By the time the Salk vaccine emerged, Dwight D. Eisenhower was in charge of the country and debates within the government arose on how to best distribute the vaccine. The idea of ‘socialized medicine’ arose, the phrase appearing in an article by Government Executive featuring Harvard historian Jill Lepore, is best described as a refusal of the federal government to mandate and distribute medicine over the fear of the government becoming authoritarian with such powers (Abramson). In a statement released by Eisenhower himself at the end of May 1955, he announced that vaccine distribution powers would be given to individual states. In addition, his statement also explained the safety of the vaccine, encouraged children to receive all three doses of the vaccine, method of distribution of vaccines to the most susceptible first, legislation to allocate funds to the states to provide free vaccinations, and his personal hope for polio eradication (Eisenhower). As a result, by July 1955, just two months after Eisenhower’s statement, four million children received their vaccinations (Abramson). Both Eisenhower and Roosevelt set examples of compassionate presidents that took care in addressing the national crisis beginning with action from the government. Their encouragement united the American people more than it divided them.
The political context of covid, on the other hand, was (and still is) filled with division. Based on a survey from March 2021, according to an article published in The Lancet, spearheaded by Yale School of Medicine Professor Saad Omer, 49% of males affiliated with the Republican party said they would not vaccinate, while only 6% of males affiliated with the Democratic party would choose not to vaccinate. Other research studies, the article writes, have concluded that political polarization has damaged the potential of America’s response to the health crisis (Omer). What is contributing to this divide? An article by The Atlantic holds some of the answers: President Donald Trump’s dishonesty about the virus. Starting from the beginning of 2020 up to November 2020, the article tracks each false claim that Trump made about the coronavirus. These include instances and quotes such as on February 27, he claimed “It’s going to disappear. One day, it’s like a miracle–it will disappear.” He made other similar claims downplaying the severity and increasing daily covid cases, making general statements about covid cases dropping extremely low when they were, in fact, either surging or plateauing, and how 99% of covid cases were harmless, which was disproved by the director of the National Institute of Allergy and Infectious Diseases, Anthony Fauci. Trump also falsely cited a CDC study and claimed that 85% of mask-wearers would still catch the virus. The list goes on (Paz). Trump’s continuous neglect to treat covid as a national health crisis and hailing the virus to be less severe than it was in reality, led to many of his supporters echoing his attitude and refusing to vaccinate. Stacy Wood, in her journal article in the New England Journal of Medicine, explains how a main factor in choosing to wear facemasks was associated with political affiliation (Wood). Given the earlier-mentioned false claims that Trump made about masks, it supports Wood’s claim about political association because those who were less likely to vaccinate were more likely in support of not wearing masks, from the social contexts in the previous section (Hotez). Other political explanations for the division surrounding covid vaccinations is the mistrust that Americans have in their government. Senior scientist Frank Newport with data company Gallup writes that the low levels of trust in the government could have impacted the effects of covid, backed up by a CNBC poll and Census Bureau data that showed low levels of trust in the government was one of the top reasons to refuse a vaccine. “It is plausible to assume,” Newport writes, “that Americans' trust in government is at least partially related to their willingness to adhere to government vaccine recommendations.” The choice of many states run by democratic governors to lift their state mask mandate is an example of distrust of the federal government, which still recommends masks according to the CDC guidelines, Newport also claims (Newport). The federal government must have earned this low trust, through failing to meet demands or respond quickly to different emergencies and responsibilities. As a result, the public is less inclined to trust the government, and some people may even actively go against their recommendations. Regarding covid, this means that recommendations to social distance, wear masks, and get vaccinated will be met with resistance from citizens who don’t trust the government’s capacity to make the right decisions. The distrust, paired with flawed administration, creates a general negative attitude for its citizens and dissuades them from wanting to be vaccinated.
Vaccines and Vaccination Responses to Polio and Covid
The development of the first successful polio vaccine began in 1952 when Jonas Salk received funding to begin working on his vaccine, although research had begun since the 1930s. In 1954, Salk ran a double blind vaccine trial that utilized the help of over 1.8 million children, 50 thousand teachers, 60 thousand doctors and nurses, and 200 thousand volunteers (Larsen). The trial snowballed into a nationwide vaccination campaign. The NFIP was heavily involved in promoting the trial to parents, passing out flyers and consent forms that framed the trial efforts as a sense of obligation to the community (Ujifusa). Within two years of Salk’s vaccine being approved in 1955, polio rates dropped by 80% (Larsen). People were lined up to receive the vaccine.
Organizations had been promoting polio awareness and treatments for years before the Salk vaccine came to light. FDR founded the NFIP in 1938, which has now become one of the largest voluntary nonprofit organizations in history, with the goals of treating polio victims, raising awareness, and sponsoring research to discover a cure. Because of the organization’s infamous dime-sized donations, the NFIP became better known as the March for Dimes (Larsen). While the vaccination of children was greatly successful, vaccinations fell short among teenagers, who held promising cultural influences whose support could lead to great positive shifts in vaccinations. Ann Johnston Research Fellow Steven Mawdsley dove into teen health activism in his article published in The Journal of the Social History Society with the NFIP’s creation of its youth chapter in 1954, called Teens Against Polio (TAP). TAP reached out to schools, boys and girls clubs, YMCA, sporting teams, and more in an attempt to recruit teenagers to help fundraise and promote vaccinations for polio. Teens in TAP hosted car washes, block parties, bake sales, ticket parties, and went door to door to fundraise. They appeared on television programs to talk about the vaccine, helped create print materials and pamphlets to distribute, because the best way to target teenagers was to create material “by teens, for teens, with teen language”. TAP’s efforts were ultimately successful in reducing the vaccination gap (Mawdsley). Another campaign to increase vaccination among youth was using popular figures, such as Elvis Presley. Scientific American article states how Presley was vaccinated for polio on live television, and vaccination rates among the youth increased to 80% within six months. His campaign held three key components: he held significant social influence, changed social norms by vaccinating, and his vaccination came across as more personal and impactful to young American viewers (Hershfield). The polio vaccination effort was truly a community effort. The March for Dimes played an enormous role in this battle from the beginning, but it was also the willingness of parents, teachers, and teenagers to support the vaccine.
While the polio vaccine took over 20 years of research to develop, the advanced technology around the emergence of covid resulted in vaccine production and distribution within 12 to 18 months. According to Claire Klobucista’s article in the Council on Foreign Relations, In May 2020, Trump launched Operation Warp Speed to push for fast development of a vaccine through funding around $4 billion dollars total to Moderna, Pfizer, and BioNTech. After President Biden took office, the federal government has purchased over 1 billion more doses to distribute to Americans and donate to the rest of the world as well (Klobucista).
Despite the government’s fast action towards developing a vaccine, the public was still hesitant to vaccinate. Executive director Georges C. Benjamin of the American Public Health Association said in Klobucista’s article regarding vaccinations, that “‘We’ve not done a really good job of saying, ‘Here’s what happens if you get this vaccination and here’s what happens if you don’t,’. We’ve not married those two stories in a compelling way for a lot of people who are fundamentally hesitant’” (Klobucista). The cause of vaccine hesitancy, according to Benjamin, is that the government or other organizations have not convinced enough people of the importance of vaccinations. Polio had the March for Dimes, empowering the American people–covid has no such organization. Dr. Rahul Gupta with USAToday suggests that this pandemic needs a March for Dimes of its own: non-partisan, direct communication to the public[3] , and most of all–no political influence (Gupta). Other suggestions for how to promote vaccinations have included creating more on-site vaccination locations such as at work or school, increasing observability through making vaccinated people into ‘walking vaccination advertisements’ with stickers, buttons, or pins, or offering free incentives to get vaccinated such as food, work days off, tax benefits, etc (Omer, Wood). From personal experience, many schools and workplaces have implemented mandatory vaccinations, stores and supermarkets require masks for unvaccinated customers, and college campuses are plastered with posters and signs encouraging vaccinations and masks. According to the CDC, countless volunteers, smaller organizations, companies, schools, have successfully reached members in their communities to increase vaccinations through vaccine outreach strategy programs, Zoom panels, flyers, community conversations, on-site vaccination clinics, and social media. The CDC even provides a guide for how to promote vaccinations in different community spaces (CDC). While small-scale efforts have been successful, larger organizations such as the World Health Organization (WHO) face criticism on a global scale for their response to covid. An article by Lidia Kuznetsova, faculty of medicine at University of Barcelona, published in Frontiers of Medical Health explains that the most popular criticisms of the WHO include both the over and underestimation of the threat of covid, allowing political biases to conflict with interests and agenda, lacking preparedness and responding too slowly. To add to the conflicts, Trump pulled the United States out of the WHO and suspended America’s financing of the organization (Kuznetsova). America’s struggle with vaccine hesitancy has been more supported locally than it has nationally. Lacking a strong, nationwide, organized effort to promote vaccinations and battle the vaccine hesitancy, the country lags behind.
Analysis and Conclusion
Despite this paper’s differentiation between sociopolitical contexts and vaccination responses, the reality of a society’s actions towards vaccinations is the deep intertwining of all three components, and even more. Thus, overlaps between these three sections exist, for both covid and polio. In the context of polio, for example, FDR’s presidency set the tone for attitudes towards polio because he was a victim of the disease himself. FDR cared deeply about treating polio and aiding victims, leading to the American people taking more urgency to vaccinate their children. His founding of the NFIP/March for Dimes meant that the organization would be able to reach people on a national scale and have significant funding and resources to produce and promote vaccines to the public. The organization had also been around for over a decade before the vaccine was released, thus had been gaining traction and gathering support for many years. America’s leadership during the start of covid, in contrast, made it difficult for a vaccination campaign to lift off the ground. Trump’s initial downplaying of the severity of the virus aimed to put the public more at ease and prevent panic, but according to news published by the Harvard T.H. Chan School of Public Health, numerous experts have criticized Trump’s decision to downplay the facts and say that if he was straightforward, it would be the best way to minimize panic (Harvard). His reaction to the virus was reflected on a national level, and conspiracy theories and anti-covid protection movements arose because there was no perceived urgency to accompany the rising pandemic until later on. The disorganization from the federal government meant that preventative measures were left up to the states and local cities, while they pushed urgently towards developing a vaccine at an extremely accelerated rate. Although the vaccine was quickly developed, the government was left with an unwilling crowd.
The American covid era did not have the same luxury as the polio era of having an organization to raise over a decade of awareness before the emergence of the vaccine, thanks to developments in immunology today–perhaps both a blessing and a curse. A covid-geared organization similar to the NFIP would certainly have benefited the nation, but it may be more unrealistic to have a new national organization for each new pandemic/epidemic. However, a solution would be to have a nonpartisan, nonpolitical organization as Dr. Rahul Gupta suggested, geared more generally towards vaccine promotion for all different kinds of viruses and offering a variety of vaccination programs. Most of all however, the country needs a compassionate leader to take action and rally the public together against the enemy of the disease, not each other.
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Moran, Padraig. "Polio Vaccine Set off Wave of Relief, and a Wave of Resistance. COVID-19 Era May Be Similar, Says Jill Lepore." CBC, 15 Dec. 2020, https://www.cbc.ca/radio/thecurrent/the-current-for-june-9-2020-1.5604421/polio-vaccine-set-off-wave-of-relief-and-a-wave-of-resistance-covid-19-era-may-be-similar-says-jill-lepore-1.5604925#:~:text=wave%20of%20resistance.-,COVID%2D19%20era%20may%20be%20similar%2C%20says%20Jill%20Lepore,the%20era%20of%20COVID%2D19.
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Paz, Christian. "All the President’s Lies About the Coronavirus." The Atlantic, 23 Feb. 2021, www.theatlantic.com/politics/archive/2020/11/trumps-lies-about-coronavirus/608647/.
Schupmann, Will D. "Human Experimentation in Public Schools: How Schools Served as Sites of Vaccine Trials in the 20th Century." American Journal of Public Health, vol. 108, no. 8, 2018, pp. 1015-1022. https://repository.upenn.edu/cgi/viewcontent.cgi?article=1084&context=phr
Scientific American. "Paranoid Gossip About Polio Vaccine." Scientific American, 13 Apr. 2020, www.scientificamerican.com/article/paranoid-gossip-about-polio-vaccine/.
Steinberg, Neil. "Americans Were Scared of Polio Vaccines Too." Chicago Sun-Times, 31 Aug. 2021, chicago.suntimes.com/columnists/2021/8/31/22626790/coronavirus-vaccine-anti-vaxxers-polio-winchell-steinberg.
Stephen E. Mawdsley (2016) ‘Salk Hops’: Teen Health Activism and the Fight against Polio, 1955 – 1960, Cultural and Social History, 13:2, 249-265, DOI: 10.1080/14780038.2016.1145393
Thompson, Kimberly M., and Radboud J.Duintjer Tebbens. “Retrospective Cost-Effectiveness Analyses for Polio Vaccination in the United States.” Risk Analysis: An International Journal, vol. 26, no. 6, Dec. 2006, pp. 1423–40. EBSCOhost, https://doi.org/10.1111/j.1539-6924.2006.00831.x.
Ujifusa, Andrew. "Schools Helped Defeat Polio and Diphtheria With Vaccine Efforts. Can They Do It With COVID?" Education Week, 19 Oct. 2021, www.edweek.org/leadership/schools-helped-defeat-polio-and-diphtheria-with-vaccine-efforts-can-they-do-it-with-covid/2021/10.
Wang, Xiangyu et al. “Understanding the spread of COVID-19 misinformation on social media: The effects of topics and a political leader's nudge.” Journal of the Association for Information Science and Technology vol. 73,5 (2022): 726-737. doi:10.1002/asi.24576
Wood, Stacy, and Kevin Schulman. "Beyond Politics — Promoting Covid-19 Vaccination in the United States." New England Journal of Medicine, vol. 384, no. 7, 2021, p. e23. https://www.nejm.org/doi/full/10.1056/nejmms2033790
Yeracaris, Constantine A. “The Acceptance of Polio Vaccine: An Hypothesis.” The American Catholic Sociological Review, vol. 22, no. 4, 1961, pp. 299–305. JSTOR, https://doi.org/10.2307/3708037. Accessed 21 Oct. 2022.