3 ms·

I've read in a few reputable seeming places that polio was on the decline before the vaccine was introduced [1]. This chart [2] (if accurate) is pretty eye ope

I've read in a few reputable seeming places that polio was on the decline before the vaccine was introduced [1]. This chart [2] (if accurate) is pretty eye opening. I've also read that the diagnostic criteria for polio was changed roughly in conjunction with the release of the vaccine, which resulted in a significant decline in case counts. This article [3] discusses that and the headline claims to debunk it, but the content didn't do a very good job to me, it kind of did the opposite when I read it, so I'm still left curious. I've also read that the primary contributing factor to the decline (and recent rise) in polio is sanitary conditions. Most of these arguments come from biased anti-vaccine publications, so I'm skeptical but that doesn't necessarily invalidate the points. I've discussed this with older relatives who swear to me, pointedly, that the polio vaccine was a godsend, and that polio was a common horror prior to the vaccine. Note I am looking for expert feedback on these points, I would appreciate it if folks avoided just piling on me and calling me an anti-vaxxer (I'm not, I have to receive regular life saving vaccines due to a medical condition). I don't have any "sacred cows" though, and I'd love more information from experts out there that can explain/refute these points, because once I parse through all the propaganda and anecdotes I'm left very confused about the actual efficacy of the polio vaccine. Are there controlled studies that compare infection rates in populations that account for confounding variables like sanitation? [1] https://www.researchgate.net/publication/252553744_The_polio_vaccine_a_critical_assessment_of_its_arcane_history_efficacy_and_long-term_health-related_consequences https://www.researchgate.net/publication/252553744_The_polio... [2] https://www.researchgate.net/figure/The-polio-death-rate-was-decreasing-on-its-own-before-the-vaccine-was-introduced_fig2_252553744 https://www.researchgate.net/figure/The-polio-death-rate-was... [3] https://vaxopedia.org/2018/07/25/the-myth-that-polio-only-went-away-because-they-changed-the-way-it-was-diagnosed/ https://vaxopedia.org/2018/07/25/the-myth-that-polio-only-we...

aw1621107 4y ago
> This chart [2] (if accurate) is pretty eye opening. It might be important to note that that chart specifically tracks deaths, not incidence. At least according to the US CDC [0], paralytic polio (which I think most people think of when they see the word "polio") is generally the type that kills, usually due to paralysis of respiratory muscles and related symptoms. Given all that, it turns out that the first iron lung that saw widespread use was developed in... 1928! (And other versions had been developed before that) [1] And iron lungs are fantastic for preventing death due to paralysis of respiratory muscles, as the lung does the muscles' job. This could either be until the patient recovers or permanent. So in short, it's entirely possible the death rate fell because new tech allowed doctors to get better at keeping patients alive, rather than reducing the incidence, as the vaccines were generally intended to do. > I've also read that the primary contributing factor to the decline (and recent rise) in polio is sanitary conditions. At least according to the CDC, it's a mixed bag: > In the immediate prevaccine era, during the first half of the 20th century, improved sanitation resulted in less frequent exposure and increased the age of primary infection, resulting in large epidemics with high numbers of deaths. Can't really say much on the other claims or the paper, since that'd take way more expertise and/or time than I currently have. [0]: https://www.cdc.gov/vaccines/pubs/pinkbook/polio.html https://www.cdc.gov/vaccines/pubs/pinkbook/polio.html [1]: https://en.m.wikipedia.org/wiki/Iron_lung https://en.m.wikipedia.org/wiki/Iron_lung
- claytongulick 4y ago
  These are great points, thanks for helping me learn something!
  - gus_massa 4y ago
    Also, polio has waves. 95% of the persons that get the virus doesn't get paralysis, so in a big outbreak most people get infected but only a small part get paralysis. If there are no infections going on for a long time, there are many people that can be infected and if there are some initial cases you can get a wave. After the wave almost everyone got infected and will not be infected again so any outbreak dies. But after some years there are too many young people that can be infected and you get another big wave. Total cases in USA: https://ourworldindata.org/grapher/reported-paralytic-polio-cases-and-deaths-in-the-united-states-since-1910 https://ourworldindata.org/grapher/reported-paralytic-polio-... Note that the peak is near 60.000 per year Recent worldwide cases https://en.wikipedia.org/wiki/Polio#/media/File:Number_of_wild_polio_and_cVDPV_cases_since_2000.png https://en.wikipedia.org/wiki/Polio#/media/File:Number_of_wi... Note that the peak for the wild type is near 2000 and the vaccine derived type is near 1000.

aw1621107 4y ago

> This chart [2] (if accurate) is pretty eye opening. It might be important to note that that chart specifically tracks deaths, not incidence. At least according to the US CDC [0], paralytic polio (which I think most people think of when they see the word "polio") is generally the type that kills, usually due to paralysis of respiratory muscles and related symptoms. Given all that, it turns out that the first iron lung that saw widespread use was developed in... 1928! (And other versions had been developed before that) [1] And iron lungs are fantastic for preventing death due to paralysis of respiratory muscles, as the lung does the muscles' job. This could either be until the patient recovers or permanent. So in short, it's entirely possible the death rate fell because new tech allowed doctors to get better at keeping patients alive, rather than reducing the incidence, as the vaccines were generally intended to do. > I've also read that the primary contributing factor to the decline (and recent rise) in polio is sanitary conditions. At least according to the CDC, it's a mixed bag: > In the immediate prevaccine era, during the first half of the 20th century, improved sanitation resulted in less frequent exposure and increased the age of primary infection, resulting in large epidemics with high numbers of deaths. Can't really say much on the other claims or the paper, since that'd take way more expertise and/or time than I currently have. [0]: https://www.cdc.gov/vaccines/pubs/pinkbook/polio.html https://www.cdc.gov/vaccines/pubs/pinkbook/polio.html [1]: https://en.m.wikipedia.org/wiki/Iron_lung https://en.m.wikipedia.org/wiki/Iron_lung

claytongulick 4y ago
These are great points, thanks for helping me learn something!
- gus_massa 4y ago
  Also, polio has waves. 95% of the persons that get the virus doesn't get paralysis, so in a big outbreak most people get infected but only a small part get paralysis. If there are no infections going on for a long time, there are many people that can be infected and if there are some initial cases you can get a wave. After the wave almost everyone got infected and will not be infected again so any outbreak dies. But after some years there are too many young people that can be infected and you get another big wave. Total cases in USA: https://ourworldindata.org/grapher/reported-paralytic-polio-cases-and-deaths-in-the-united-states-since-1910 https://ourworldindata.org/grapher/reported-paralytic-polio-... Note that the peak is near 60.000 per year Recent worldwide cases https://en.wikipedia.org/wiki/Polio#/media/File:Number_of_wild_polio_and_cVDPV_cases_since_2000.png https://en.wikipedia.org/wiki/Polio#/media/File:Number_of_wi... Note that the peak for the wild type is near 2000 and the vaccine derived type is near 1000.