The Vaccine Race
Author: Meredith Wadman
All great breakthroughs are achieved on the back of the vision and commitment of dedicated researchers whose ambitions compel them towards scientific glory, and this book about vaccines is no exception. The author relates the epic story of how ‘the best and most ambitious scientists’ of the 1960’s cooperated and competed in equal measure to devise sustainable viral culture cell lines in which to produce an array of potent and life-saving vaccines (page 4). The book depicts how the quest to conquer the dangerous viruses that have plagued humanity was ennobled by extraordinary strengths, and discredited by all-human weaknesses-individual and institutional alike. It is as much a tale of how legendary rivalries and petty disputes threatened the development of safe and effective vaccines, as it is a story of deadly pathogens such as rabies virus, ‘the most lethal infectious disease to afflict humans’ (pages 216 and 223). It is, above all, an eloquent story of scientific triumph over natural adversaries.
The major protagonist at the centre of the book is undoubtedly the virologist Leonard Hayflick. Whilst working at the famous Wistar Institute of Anatomy and Biology, Hayflick had the critical insight that human foetal cells make the safest cell lines for developing antiviral vaccines, a monumental breakthrough in the science of vaccines (page 5). Emphasising the significance of his achievement, the author pointed out that Hayflick’s method has so far been used to produce 6 billion vaccines, and 300 million people have so far received vaccines developed in his iconic WI-38 cells (page 6). It is a sign of the importance of the cells that they have been widely applied to research in areas such as the study of cancer cells, and the assessment of drug toxicity (page 7). Beyond his accomplishments in vaccine development, Hayflick was also instrumental in debunking the misleading paradigm, established by the Nobel prize winner Alexis Carrel, that cells in culture were immortal (pages 74-88). The author depicted how Hayflick proved that cells in culture die after a finite number of divisions; this concept, now known as the Hayflick limit, has had a profound impact not just on vaccine development, but in diverse fields such as ageing, cancer, and the genetics of telomeres.
It is a reflection of the singular contribution of Leonard Hayflick to vaccine development that the book explored all aspects of his life beyond his scientific attainments. This biographical narrative provides an insight into how his childhood and upbringing fashioned his personality, and how his prior scientific experiences made him well-placed to alter the course of science. The author attributed his success to his exemplary and meticulous work and research ethics, often going to extraordinary lengths to prove his hypotheses. The book however also portrayed Hayflick as man with deep human flaws which unfortunately marred the latter part of his career; he fell out with his institute and got embroiled in a bitter dispute with his boss, the ‘imperious, domineering, irrepressible, and manipulative’ Hilary Koprowski (page 41). He also became mired in a bitter legal and financial battle with the National Institutes of Health over ownership of his WI-38 cells, a squabble that raged for years through the legal system and permanently tainted his legacy (page 365).
Perhaps the most crucial of all the vaccine races was the fiercely competitive endeavour to develop a rubella vaccine. In this race, the single-minded Stanley Plotkin succeeded against all odds to develop what turned out to be the most effective rubella vaccine. The outcome was particularly gratifying because Plotkin was the clear underdog in a competition in which his rivals were much better resourced; he also had to contend with Roderick Murray, a director at the National Institutes of Health, who the author described as an ‘inveterate obstacle‘ to Plotkin’s attempts to have his vaccine approved (pages 272-279). It was significant that Plotkin’s vaccine, developed in Hayflick’s human diploid cells, was much safer than the vaccines his rivals produced using the African green monkey kidney cells which harboured latent viruses such as Marburg (pages 199-214 and 229-267). Other remarkable vaccine stories included the race, between Albert Sabin and Hilary Koprowski, to develop the first live polio vaccine, and the challenges scientists faced in developing a rabies vaccine that would be more effective than the weak and hazardous version developed by Louis Pasteur in 1885 (pages 43, 397-402 and 218-219).
Throughout the book, the author recounted fascinating accounts of major historical landmarks in the discovery of viruses and their vaccines. The author, for example, noted that viruses first came to the attention of scientist in the 1890’s when pioneer Dmitri Ivanovsky suspected that tobacco mosaic disease was caused by a microbe much smaller than bacteria (pages 24-28). Another worthy insight was made by Francis Peyton Rous who, whilst studying chicken sarcoma, realised the role of viruses in causing cancer (page 57). The development of many other vaccines featured prominently in the book, from the killed polio vaccine of Jonas Salk, to the chickenpox, hepatitis A, and MMR vaccines (pages 44, 29-31, and 402-403). Other vaccine milestones the book highlights included the introduction of game-changing cell culture innovations such as the roller-tube system by Nobel Prize winners John Enders, Thomas Weller, and Frederick Robbins (pages 28-31).
Whilst the book concentrated mainly on the remarkable breakthroughs in vaccine development, the author also explored several unedifying practices that marred the vaccine race. Perhaps the most regrettable was the deplorable standard of research ethics which tainted most of the vaccine trials. The author illustrated this with several unscrupulous practices that were considered the norm at the time; a particularly egregious example was the ‘deliberate‘ injection of untested and potentially fatal viruses into ‘marginalised groups‘ such as prisoners, the intellectually disabled, and African Americans. Another ethical trap at the time was the practice of researchers benefiting financially from the proceeds of their discoveries and inventions; the author noted that this was considered deplorable until the 1980’s when there was ‘a shift to the acceptance within academia of biologists as businessmen‘ (pages 89-97, 287-294, and 415). Other practices that besmirched the race included the underhand tactics and open bias that authorities used to approve vaccines.
This excellent book is a fine mix of scientific advancements, political tactics, and interpersonal conflicts. The book brings to light the effort and commitment that drive important breakthroughs, thereby engendering a deep respect for the scientific process. In chronicling the progress of vaccine development, the author accurately captured the ingredients that propel scientific progress-basic research, ambition, and the desire to make a difference to people’s lives. Whilst the contents made for a long read, this was perhaps because the vaccine race consisted of many momentous and noteworthy landmarks. The author’s attempts to justify the poor ethical standards of the vaccine trials, as a carry over of second world war practices, was probably misjudged; that apart, the sentiments the author expressed were otherwise appropriate.
This insight into the history and process of vaccine development is enlightening. It puts in perspective the devastating nature of viral infections, and the remarkable progress that has been made to eradicate or limit their effects. It is no doubt to the efforts of these earlier scientists that vaccine production is at the high standard it is today. The book is extremely well-researched and the subject is fundamental to medicine. In detailing the history of the scientific breakthroughs, and the lives of the major actors, the book teaches invaluable lessons for healthcare, and I recommend it to all doctors.
Publisher, Place, Year: Transworld Publishers,London, 2017
Number of chapters: 27
Number of pages: 588
Star rating: 5