How safe is America from polio?

In 1958, audiences saw the extraordinary talent of 13-year-old musical prodigy Itzhak Perlman when he performed on “The Ed Sullivan Show.” What they don’t see are the braces and crutches he needs to walk.

Perlman contracted polio when he was four years old. “I was already running and walking, and I remember one morning when I got up, I couldn’t stand,” he said. “I usually stand up in bed. Then I’ll go out and get dressed and stuff. And all of a sudden, it’s like, stop. Can’t do this anymore.“

Perlman, like hundreds of thousands of other children around the world, was infected with the poliovirus before the first vaccine against polio became available in 1955. He missed about six years of vaccinations. “Yes, I’m here to tell you that if you’re not vaccinated, this is what’s going to happen,” Perlman said. “My life changed forever. My parents were depressed. Well, they were so depressed.”

The polio virus can cause severe paralysis and some children require machines to breathe. During the height of the epidemic in the late 1940s and early 1950s, thousands of children were kept alive in iron lungs.

“There was no protection and there was no cure,” said historian David Osinski, a professor at NYU Grossman School of Medicine and author of the Pulitzer Prize-winning “Poliomyelitis: An American Story.” “You could be a hands-on parent or a hands-off parent. It didn’t matter. You couldn’t protect your child from polio.”

Poliovirus is spread through water, food, and close contact with infected people. There is currently no cure and no FDA-approved antiviral treatment.

Osinski recalled the impact this had on his childhood in the 1950s: “You had to stay away from people. You couldn’t go bowling. You couldn’t go to the movies. You couldn’t go swimming. The beaches would be closed. The swimming pools were closed. I remember my parents giving me weekly polio tests: Can I touch my chin to my chest? Can I touch my toes? The slightest stiffness brought panic.”

But what is this fear about? “The vaccine takes away that fear,” Osinski said.

The first polio vaccine was developed in 1954 by Dr. Jonas Salk. Before release, it was tested on nearly 2 million children, some of whom received the vaccine and others who received a placebo. “Imagine an example today, if they had an experimental vaccine, you’d have parents rushing 2 million kids to get in line,” Osinski said. “That would be unheard of today.”

The vaccine proved safe and effective, and cases of paralytic polio dropped dramatically. Parents rushed to vaccinate their children.

What did Osinski’s mother do? “Push me into the queue!” he laughed.

In 1961, Dr. Albert Sabin developed the oral polio vaccine (essentially a drop of vaccine injected with a piece of sugar) that was widely used in the United States and abroad.

However, the virus is still circulating in some parts of the world today.

“If this virus comes to the United States and a large portion of our population is unvaccinated, polio will come back. All it takes is a plane ride,” Osinski said.

If a polio patient comes into contact with enough people who are immune to it, the virus can hit a dead end. So-called “herd immunity” helps protect the unvaccinated and the estimated 20 million or more Americans who have weakened immune systems.

All 50 states require polio vaccination in school. But in recent years, an increasing number of parents have used exemptions to avoid vaccinating their children, raising concerns that polio may be making a comeback.

In a recent podcast interview, Dr. Kirk Milhoan, chairman of the CDC’s Advisory Committee on Immunization Practices, suggested it might be time for polio to become a vaccine. Elective:

“If you look at polio,” Milhoian said, “we don’t need to be afraid to consider that we’re in a different era now than we were before. Our sanitation is different. Our risk of getting sick is different. So those all play into the assessment of whether it’s worth the risk to get vaccinated.”

Milhoian declined a request from Sunday Morning to be interviewed for this article.

“It seems to me that this is a situation where a child’s life is at risk, and that changes the dynamic,” Osinski said.

When asked why some parents don’t think it’s necessary to get the polio vaccine, Osinski responded: “Most people think polio is gone. They really don’t realize it’s still spreading in parts of the world.”

Just four years ago, an international traveler brought poliovirus to an undervaccinated community in New York state. There is no herd immunity to protect him, Unvaccinated 20-year-old man paralyzed.

For Itzhak Perlman, the choice to be vaccinated against the disease that paralyzed him was clear: “For 70 years, we’ve been doing a very, very good job of almost eradicating polio. Why take a chance? Don’t take a chance. Trust me, it’s not worth it. It really isn’t worth it.”

Web Exclusive: In-Depth Interview with Itzhak Perlman (Video)
The renowned violinist talks with Dr. Jonathan Rapke about his experience after contracting polio as a child, the development of the polio vaccine several years ago, and the obstacles he has had to adapt to living with his disability. He offers advice for those questioning vaccination. He also talked about the impact music has on the brain and how he hopes to be remembered.

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Story by Mary Refaeli. Editor: Carol Ross.