Sabin, Albert Bruce

(b. 26 August 1906 in Biatystok, Russia [now Poland]; d. 3 March 1993 in Washington, D.C.), virologist who developed the live-virus oral vaccine that helped make possible the global eradication of polio.

Sabin was one of four children of Jacob Sabin, a silk weaver, and Tillie Krugman. In 1921, leaving behind an impoverished life in tsarist Russia, the family immigrated to the United States and settled in the Jewish section of Paterson, New Jersey, and Sabin’s father went to work in the textiles industry. After receiving a crash course in English from two of his cousins, Sabin attended Paterson High School, graduating in 1923.

Sabin entered New York University to study dentistry under the auspices of an uncle who had offered to finance his education if he entered that profession. But guided by William H. Park, his professor of bacteriology, Sabin switched his academic focus to medicine two years later. He subsequently supported himself through scholarships and by working as a laboratory technician. He was also influenced in his choice of careers by Sinclair Lewis’s novel Arrowsmith (1925), about an idealistic doctor, and Paul De Kruifs Microbe Hunters (1926), a classic of scientific biography. In 1974 Sabin told National Public Radio that, in reading these texts, his “imagination was fired by what had been done and by the possibilities of things yet to be done.”

After receiving a B.S. in 1928, Sabin entered the New York University medical school. Distinguishing himself as a researcher, he developed a rapid typing system for the identification of pneumococci, the viruses that cause pneumonia, and published papers in major medical journals. He became a U.S. citizen in 1930. Upon obtaining his M.D. degree in 1931, Sabin undertook his residency in pathology, surgery, and internal medicine at Bellevue Hospital in New York City. That year, a major epidemic of poliomyelitis, familiarly known as polio, a highly infectious disease that can impact the spinal cord and lead to paralysis or death, hit the city. Park, who had become director of the New York City Department of Health Bureau of Laboratories, recruited his former protégé to take part in the ongoing research into this disease, also called infantile paralysis, which had been growing as a threat since 1916, the year of the first large epidemic in the United States. Sabin wrote the first of his many papers on polio in 1931. During Sabin’s internship a fellow researcher at Bellevue, William Brebner, died after being bitten by a laboratory monkey. Sabin isolated and identified Cercopithecine herpesvirus 1, commonly known as B virus, a fatal infection transmitted by rhesus monkeys. This contribution was one of several Sabin made to the understanding of nonpolio pathogens during his polio research.

Sabin was awarded a National Research Council Fellowship in 1934 and spent the following year on the staff at the Lister Institute of Preventive Medicine in London. Returning to New York City, he joined the staff of the prestigious Rockefeller Institute for Medical Research, now Rockefeller University. In his application to the institute Sabin stated that his interest was in “filterable viruses with special reference to the study of the mechanism of immunity.” He spent the next four years at Rockefeller, which by the mid-1930s was the center for virus research in the United States, a status largely attributed to Thomas M. Rivers, who became a strong supporter of Sabin’s research career. In 1935 Sabin married Sylvia Tregillus, with whom he had two daughters.

Sabin’s focus at Rockefeller soon narrowed to polio, a disease whose visibility in the United States increased dramatically with President Franklin D. Roosevelt’s ascendancy to the presidency in 1933. Roosevelt, whose infection with the virus in 1920 had left him partially paralyzed, spearheaded a massive fund-raising campaign—which became known as the March of Dimes—through the National Foundation for Infantile Paralysis, founded in 1937 to help victims of polio and to support scientists and institutions in finding a cure. Sabin was among the researchers the foundation supported.

Although it is an ancient disease, polio epidemics were unknown in the western hemisphere until the early twentieth century, when, ironically, improvements in public hygiene prevented infants from developing a natural immunity to the disease. By the 1930s the mode of transmission of poliovirus was largely a mystery. This, combined with the quick onset of symptoms, the disease’s preference for children, and the fact that polio struck entire communities, turning the summer months into “polio season,” caused widespread fear bordering on national paranoia. Although most people who contracted polio made a full recovery, the disease killed a number of people and paralyzed even more. Iron lungs, wheelchairs, steel braces, and aluminum crutches became visible reminders of its ravages.

At Rockefeller in 1936 Sabin, working with Peter Olitsky, became the first to cultivate poliovirus in vitro. Laboratory production of the virus in large quantities was considered the first step in developing a vaccine, which would introduce into the body a modified form of the virus to provoke an antibody response. But Sabin and Olitsky’s finding presented new problems. Using human embryonic tissue, they found that poliovirus thrived in nerve cells but not in kidney, liver, skin, or any other types of cells. This reinforced what other research, based on pathology reports, had suggested, that polio attacked nerve cells exclusively. Since viruses grown in nerve-cell culture could cause a fatal reaction if injected into humans, the finding appeared to confirm that development of a vaccine against polio was unfeasible and in fact delayed such development for decades.

In 1939 Sabin joined the staff of the Children’s Hospital Research Foundation at the University of Cincinnati, where he also worked as an associate professor of pediatrics at the College of Medicine. His continuing research into poliovirus was interrupted during World War II. Commissioned a major in the U.S. Army Medical Corps, Sabin saw active duty in the Pacific theater from 1943 to 1945, combating the threat to American soldiers from endemic illnesses overseas. In his research into arboviruses, or insect-borne pathogens, he isolated the virus causing sandfly fever, a nonfatal epidemic disease affecting troops in Africa, and he developed a vaccine for dengue, a debilitating illness prevalent in the South Pacific. A vaccine Sabin developed against Japanese encephalitis was administered to about 70,000 U.S. troops prior to the invasion of Japan. He was discharged from the army in 1946 with the rank of lieutenant colonel.

Sabin then returned to Cincinnati and what he called his “thirty-year war against polio.” The postwar period from 1945 to 1955, the start of the American baby boom, marked an increase in polio outbreaks that culminated in the worst epidemic, in 1952, when 58,000 cases were reported. In addition the postwar period was the most fruitful for polio research. In the 1940s researchers at Johns Hopkins University discovered that polio was caused by more than one type of virus. In 1949 John Enders and his research team discovered that poliovirus could indeed be grown in nonnervous system tissue in the laboratory (Enders later won a Nobel Prize for this). In fact poliovirus could grow in cell and tissue cultures of almost any kind of human cell. In their 1936 research Sabin and Olitsky, it turned out, had used a strain of the virus that was resistant to growth in any but nervous system cells.

After the Enders discovery, the scientific community immediately rallied to the development of a polio vaccine. Scientific thinking soon cohered around two different approaches: a live attenuated vaccine, advocated by Sabin and others, and a killed-virus vaccine that a researcher eight years Sabin’s junior, Jonas Salk, was working on at the University of Pittsburgh. This divergence led to one of the most famous rivalries, both personal and professional, in twentieth-century medicine and eventually enabled the first global disease-eradication initiative in history.

In 1946 Sabin was promoted to full professor of research pediatrics at the University of Cincinnati and chief of infectious diseases at the Children’s Hospital Research Foundation. Through his research in the late 1940s, Sabin showed that poliovirus was present in the intestinal tracts as well as the central nervous systems of victims, indicating that the pathogen did not enter humans through the respiratory tract, as previously thought, but through the mouth. This finding informed his conviction that an oral live-virus vaccine was the most efficacious way to combat the disease. While at Cincinnati, Sabin worked twelve-hour days and expected the same from his staff. Though he was considered a demanding taskmaster, he also had a lighter side. Sabin, an avid pipe smoker, enjoyed inviting reporters into his laboratory to show off a research monkey he had trained to smoke a cigar.

Upon Salk’s announcement in 1953 that he had developed a killed-virus polio vaccine, Sabin, who had a reputation in the scientific community as a fierce and articulate debater, became an outspoken opponent against its production. Speaking before the American Medical Association, the National Foundation for Infantile Paralysis Committee on Immunization, and ultimately the U.S. Congress in October 1953, Sabin criticized the Salk vaccine as unsafe and maintained that a field trial of the vaccine scheduled for 1954, in which thousands of children would be inoculated, was dangerously premature. He maintained that the killed-virus vaccine was ineffective in conferring long-term immunity, requiring frequent reinoculation and leaving open the possibility that people would reach adulthood without permanent immunity. He also petitioned Salk in private on various occasions not to go forward with the trials, which he considered scientifically irresponsible and doomed to failure. But the fear of polio had reached a pinnacle in the 1950s, and expedience won out over caution. Sabin’s concerns proved valid, however. In April 1955, after the Salk vaccine was declared safe, 204 people contracted polio following inoculation, and eleven eventually died. The vaccination program was temporarily halted, but it started up again after the problem was assessed as an aberration. By 1960 the Salk vaccine had in fact virtually ended the epidemic scare in the United States, and Salk was hailed as the hero who had conquered polio.

Sabin nevertheless persevered in his efforts to develop a live-virus vaccine, and based on his arguments against the Salk vaccine, the National Foundation for Infantile Paralysis continued to support him with research grants. By 1954 his oral vaccine, an attenuated live strain of all three types of poliovirus, was ready for field tests, and between 1954 and 1957 it was administered to volunteers at the federal penitentiary in Chillicothe, Ohio. A major trial of the Sabin vaccine, involving 6 million children and adults, took place in the Soviet Union in 1959.

Field trials of the Sabin vaccine were first conducted in the United States in April 1960, and in August 1961 the vaccine was approved by the U.S. Public Health Service. Throughout the 1960s millions of children received the vaccine in mass weekend inoculation drives that became known as “Sabin Sundays.” Local physicians administered the free vaccine orally in a cherry-flavored liquid. By the mid-1960s, after the American Medical Association recommended its use over the Salk vaccine, the Sabin vaccine became the polio vaccine of choice throughout the world.

Sabin’s vaccine had several advantages over Salk’s. It was less expensive to produce, easier to administer because it was not injectable, did not require booster shots, and conferred “intestinal immunity,” which can spread throughout populations and protect even those who are not vaccinated. It was this “herd immunity” concept that made the Sabin vaccine a valuable tool in regions of the world without an organized public health program.

Sabin retired from the University of Cincinnati in 1970. In that year President Richard Nixon awarded him the National Medal of Science “for numerous fundamental contributions to the understanding of viruses and viral diseases, culminating in the development of the vaccine which has eliminated poliomyelitis as a major threat to human health.” Sabin’s first wife died in 1966, and in 1970 he married Jane B. Warner. They divorced in 1971, and in 1972 Sabin married Heloisa Dunshee de Branchis. His second and third marriages produced no children.

Much of Sabin’s postpolio research concerned the relationship between viruses and cancer. He served as president of the Weizmann Institute of Science in Rehovoth, Israel, from 1970 until 1972, but he was forced to leave that post to undergo heart bypass surgery. He was a consultant to the National Cancer Institute of the U.S. Public Health Service in 1974, distinguished professor of biomedicine at the College of Medicine of the University of South Carolina from 1974 to 1982, and consultant to the National Institutes of Health Fogarty Center for Advanced Studies in Washington, D.C., from 1984 to 1986. Sabin’s hair turned white in middle age, and in his later years he grew a beard, reinforcing the shrewd academic demeanor he projected throughout his career.

In the early 1980s Sabin developed a nasal aerosol vaccine against measles, which like his polio vaccine was easier to administer than the previously available injectable vaccine. In 1983, while working on the vaccine, Sabin contracted a rare paralyzing illness, Guillain-Barré syndrome, giving him a new perspective on perhaps the most brutal aspect of the disease he had spent the better part of his life trying to wipe out. Although he recovered, other health problems led to his complete retirement in 1988. Sabin died in 1993 of congestive heart failure at Georgetown University Medical Center in Washington, D.C. He was eighty-six years old. President Bill Clinton hailed him as “one of the great heroes of American medicine.” Salk, who died two years later, issued a statement calling Sabin’s death “a great loss” and acknowledging that “the effect of his contributions toward the control of polio will endure long in the future.” Sabin is buried at Arlington National Cemetery.

Scientific advance, like all human achievement, is cumulative, and Sabin’s role in conquering polio impacted later medical research. In 1993 Sabin’s colleague, Bernard N. Fields, then chairman of the Department of Microbiology and Molecular Genetics at Harvard Medical School, told NPR that Sabin had a profound effect on how viruses are taught and studied:

In the era where we’re still trying to understand how HIV causes AIDS, the questions that Albert Sabin asked remain as fresh as they were thirty, forty, and fifty years ago. . . . Many of us still assign some of his papers from the 1940s for reading among our students, so that they can understand how a fresh and brilliant mind came to understand how a virus like polio actually gets into the body.

Widespread use of the Sabin polio vaccine throughout the 1970s and 1980s revealed a risk that Sabin persisted in denying. His vaccine in rare cases, about 1 in every 2.4 million doses of vaccine, caused polio. Critics attributed Sabin’s stance to stubbornness and egoism. Salk denounced the Sabin vaccine in a 1973 editorial in the New York Times, urging return to the injectable vaccine. Sabin, into his eighties, continued to denigrate the Salk vaccine as “pure kitchen chemistry.” Some scientists believed that the ill will between the two prevented either from winning the Nobel Prize. In the 1980s the Centers for Disease Control began advocating the use of both vaccines for maximum protection against polio.

In 1988 the World Health Organization (WHO), in the first program of its kind, launched an initiative to eradicate polio from the globe by the end of the year 2000. Although the western hemisphere was declared polio free in 1994, the disease remained endemic in sub-Saharan Africa and central Asia at the beginning of the twenty-first century. But officials at WHO continued to believe in global eradication of polio by 2005 and vaccination against polio becoming obsolete by 2010. Sabin’s vaccine was replaced with a stronger version of the injectable Salk vaccine in 2000, and medical historians concluded that both vaccines played essential roles in the triumph over polio.

Sabin’s papers are in the Albert B. Sabin Archives at the Cincinnati Medical Heritage Center. A separate collection of biographical material, clippings, correspondence, and photographs is at the Rockefeller University Archives in New York City. Information about Sabin is in books documenting the history of polio and its eradication, including Greer Williams, Virus Hunters (1960); John R. Paul, A History of Poliomyelitis (1971); Aaron E. Klein, Trial by Fury: The Polio Vaccine Controversy (1972); Jane S. Smith, Patenting the Sun: Polio and the Salk (Vaccine (1990); and Nina Gilden Seavey, Jane S. Smith, and Paul Wagner, A Paralyzing Fear: The Triumph over Polio in America (1998). Obituarics are in the New York Times and Washington Post (both 4 Mar. 1993).

Melissa A. Dobson