SciShow Tangents - Special Episode: "Our Big Shot" from Chalk and Blade Productions

Episode Date: January 3, 2025

Hello Tangents listeners! We are off this week to rest up and enjoy the holidays, so in place of a regular episode we have a super special treat from friends of the show that we're excited to share! We're dropping an episode of a new podcast series from Chalk and Blade Productions called "Our Big Shot."What if we could build a disease free world? Well, we almost have. We are at a point in history where we have a Big Shot to make that happen. Dr Seema Yasmin, expert in disease control, brings you the stories of disease eradication, and the pioneers who can tell us how to finish the journey. These conversations will make you smarter, entertain and surprise you, and give you hope for the future of humanity.SciShow Tangents is on YouTube! Go to www.youtube.com/scishowtangents to check out this episode with the added bonus of seeing our faces! Head to www.patreon.com/SciShowTangents to find out how you can help support SciShow Tangents, and see all the cool perks you’ll get in return, like bonus episodes and a monthly newsletter! A big thank you to Patreon subscriber Garth Riley for helping to make the show possible!And go to https://store.dftba.com/collections/scishow-tangents to buy some great Tangents merch!Follow us on Twitter @SciShowTangents, where we’ll tweet out topics for upcoming episodes and you can ask the science couch questions! While you're at it, check out the Tangents crew on Twitter: Ceri: @ceriley Sam: @im_sam_schultz Hank: @hankgreen

Hello, Tangents listeners! We are off this week to rest up and enjoy the holidays. So in place of a regular episode, we have a super special treat from friends of the show that we are excited to share. We're dropping an episode of a new podcast series from Chalk and Blade Productions called Our Big Shot. Our Big Shot dives into the history, science, and future of one of humanity's

most significant accomplishments, immunization. Talking about immunization and vaccines can be tough. Sometimes you have to navigate stories about tragedies. And often you are just trying to combat misinformation effectively. The team behind Our Big Shot squares up against these challenges with compassion and expert insight. And the show is ultimately a celebration of the millions upon millions of lives saved by vaccines.

The show is hosted by Dr. Seema Yasmin, a fellow science communicator, public health doctor, stand-up comedian, and, this is a real thing, a disease detective who worked at the U.S. Epidemic Intelligence Service. Dr. Yasmin brings her years of experience and her sharp storytelling skills to all the conversations on Our Big Shot, and takes listeners right to the people

on the front lines of vaccine research and advocacy. The episode you're about to hear tells the epic story of how polio and its vaccine fundamentally altered approaches to public health. We think Our Big Shot is going to be a slam dunk of a show with you all. It's got the storytelling, the humor, and the learning you love from us, and we're excited for you to hear it. If you like what you hear, be sure to search for and subscribe to Our Big Shot Wiping Out Disease on on Apple podcasts or your favorite podcast app.

Celebrity endorsements are kind of a cliché when it comes to health campaigns. But here's the thing. They work. These are the sounds of the reigning queen of afro beats, Nigerian pop sensation Tiwa Savage. Here she's performing at the 2023 coronation of the new British monarch, King Charles. And Charles is looking kinda impressed. But not only is Tiwa a superstar, she's also a health campaigner. In Nigeria, where she's from, she's been advocating for the polio vaccine

as part of the government's campaign to get rid of wild polio virus, something they managed to do in 2020. Wild polio virus now remains in only two countries, Pakistan and Afghanistan. Back in 2017, three years before Nigeria was declared free of wild polio virus, Tiwa was an ambassador for the International Rotary Club, a global organization that works with governments to help them get rid of polio in their countries.

Nigeria succeeded in wiping out wild polio virus in no small part because of Tiwa and other high-profile Nigerians. It was their outspokenness and their passionate advocacy which made a huge difference. Polio is a devastating disease. And in this episode, we're going to explore why, in the history of immunization,

polio would push medical science and public health strategy to new heights. We're gonna ask the question, how and why did polio kickstart a unique moment in civic and scientific partnership? and scientific partnership. The March of Dimes is a story well known in the history of immunization. The campaign was established in 1938 by President Franklin D. Roosevelt to combat polio specifically. That name, March of Dimes, was actually coined by an entertainer, Eddie Cantor, who led a nationwide fundraising effort encouraging people to send dimes to the White House.

By 1948, the campaign had raised a substantial sum, which in today's money would be worth hundreds of millions of pounds. And all of that cash, all of those dimes were gathered together and used to fund research into vaccines. As is nearly always the case with science, there was competition because there was more than one person working on a polio vaccine. In fact, there were two competing researchers, Jonas Salk and Albert Sabin. Jonas Salk developed a vaccine that contained the killed virus, and Albert Sabin proposed a vaccine containing live virus.

In 1955, it was Jonas Salk who won the vaccine race when his vaccine was approved. He found out it was going to be used widely in the US, and it would eventually lower the cases of polio dramatically within the space of just a few years. But Albert Sabin's vaccine research did not go to waste. His live virus vaccine would be approved years later in 1961. And that vaccine was actually an oral vaccine, which would also go on to have a huge global impact. There was, of course, this rivalry between these two guys, Jonas Salk and Albert Sabin, but it's really the combination of both of their vaccines that's

placed us here on the brink of worldwide polio eradication today. But here's an interesting fact, a story that's not so often told. The March of Dimes is often referred to as this heroic moment in Western medicine, specifically American medicine. It's talked about as this heroic moment based on cutthroat rivalry in the lab. But it's actually a story of collaboration. A scientific story about the necessity of building bridges and even working alongside your enemy. I grew up with polio. My father contracted polio when he was three years old and spent 12 years in the hospital.

You know, it's always been part of my life, visible disability. And it was my reality, my normal. Professor Dora Varga is a historian of medicine, technology and politics, and she specializes in understanding the dynamics of historical epidemics. For her, the story of polio is also a deeply personal story. So 1940s America, we have these scary summers where parents are petrified their kids might become infected with polio and paralyzed. Then these two men come along, Jonas Salk, Albert Sabin, both working on polio vaccines, different kinds of vaccines, and they're getting to the vaccines in different ways.

But one of them gets buy-in from the US government to trial the vaccine, and one of them does not. So where does that guy go to do the clinical trials? Well, Salk puts his vaccine to mass trial in the United States, the largest trial up to date then. Sabin, who at the stage of trials a few years later could not. And the reason for this was that a lot of people were already vaccinated by the Salk vaccine. And second, more importantly, the US

government did not want to commit huge resources for yet another trial because they already had a working vaccine. So there was really no incentive. So Albert Sabin had to look elsewhere and he did smaller trials in various parts of the world, partly in Mexico. Other people who were working on live virus vaccines did trials in Poland and the Belgian Congo and Ireland. And really it was a very global set of trials if one thinks about it. But there was still need for a large trial

that would prove that the vaccine was going to work and that it's safe. There were very big concerns with the safety because it was such a new approach. This happened very surprisingly in the middle of the Cold War in the Soviet Union and became even larger than the Salk trials in the U.S. involving over 70 million people. And by the time they completed the trial, a lot of the Soviet population had been immunized. So we're at the height of the Cold War, the height of these tensions between the US and the USSR. Jonas Salk comes along, develops a killed oral polio vaccine, gets to test it out in America.

It gets approved. They give it to like 1.6 million kids, I think in like the very early 1950s. In the meantime, Albert Sabin is developing a different kind of polio virus vaccine, can't do the testing in the US. So he goes to the country that essentially America's at war with. He goes to the Soviet Union to test out his vaccine.

There was this moment after Stalin's death where there was a slight opening and warming of Soviet-American relations, which enabled Soviet researchers to visit the United States. They mainly went to visit Salk's laboratories and to study the Salk vaccine. But while they were there, might as well also meet with Albert Servin. And that resulted in a very long-term relationship. And building on that existing relationship, he developed this trial in the Soviet Union. And this was a huge thing, obviously, the US and the Soviet Union working together in this sense.

And this was recognized by contemporaries. So at the end of these trials, when it turned out that the Sibin vaccine was successful, Basil O'Connor, who was the head of the Inconceivable Paralysis Association in the United States, he was one of the key people with Franklin Roosevelt with the March of Dimes campaign.

So he was like really one of the main figures of the American polio scene. He said, this shows that there is no cold war when it comes to disease, and when it comes to working together to free mankind from disease, there is no cold war. So polio in this way created this safe haven where the warring parties could in this way created this safe haven where the warring parties could come. And it was in a way a deflection of the actual war between them. So to kind of almost wage a war instead on something else together.

And that was this virus. It's a really fascinating story. was this virus. It's a really fascinating story and it really shows to me the power of the disease, that it was universally feared and it was an incredibly high priority everywhere. And when I started my graduate studies I was thinking about a topic and traveling home to my father and I just realized that is actually a disease that could be interesting. And I was thinking, you know, when was this when he contracted it, what was happening around him? And suddenly, all these complexities kind of bubbled up. And I thought, okay, this is something I really want to look into. I'm sorry your dad was affected.

I have an uncle who's in England now, but he was infected with polio as a child in India and is still disabled by it. Where was your dad when he became infected? He was in Hungary. That kind of came with the very strong connotation of communism. And this was the time, the 50s, where when he contracted polio, when this was the kind of a very harsh part

of the communist regime. So the politics of it were really in your face and inescapable. And that's when I really started thinking about this intertwining of politics, disease, and medical research and treatment and so on. Thinking about polio, if we were to play word association with someone off the street, they

might hear polio and think immediately of the March of Dimes. So tell us a little bit about the March of Dimes, why the story of the March of Dimes has remained so present, as an example of how science and public support can produce that much progress against an infectious disease. Yeah, the March of Dimes is really, it's a very heartwarming story. It was a huge campaign to fund polio research

and vaccine research in particular, but also research in terms of treatment by asking people, this was in the United States, by asking people to donate as little as a dime, so 10 cents, basically. And it involved such a huge amount of people who donated through various campaigns and balls and social events that it actually accumulated to an enormous amount of money that partly made it possible to develop vaccines and to develop treatment and fund treatment options for a lot of people. This is, I think, speaks to the incredible importance that polio occupied in people's lives. This was something that every parent was worried about every single summer. If there's going to be an epidemic,

if their child is going to contract it. Just from our conversation, most probably, most people know somebody still today who has had polio, had family member or family member of a friend or has met someone and it was really present in the lives of everyone. And there was no way to prevent it. No clear way, no clear understanding of how it spreads, and no clear way to

treat it, which is still the case. And this is what animated, I think, a lot of the attention, apart from the fact that it was very expertly done as a public relations campaign as well. So this is kind of a poster child of public health campaigns. And interestingly, of course, the poster child also comes from Polio. They used children who had contracted Polio and were wearing braces to help with the collection,

to help with the publicity. And these children were very visible to everyone. Universal fear. This is something we'll come back to. But Dora Varga's work understanding international collaboration around the polio eradication program is not a story with a neat ending. In fact, this story doesn't have an ending yet.

Wild polio virus is still with us, and it's as threatening as ever. Wild polio virus type 1 is still circulating in two countries, Afghanistan, which has had recent outbreaks in the Kandahar region, and in Pakistan, specifically in the Balochistan region. And, as with all infectious diseases, suppressing the virus or even eradicating it is an elaborate game of medical whack-a-mole. I want to introduce you to one whack-a-mole expert. We can call her the chief whack-a-mole, if you like, Dr. Hanan Balkhi.

So my name is Hanan Balkhi. I'm a pediatric infectious disease consultant or professor in my previous life. And I'm the regional director of the Eastern Mediterranean region since 2024, February 2024. But as the regional director and as a pediatrician, I think I'm very laser focused on the benefits of immunizations. Dr. Balkhi's expertise is in fighting infectious diseases and in the ways that pathogens become resistant to our efforts. Born in Saudi Arabia, she was elected as the regional director for the World Health Organization's

Eastern Mediterranean region in 2024, making her the first woman ever to take on that role. Those nations with wild polio virus still circulating, they fall under her remit, and she is in no doubt of the challenges ahead. So the most critical challenge that I see is the large number of internally displaced populations and migrants in the region. That is the most troubling issue that I have in this region,

is the conflicts that we have. And it takes away from any kind of investment, whether national investments or international investments, because when the infrastructure is destroyed, then an investment is gone down the drain, if you will, literally. Some of the challenges that the audience might be more familiar with, which is the anti-vaxxers or the myths around immunizations, these are kind of pockets. I see those as less significant challenges now that I'm working specifically in this region, our challenges are much bigger.

It is the displaced populations, the lack of access to certain areas. There are certain communities that continue, we continue to have large zero-dose children in this region. Specifically, if we talk, we can have a whole session on the polio vaccine. This region specifically has been struggling with the last two countries that has circulating wild polio virus. And those two countries are Pakistan and Afghanistan. The role of the WHO is critical in supporting the leadership in those two countries

that are very keen in eradicating the disease. However, some of the internal challenges need to be addressed internally, and we're working really hard to convene the proper diplomatic platforms. So it's really a major partnership among everybody. The member states had to make sure that they're giving the primary

immunizations. Those are the countries that are not in conflict and don't have any major displacements. Those who do, we have to work with them even closer to ensure that the support that they need and technical assistance that they need from epidemiologists, from field immunizers or vaccinators, which are usually coming from the communities that we're serving, are educated, trained, supported, that the immunizations are purchased, are stored appropriately, the cold chain is maintained. So there's a lot of technical issues that go into this process. The WHO has led major efforts in making sure that the messaging is also correct, that the scientific language around the polio immunization campaigns are accurate,

that the Q&As on the myths and misunderstanding and misinterpretation of the immunizations are consistent and are accurate, so that we're not losing the trust of the populations when we go out and immunize. So there's a lot of work that as a major, the major health organization in norms and standards in putting the guidelines and the guidance on how to pursue such campaigns,

but also the operational support that we have through our over 194 country offices, specifically those in need. Some of our country offices have over 300, 400 polio immunizers, an immunize health workforce that actually works hand in hand with the ministries of health on the ground to ensure that the processes, the identification of the children, the logging in of the children is taking place in a way that we can ensure that the process is done and that we reach our end goal of eradicating polio.

I think innovations are extremely critical in all aspects of us, you know, moving into the future. But there's one innovation that's a very logical one that I really hope for for this region is peace. If we can make sure that we have no conflicts, that the destruction stops, that we can rebuild infrastructure, make sure that people in the region and countries of conflict can live with dignity and in a hygienic environment and raise healthy children, that's the first, if I want to call it, an innovation that I would really hope for to happen. an innovation that I would really hope for to happen. The other innovations is how are we going to keep record of the immunization and the

immunized children among these displaced populations and in these conflict areas so that we do not miss out on people and we do not over-vaccinate other children. So there needs to be these medical records or immunization records. And there are innovations, if you remember during COVID, is to have electronic records for the COVID immunization. If that can be spread out so everybody can have it, that would be really helpful, especially for those who are moving from one country or displaced. The people in Gaza have moved 11 times. The people on different borders from Sudan to five different neighboring countries have been displaced, even displacement within the country. And how can we better understand the zero-dose children? Where do they exist?

Where are they? And what are the best methods for us to reach them? And again, we're not talking about reaching them once. All immunization programs, there's multiple inoculations that need to take place. Some have certain inoculations at zero at the time of birth, then two, four, six, nine, 12, 18, 24 months. So that's the program that most countries would have when it comes to immunizing children. And that's not going to be easy in the Eastern Mediterranean region for some of the most troubled countries that we have. Even as we stare at a possible finish line when it comes to wild polio virus, the challenges

in getting to that finish line are substantial. One of the problems is we've lost much of our fear and our muscle memory because many of us don't see the disease as much. In 2020, Nigeria became the last major nation to be certified polio-free, and that made the entire African continent free of wild polio virus. Despite all the challenges, Nigerian public health workers,s and, yes, T.W. Savage all lent to that epic push to get rid of the wild virus. Dr. Tunji Funcho is a distinguished Nigerian cardiologist and Rotary representative to the African region. Rotary International and its more than 45,000 affiliated Rotary clubs around the world are critical to the fight for polio eradication.

Dr. Funcho's muscle memory is still very much there. His understanding of what it takes to fight wild polio virus is hard won. And considering his nation's close proximity to the pain and suffering caused by the disease, his understanding of what's happening is incredibly insightful. I think the most significant challenge was lack of awareness. The second challenge of course was a kind of pushback for various reasons, some were ideological, some were religious, some were based on, you know, conspiracy theory, you know, beliefs. Others were based on just ignorance of what vaccines do. So their awareness was not there, the information about what this is all about

was not there, and of course the suspicion that somebody is bringing us something that is free, there must be something wrong here. You know, nothing is free in the world. So at some point in time, it was obvious to us that the people who are closest to the communities are the traditional leadership. And so we had, you know, through the efforts of the government from the traditional leaders council for primary health care and polio eradication.

And they were a major game changer really in changing the minds of the people and creating demand. It makes it much easier for us to go into communities and have much less number of people not complying with bringing out their children to have them immunized for polio. Polio immunization is a product. And like every product, you need to convince people that this product is worth their while. It's worth their while in bringing out their children to be immunized. You want to tell people that the products you're selling to them are safe and they will take information better from those they already know and trust.

So yes, community leaders play a very huge role in having acceptance for anything. In this case, particularly for polio, those kinds of celebrities who also are parents themselves who have had their children immunized can beat their chests to say, look, this thing is safe, my child has had it. We got a few traditional leaders to actually immunize their grandchildren in public.

We made a lot of noise about that so that it reaches every nook and cranny of the community. It creates some element of confidence for parents and guardians to bring out their kids and have them immunized. It wasn't easy at that time to reach every child and get every child immunized to the point where we had zero cases of polio for three years, which led eventually to Nigeria being certified polio-free. So there was elation, there was relief, there was the feeling that we have, despite all the odds, vanquished this wild polio virus from the Nigerian territory. Learning from Dr. Funcho and Nigeria's success story

actually leads us back to where we started with those two competing scientists, Albert Sabin and Jonas Salk. Their rivalry drove them scientifically, but in the end it was collaboration that was the key. To this day, it's a dual vaccine strategy of using Sabin's oral live virus vaccine, followed by Salk's dead virus vaccine that is our driver towards full eradication of polio someday.

Polio is a disease that has touched so many of us, including my own family and maybe yours. It's a disease that's blighted and shortened so many lives. One day it won't, and that seemingly impossible task will be achieved by a powerful combination of science and society. And of course that hinges on trust. Thank you so much for listening. Please review and share this podcast and get in touch with me. Let me know what you think by hitting me up on my Instagram. I'm at Dr. Sima Yasmin. This podcast is supported by UNICEF, Gavi, the World Health Organization and the Gates Foundation, and it's part of a campaign running in 2024 and 2025 called Humanly Possible.

The campaign raises awareness of global immunization campaigns and goals as we mark half a century of international public health vaccinations and as we look to the future. Check out the link in the show notes. In the next episode of Our Big Shot, we delve into a uniquely destructive medical fraud and its connection to one of the most successful combined vaccines, you guessed it, the MMR vaccine. And I'll be asking a critical and oh,so-pertinent question, why are lies so contagious? Our Big Shot is a Chalk and Blade production with archive in this episode from BBC and

Immunization Action Coalition.