How many scientists can you name? Pasteur, Einstein, and maybe Salk (polio vaccine). Paul Offit asks at the beginning of his riveting, and pleasantly concise book, Vaccinated, which was published in 2007.
Why do we not know the name, Maurice Hilleman? If you do, well done! I had never heard of him, but he turns out to be the inventor of many vaccines. I usually skipped over the history books on pandemics and infectious diseases in the before-times, but people in the field must know of Hilleman. Like the pediatricians who recommend the vaccines-- they know about him, right?
In the days after Hilleman died in the spring of 2005, there was an event at the University of Pittsburgh to celebrate Jonas Salk Polio vaccine's fiftieth anniversary. One of the participants mentioned to a group of pediatric infectious disease specialists that Hilleman died, and Offit writes--
"No single group of doctors were better positioned to appreciate the impact of Hilleman's work, but after hearing the news, all looked up with blank expressions, unmoved. Not one of them had ever heard his name."
Hilleman developed most of the vaccines my child's pediatrician administers. The vaccine for measles, Mumps, rubella, chickenpox, hep A, hep B, pneumococcus, meningococcus, and Hib is all Hilleman.
Offit writes, "these nine vaccines virtually eliminated all of this suffering and disability and death. And Hilleman made every one of them."
Why is he not the first scientist we learn about in school?
Well, he was humble. He did not name the vaccines he created after himself as many other inventors had done. The vaccines were named after those who helped build the foundation for the invention. He knew he stood on the shoulders of his predecessors. But still--others would have used their name. The only name connected to his family was the vaccine for Mumps, named after his daughter Jeryl Lynn. When Jeryl Lynn was a child, she developed mumps, and he used a sample from her throat to begin work on the vaccine creation process.
Tony Fauci once said about him, "He was interested in the result and the product, and not in taking credit for it. When he had a vaccine or a discovery, his attitude was more, 'isn't this an interesting discovery,' rather than, 'I, Maurice Hilleman did this. It's almost like it never crossed his mind. He did not care about that. He just did the work, and he let his accomplishments do the talking. So people know an incredible amount about what he did, but they don't know that it was he who did it. And when the obituaries and the eulogies came out, that's when people said, 'Oh, my God, this one guy did all of this?'"
It was not just his lack of hubris that created such a low profile, but also that he never went to medical school, instead-- getting a doctorate in microbiology. He turned down a career in academia to work for Merk. According to Offit, since he was not an MD, explaining the vaccines to the public, few knew his name.
Offit is a talented writer, a doctor, a professor, and oh by the way- he co-developed the vaccine for rotavirus. What did you do today?
As we continue to battle the Covid pandemic, we are looking to vaccines to help us return to a life that we once knew. I find reading about this subject to fill such a visceral need. I have a thirst for learning more, while also at the same time, afraid to know more because it makes me less optimistic that we can eradicate a coronavirus.
Please feed me more knowledge, but let me digest it slowly, or I will fold into a ball in the corner and not get up. Clearly, I am not built for this field.
Offit offers many examples of Maurice Hillelman's amazing fortitude to combat infectious disease and his skill in developing vaccines. The story of the 1957 flu outbreak is fascinating, considering our current pandemic. It is an excellent example of how history may not repeat itself, but it rhymes.
During the late 1940s, two institutions monitored the flu that spread through the world: Walter Reed institute and the newly founded World Health Organization (WHO). "I was in charge of the central lab for the military worldwide surveillance for early detection of pandemic viruses. And in 1957 we all initially missed it. The military missed and the WHO missed it," Hilleman recalled.
While reading the paper where every story is fit to print, Hilleman noticed a Hong Kong outbreak of influenza. It had infected 250,000 people, 10% of Hong Kong's population at the time. "My god, this is the pandemic, it's here," Hilleman shouted.
He asked a medical officer to find a sick serviceman, and took a sample from his throat, and sent it back to Maurice. I am truly astonished about what he did next, mostly because of the wonder of science.
"Hilleman took an incubating hen's egg, cut a small window in the shell, and injected the egg with throat washings from the navy serviceman. Influenza virus grew readily in the membrane surround the chick embryo. He harvested the virus-containing fluid, purified it, and added sera from the members of the American military, hundreds in all. No one had antibodies to the new virus."
On May 22nd, 1957, he sent a press release stating that the next horrible pandemic had arrived. And you will never guess what happened next?
'I had a very difficult time getting anybody to even believe this," Hilleman said.
Not only was it going to be a global pandemic, he warned, but it was going to come to the states by early September. Again, he was dismissed, and ultimately, ignored.
It spread exponentially in the spring in Asia, partly because the navy serviceman with the flu would go into town, bar hop, and spread it all over the Far East.
Knowing that he only had a precious few months before the school year, Hilleman had to persuade the pharmaceutical companies to create and distribute the vaccine rapidly. It would take too long if he went through the Division of Biological Studies, the FDA at the time, so he called the manufacturers himself and told them to make sure they kept the roosters around. They were going to need as many fertile eggs as possible.
As he predicted, the first lab-confirmed cases of what was deemed "Asian Flu" were found on both coasts- Newport, RI, and San Diego at the city's naval bases. Then, a girl from San Diego traveled to Iowa for an international church conference, and the virus spread more. A boy scout troupe from Hawaii took a train trip across the states and spread it even more. At precisely the time table Maurice predicted, an epidemic was in the United States as the public ignored his warnings.
The vaccines were developed in July, and forty million doses were distributed six weeks later. But it was not fast enough. By October, there were an estimated twenty million Americans infected with the virus.
When it was over, the 1957 "Asian Flu" virus killed forty thousand Americans, including a thousand children. Still, it would have been a lot worse without Hilleman's quick thinking of getting a vaccine to people as quickly as possible. For his incredible fortitude, he was awarded the Distinguished Service Medal from the American military.
He also correctly predicted in the 1950s that "protection against influenza would require yearly vaccination" since the strains could be dramatically different year to year. Some years would be worse than others. Right before his death, he predicted that in 2025 there could be a deadly flu pandemic. Most of his predictions have come true, will this one too?
Recently, Merck announced they were discontinuing their work on a Covid-19 vaccine. Would that have happened if Hilleman was still alive and working there? It is hard to say, but he might have figured out the best solution with his track record. We cannot fix the past, go back to March 2020, and say we would have listened better and taken what was happening in the Far East more seriously. But maybe in late 2024, when a possible deadly influenza pandemic starts to appear and scientists warn us, we will not ignore the Cassandras and dismiss it as merely another countries problem to bear. That is the least we can do to honor the work of Maurice Hilleman truly.
Going to the internet (for more vaccine news)
Offit also alerted me to a measles outbreak that occurred in Boston in the summer of 2006. The article is truly amazing, also with the hindsight of our current quarantine times. Here’s the link, and I wrote a twitter thread on it too, don’t @ me (just retweets, please).
Guess I need to watch this, starring Fauci!
Nice post.