The AIDS Vaccine Impasse: Lessons from Jonas Salk and the March of Dimes (Draft)

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evaluation team carefully compared the subsequent incidence of paralysis
among the children who had received the vaccine with those who had
received placebo shots. In the meantime, the Foundation committed to
widespread public distribution of the vaccine even if it turned out to be
only 25% effective. Finally, on April 12, 1955, the results were
broadcast to an expectant world: "It Works!" Paralysis was 70% to 90%
rarer among vaccine recipients.
As it turned out, Dr. Sabin's "live" oral polio vaccine --
remembered by the sugar cube which often contained it -- would not become
available until the early 1960s. The introduction a half-decade earlier
of Dr. Salk's vaccine saved tens of thousands of lives and prevented
hundreds of thousands of lifelong disabilities which would otherwise have
occurred if the field trial had been blocked. In the face of an epidemic,
risks must often be taken to protect the public health: The costs in time
and money and the damage to reputation and prestige if the vaccine did not
work were outweighed by the potential benefits.
Despite their perseverance and courage to achieve this great
success, neither Salk nor the March of Dimes were ever recognized by the
theoretical "basic" or "pure" scientists who select for the Nobel award in
Physiology or Medicine. They were dismissed as mere technicians who
applied the discoveries of others. Yet what is the meaning of "Medicine",
if not to apply science to prevent or relieve human suffering?
The current impasse over AIDS vaccines reflects the tension between
two schools of thought -- the empiricists and the theorists -- whose
arguments parallel those of Salk and Sabin. The debate came to a head in