In late 2024, multiple outlets reported that an associate of Robert F. Kennedy, Jr., U.S. President Trump’s nomination for Health and Human Services Secretary, had petitioned to revoke approval for the polio vaccine. The petition requested the U. S. Food and Drug Administration to suspend or withdraw approval of Sanofi’s polio vaccine for children, questioning its safety and arguing for further studies (Roubein & Weber). Although originally filed and reported on in 2022, the petition remains under review by the FDA (Goodman) and its resurfacing has alarmed political, academic, and medical communities alike (Aljazeera; Public Health on Call). For many, the petition not only represents a political attack against evidenced-based approaches to public health (Rosenstock & Lee; Reed), but threatens to bring about another wave of vaccination hesitancy, similar to what occurred with Covid-19 (Albrecht). For others, it is an unsettling reminder of a time before the vaccines, invoking painful memories of polio’s impact on their lives, and those of others (Oza). This renewed concern for polio and its vaccines raises the question; are there those who have forgotten about polio, and what it took to get where we are with the disease today?
Polio is a highly infectious viral disease that largely affects children under the age of 5 and may result in irreversible paralysis or death due to the immobilization of the breathing muscles (World Health Organization). The disease is most often transmitted via a fecal-oral route, and less frequently by contaminated food or water. Prior to the development of a vaccine in the 1950s, polio disabled over half a million people worldwide (Eggers). However, since the establishment of the Global Polio Eradication Initiative (GPEI) in 1988, cases of polio worldwide have decreased by 99%, and poliovirus remains endemic in just two countries, Afghanistan and Pakistan (GPEI). The current eradication strategy aims to eliminate the transmission of polio by next year (WHO “Polio Eradication Strategy”). Yet this may be optimistic, for eradication efforts face numerous obstacles, including waning political support, insufficient funding, and limited access to vulnerable and unvaccinated populations.
Polio itself is thought to be an ancient disease, predating written records and affecting human populations for millennia (Nathanson & Kew). One of the earliest depictions of the disease may be an Egyptian slab, circa 1580-1350 BCE, portraying an individual with a withered leg using a crutch-like support; it is an image with notable similarities to patients with paralytic polio today (Paul). In 1789, the physician Michael Underwood was the first to offer a clinical description of polio, describing it as a “debility of the lower extremities” (Toole). Polio’s clinical presentation and impact on the spinal cord was further described in the nineteenth century by Dr. Jacob Heine, who was the first to posit that polio was contagious (Pietrzak; GPEI). As outbreaks occurred primarily among children (Ross), the disease was often referred to as “infantile paralysis” or “Heine-Medin disease” until the early twentieth century, when the viral nature of the disease was discovered (Pearce). It was renamed “polio” or “poliomyelitis”, derived from the Greek words poliós “pale grey” and myelós “marrow”, alluding to the gray matter of the spinal cord which the disease affects (Merriam-Webster).
The first polio vaccine was developed in the 1950s by Jonas Salk, after he was able to isolate the three strains of the virus (type 1, 2, and 3) and eliminate them using an inactive (dead) version of the virus, which came to be known as Inactive Polio Vaccine (IPV) (Salk; WHO “History of the polio vaccine”). Salk’s IPV would go on to be widely used until a second vaccine was developed by Alber Sabin in the early 1960s. Sabin’s vaccine was based on a live, attenuated (weakened) virus, which was not only cheaper to produce, but resulted in a more effective immune response (Bartlett). As the vaccine was administered orally, it became known as the Oral Polio Vaccine (OPV). Sabin’s OPV would, over time, become more widely used than Salk’s IPV. Both vaccines greatly reduced the incidence of polio around the world, ultimately leading to its nearly-eradicated status today. Poliovirus type 2 and 3 have been completely eradicated (in 2015 and 2019 respectively) (GPEI), and just 62 cases of type 1 were reported in 2024 (WHO “Statement on the fortieth meeting”). This impressive progress is the result of more than 70 years of eradication efforts. Indeed, the success of the campaign to eradicate polio is second only to that of smallpox, which was fully eradicated in 1980 (CDC).
While efforts to completely eradicate polio remain ongoing, the process is not without its own controversies and concerns. A drawback of OPV is that, in rare instances, the attenuated virus may mutate and become transmissible, leading to the circulation of vaccine-derived poliovirus (WHO “History of the Polio Vaccine”). Currently, vaccine-derived poliovirus has been responsible for outbreaks in 46 countries, and the cessation of OPV is an integral component of the endgame strategy for finally eradicating the disease (GPEI; WHO “Polio Eradication Strategy”). However, the overall low risk of vaccine-derived polio (Mohanty et al.) and the cost effectiveness of OPV continue to make it a popular vaccine around the world.
That being said, it is interesting that the aforementioned petition takes aim at Sanofi’s polio vaccine, which is an IPV, and not OPV (Sanofi). The petition claims the vaccine is unlike both Salk’s original inactivated polio vaccine and Sabin’s oral polio vaccine, taking particular issue with the way the vaccine is cultured (i.e. produced) (Siri). However, the vaccine was approved by the U.S. Food and Drug Administration (USFDA), taking no issue with its production. Therefore it remains a vital resource for protecting the U.S. and global population against polio. Given the current political climate in America, it is unclear what the result of this petition will be. The U.S. president’s recent executive order to withdraw from the World Health Organization (The White House); the Centers for Disease Control and Prevention’s apparent order to withdraw or pause the publication of research in scientific journals (Visser; Steenhuysen & Lapid); and the pause of foreign aid (The White House “Reevaluating”), will likely have a significant impact on vaccination efforts, and make it clear that the United States government is reevaluating its position on issues of public and global health.
Regardless of political alignment, it is imperative to continue to support vaccination and eradication efforts. The world is close to eradicating an incurable disease that has afflicted societies for centuries. If we are not careful, regular outbreaks of polio, and wards filled with patients on respirators, may once again become commonplace.
Image Source: Wikimedia Commons – The Ny Carlsberg Glyptothek, Denmark
Works Cited
Albrecht D. 2022. Vaccination, politics and COVID-19 impacts. BMC Public Health, 22 (96). https://doi.org/10.1186/s12889-021-12432-x
Aljazeera. 2024. Outcry after RFK Jr linked to effort to nix US approval for polio vaccine. Al Jazeera. https://www.aljazeera.com/news/2024/12/15/outcry-after-rfk-jr-linked-to-effort-to-nix-us-approval-for-polio-vaccine
Bartlett K. 2017. The health of nations: The campaign to end polio and eradicate epidemic diseases. London: Oneworld Publications
Centers for Disease Control and Prevention. 2024. History of smallpox. https://www.cdc.gov/smallpox/about/history.html
Eggers H. J. 1999. Milestones in early poliomyelitis research (1840 to 1949). Journal of Virology, 73 (6) https://www.ncbi.nlm.nih.gov/pmc/articles/P112492/
Global Polio Eradication Initiative. 2024. About Polio. https://polioeradication.org/ about-polio/
Goodman B. 2024. Kennedy’s lawyer has asked the FDA to revoke its approval of the polio vaccine. CNN. https://www.cnn.com/2024/12/13/health/kennedy-lawyer-fda-polio-vaccine/index.html
Merriam-Webster. 2025. Poliomyelitis. Merriam-Webster Dictionary. https://www.merriam-webster.com/dictionary/poliomyelitis.
Mohanty A., Rohilla R., Zaman K., Hada V., Dhakal S., Shah A., Padhi B. K., Al-Qaim Z. H., Altawfiq K. J. A., Tirupathi R., Sah R., & Al-Tawfiq J. A. 2023. Vaccine derived poliovirus (VDPV). Le Infezioni in Medicina, 31 (2. https://doi.org/10.53854/liim-3102-5
Nathanson N. & Kew O. M. 2010. From emergence to eradication: The epidemiology of poliomyelitis deconstructed. American Journal of Epidemiology, 172 (11). doi:10.1093/ aje/kwq320
Oza A. 2024. People from India remember life before the polio vaccine. They don’t want to go back. STAT. https://www.statnews.com/2024/12/27/polio-vaccine-rfk-jr-lawyer-petition-revoke-approval-reaction-from-indian-americans/
Paul J. R. 1971. A history of poliomyelitis. New Haven, CT: Yale University Press
Pearce J. M. S. 2005. Poliomyelitis (Heine-Medin disease). Journal of Neurology, Neurosurgery, & Psychiatry, 76 (128). doi: 10.1136/jnnp.2003.028548
Pietrzak K., Grzybowski A., & Kaczmarczyk J. 2017. Jacob Heine (1800-1879). Journal of Neurology, 264 (7). doi: 10.1007/s00415-017-8454-7
Public Health on Call. 2025. Polio and the polio vaccines. https://publichealth.jhu.edu/2025/ polio-vaccinations-provide-safe-effective-protection
Reed T. 2024. Polio vax petition could preview more challenge. Axios. https://www.axios.com/2024/12/16/polio-vax-petition-challenges-fda-trump-rfk
Rosenstock L. & Lee J. 2011. Attacks on science: The risks evidenced-based policy. American Journal of Public Health, 92. https://doi.org/10.2105/AJPH.92.1.14
Ross J. C. 1992. Infantile paralysis epidemic: Rutland, Vermont, 1894. Rutland Historical
Society Quarterly, 22 (4), http://www.rutlandhistory.com/documents/RHSQVol.XXIINo .41992.pdf
Roubein R. & Weber L. 2024. RFK Jr. ally filed petition to revoke FDA approval for polio. The Washington Post. vaccinehttps://www.washingtonpost.com/health/2024/12/13/rfk-polio-vaccine-fda-aaron-siri/
Sanofi. 2025. Vaccines. https://www.sanofi.us/en/your-health/products/vaccine-products
Siri A. 2022. Petition for administrative action to require clinical trial of IPOL to Assess the safety of this product. chrome-extension://efaidnbmnnnibpcajpcglclefin dmkaj/https://icandecide.org/wp-content/uploads/2023/05/Petition -IPOL-2022-08-23.pdf
Steenhuysen J. & Lapid N. 2025. CDC orders pullback of new scientific papers involving its researchers, source says. https://www.reuters.com/world/us/us-cdc-orders-pullback-new-scientific-papers-involving-its-researchers-source-2025-02-02/
The White House. 2025. Withdrawing the United States from the World Health Organization. https://www.whitehouse.gov/presidential-actions/2025/01/withdrawing-the-united-states-from-the-worldhealth-organization/
The White House. 2025. Reevaluating and realigning United States foreign aid. https://www.whitehouse.gov/presidential-actions/2025/01/reevaluating-and-realigning-united-states-foreign-aid/
Toole L. 2012. The history of polio: The Borgen Project. https://borgenproject.org/ history-polio/
United States Food & Drug Administration. IPOL – Poliovirus Vaccine Inactivated (Monkey Kidney Cell). https://www.fda.gov/vaccines-blood-biologics/vaccines/ipol-poliovirus-vaccine-inactivated-monkey-kidney-cell
Visser N. 2025. CDC Orders Its Scientists To Withdraw New Papers To Hunt Out ‘Forbidden Terms’: Reports. https://www.huffpost.com/entry/cdc-orders-papers-withdrawn-forbidden-words_n_67a02486e4b0521901454fe9
World Health Organization. 2024. History of the polio vaccine. https://www.who.int/ news-room/spotlight/history-of-vaccination/history-of-polio-vaccination#:~:text= Not%20long%20 afterwards%2C%20in%20the,Canada%2C%20Finland%20and% 20the%20USA.
World Health Organization. 2024. Poliomyelitis (polio). https://www.who.int/health-topics/poliomyelitis#tab=tab_1
World Health Organization. 2021. Polio endgame strategy. https://www.who.int/ publications/b 57914#:~:text=The%20Global%20Polio%20Era dication%20Strategy,of %20the%20ongoing%20COVID%2D19
World Health Organization. 2024. Statement of the fortieth meeting of the Polio IHR Emergency Committee. https://www.who.int/news/item/03-12-2024-statement-of-the-fortieth-meeting-of-the-polio-ihr-emergency-committee
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Steven Rhue
In late 2024, multiple outlets reported that an associate of Robert F. Kennedy, Jr., U.S. President Trump’s nomination for Health and Human Services Secretary, had petitioned to revoke approval for the polio vaccine. The petition requested the U. S. Food and Drug Administration to suspend or withdraw approval of Sanofi’s polio vaccine for children, questioning its safety and arguing for further studies (Roubein & Weber). Although originally filed and reported on in 2022, the petition remains under review by the FDA (Goodman) and its resurfacing has alarmed political, academic, and medical communities alike (Aljazeera; Public Health on Call). For many, the petition not only represents a political attack against evidenced-based approaches to public health (Rosenstock & Lee; Reed), but threatens to bring about another wave of vaccination hesitancy, similar to what occurred with Covid-19 (Albrecht). For others, it is an unsettling reminder of a time before the vaccines, invoking painful memories of polio’s impact on their lives, and those of others (Oza). This renewed concern for polio and its vaccines raises the question; are there those who have forgotten about polio, and what it took to get where we are with the disease today?
Polio is a highly infectious viral disease that largely affects children under the age of 5 and may result in irreversible paralysis or death due to the immobilization of the breathing muscles (World Health Organization). The disease is most often transmitted via a fecal-oral route, and less frequently by contaminated food or water. Prior to the development of a vaccine in the 1950s, polio disabled over half a million people worldwide (Eggers). However, since the establishment of the Global Polio Eradication Initiative (GPEI) in 1988, cases of polio worldwide have decreased by 99%, and poliovirus remains endemic in just two countries, Afghanistan and Pakistan (GPEI). The current eradication strategy aims to eliminate the transmission of polio by next year (WHO “Polio Eradication Strategy”). Yet this may be optimistic, for eradication efforts face numerous obstacles, including waning political support, insufficient funding, and limited access to vulnerable and unvaccinated populations.
Polio itself is thought to be an ancient disease, predating written records and affecting human populations for millennia (Nathanson & Kew). One of the earliest depictions of the disease may be an Egyptian slab, circa 1580-1350 BCE, portraying an individual with a withered leg using a crutch-like support; it is an image with notable similarities to patients with paralytic polio today (Paul). In 1789, the physician Michael Underwood was the first to offer a clinical description of polio, describing it as a “debility of the lower extremities” (Toole). Polio’s clinical presentation and impact on the spinal cord was further described in the nineteenth century by Dr. Jacob Heine, who was the first to posit that polio was contagious (Pietrzak; GPEI). As outbreaks occurred primarily among children (Ross), the disease was often referred to as “infantile paralysis” or “Heine-Medin disease” until the early twentieth century, when the viral nature of the disease was discovered (Pearce). It was renamed “polio” or “poliomyelitis”, derived from the Greek words poliós “pale grey” and myelós “marrow”, alluding to the gray matter of the spinal cord which the disease affects (Merriam-Webster).
The first polio vaccine was developed in the 1950s by Jonas Salk, after he was able to isolate the three strains of the virus (type 1, 2, and 3) and eliminate them using an inactive (dead) version of the virus, which came to be known as Inactive Polio Vaccine (IPV) (Salk; WHO “History of the polio vaccine”). Salk’s IPV would go on to be widely used until a second vaccine was developed by Alber Sabin in the early 1960s. Sabin’s vaccine was based on a live, attenuated (weakened) virus, which was not only cheaper to produce, but resulted in a more effective immune response (Bartlett). As the vaccine was administered orally, it became known as the Oral Polio Vaccine (OPV). Sabin’s OPV would, over time, become more widely used than Salk’s IPV. Both vaccines greatly reduced the incidence of polio around the world, ultimately leading to its nearly-eradicated status today. Poliovirus type 2 and 3 have been completely eradicated (in 2015 and 2019 respectively) (GPEI), and just 62 cases of type 1 were reported in 2024 (WHO “Statement on the fortieth meeting”). This impressive progress is the result of more than 70 years of eradication efforts. Indeed, the success of the campaign to eradicate polio is second only to that of smallpox, which was fully eradicated in 1980 (CDC).
While efforts to completely eradicate polio remain ongoing, the process is not without its own controversies and concerns. A drawback of OPV is that, in rare instances, the attenuated virus may mutate and become transmissible, leading to the circulation of vaccine-derived poliovirus (WHO “History of the Polio Vaccine”). Currently, vaccine-derived poliovirus has been responsible for outbreaks in 46 countries, and the cessation of OPV is an integral component of the endgame strategy for finally eradicating the disease (GPEI; WHO “Polio Eradication Strategy”). However, the overall low risk of vaccine-derived polio (Mohanty et al.) and the cost effectiveness of OPV continue to make it a popular vaccine around the world.
That being said, it is interesting that the aforementioned petition takes aim at Sanofi’s polio vaccine, which is an IPV, and not OPV (Sanofi). The petition claims the vaccine is unlike both Salk’s original inactivated polio vaccine and Sabin’s oral polio vaccine, taking particular issue with the way the vaccine is cultured (i.e. produced) (Siri). However, the vaccine was approved by the U.S. Food and Drug Administration (USFDA), taking no issue with its production. Therefore it remains a vital resource for protecting the U.S. and global population against polio. Given the current political climate in America, it is unclear what the result of this petition will be. The U.S. president’s recent executive order to withdraw from the World Health Organization (The White House); the Centers for Disease Control and Prevention’s apparent order to withdraw or pause the publication of research in scientific journals (Visser; Steenhuysen & Lapid); and the pause of foreign aid (The White House “Reevaluating”), will likely have a significant impact on vaccination efforts, and make it clear that the United States government is reevaluating its position on issues of public and global health.
Regardless of political alignment, it is imperative to continue to support vaccination and eradication efforts. The world is close to eradicating an incurable disease that has afflicted societies for centuries. If we are not careful, regular outbreaks of polio, and wards filled with patients on respirators, may once again become commonplace.
Image Source: Wikimedia Commons – The Ny Carlsberg Glyptothek, Denmark
Works Cited
Albrecht D. 2022. Vaccination, politics and COVID-19 impacts. BMC Public Health, 22 (96). https://doi.org/10.1186/s12889-021-12432-x
Aljazeera. 2024. Outcry after RFK Jr linked to effort to nix US approval for polio vaccine. Al Jazeera. https://www.aljazeera.com/news/2024/12/15/outcry-after-rfk-jr-linked-to-effort-to-nix-us-approval-for-polio-vaccine
Bartlett K. 2017. The health of nations: The campaign to end polio and eradicate epidemic diseases. London: Oneworld Publications
Centers for Disease Control and Prevention. 2024. History of smallpox. https://www.cdc.gov/smallpox/about/history.html
Eggers H. J. 1999. Milestones in early poliomyelitis research (1840 to 1949). Journal of Virology, 73 (6) https://www.ncbi.nlm.nih.gov/pmc/articles/P112492/
Global Polio Eradication Initiative. 2024. About Polio. https://polioeradication.org/ about-polio/
Goodman B. 2024. Kennedy’s lawyer has asked the FDA to revoke its approval of the polio vaccine. CNN. https://www.cnn.com/2024/12/13/health/kennedy-lawyer-fda-polio-vaccine/index.html
Merriam-Webster. 2025. Poliomyelitis. Merriam-Webster Dictionary. https://www.merriam-webster.com/dictionary/poliomyelitis.
Mohanty A., Rohilla R., Zaman K., Hada V., Dhakal S., Shah A., Padhi B. K., Al-Qaim Z. H., Altawfiq K. J. A., Tirupathi R., Sah R., & Al-Tawfiq J. A. 2023. Vaccine derived poliovirus (VDPV). Le Infezioni in Medicina, 31 (2. https://doi.org/10.53854/liim-3102-5
Nathanson N. & Kew O. M. 2010. From emergence to eradication: The epidemiology of poliomyelitis deconstructed. American Journal of Epidemiology, 172 (11). doi:10.1093/ aje/kwq320
Oza A. 2024. People from India remember life before the polio vaccine. They don’t want to go back. STAT. https://www.statnews.com/2024/12/27/polio-vaccine-rfk-jr-lawyer-petition-revoke-approval-reaction-from-indian-americans/
Paul J. R. 1971. A history of poliomyelitis. New Haven, CT: Yale University Press
Pearce J. M. S. 2005. Poliomyelitis (Heine-Medin disease). Journal of Neurology, Neurosurgery, & Psychiatry, 76 (128). doi: 10.1136/jnnp.2003.028548
Pietrzak K., Grzybowski A., & Kaczmarczyk J. 2017. Jacob Heine (1800-1879). Journal of Neurology, 264 (7). doi: 10.1007/s00415-017-8454-7
Public Health on Call. 2025. Polio and the polio vaccines. https://publichealth.jhu.edu/2025/ polio-vaccinations-provide-safe-effective-protection
Reed T. 2024. Polio vax petition could preview more challenge. Axios. https://www.axios.com/2024/12/16/polio-vax-petition-challenges-fda-trump-rfk
Rosenstock L. & Lee J. 2011. Attacks on science: The risks evidenced-based policy. American Journal of Public Health, 92. https://doi.org/10.2105/AJPH.92.1.14
Ross J. C. 1992. Infantile paralysis epidemic: Rutland, Vermont, 1894. Rutland Historical
Society Quarterly, 22 (4), http://www.rutlandhistory.com/documents/RHSQVol.XXIINo .41992.pdf
Roubein R. & Weber L. 2024. RFK Jr. ally filed petition to revoke FDA approval for polio. The Washington Post. vaccinehttps://www.washingtonpost.com/health/2024/12/13/rfk-polio-vaccine-fda-aaron-siri/
Sanofi. 2025. Vaccines. https://www.sanofi.us/en/your-health/products/vaccine-products
Siri A. 2022. Petition for administrative action to require clinical trial of IPOL to Assess the safety of this product. chrome-extension://efaidnbmnnnibpcajpcglclefin dmkaj/https://icandecide.org/wp-content/uploads/2023/05/Petition -IPOL-2022-08-23.pdf
Steenhuysen J. & Lapid N. 2025. CDC orders pullback of new scientific papers involving its researchers, source says. https://www.reuters.com/world/us/us-cdc-orders-pullback-new-scientific-papers-involving-its-researchers-source-2025-02-02/
The White House. 2025. Withdrawing the United States from the World Health Organization. https://www.whitehouse.gov/presidential-actions/2025/01/withdrawing-the-united-states-from-the-worldhealth-organization/
The White House. 2025. Reevaluating and realigning United States foreign aid. https://www.whitehouse.gov/presidential-actions/2025/01/reevaluating-and-realigning-united-states-foreign-aid/
Toole L. 2012. The history of polio: The Borgen Project. https://borgenproject.org/ history-polio/
United States Food & Drug Administration. IPOL – Poliovirus Vaccine Inactivated (Monkey Kidney Cell). https://www.fda.gov/vaccines-blood-biologics/vaccines/ipol-poliovirus-vaccine-inactivated-monkey-kidney-cell
Visser N. 2025. CDC Orders Its Scientists To Withdraw New Papers To Hunt Out ‘Forbidden Terms’: Reports. https://www.huffpost.com/entry/cdc-orders-papers-withdrawn-forbidden-words_n_67a02486e4b0521901454fe9
World Health Organization. 2024. History of the polio vaccine. https://www.who.int/ news-room/spotlight/history-of-vaccination/history-of-polio-vaccination#:~:text= Not%20long%20 afterwards%2C%20in%20the,Canada%2C%20Finland%20and% 20the%20USA.
World Health Organization. 2024. Poliomyelitis (polio). https://www.who.int/health-topics/poliomyelitis#tab=tab_1
World Health Organization. 2021. Polio endgame strategy. https://www.who.int/ publications/b 57914#:~:text=The%20Global%20Polio%20Era dication%20Strategy,of %20the%20ongoing%20COVID%2D19
World Health Organization. 2024. Statement of the fortieth meeting of the Polio IHR Emergency Committee. https://www.who.int/news/item/03-12-2024-statement-of-the-fortieth-meeting-of-the-polio-ihr-emergency-committee
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