Immunization is a remarkably simple concept: A person injected – or otherwise exposed – with a tiny bit of virus will develop antibodies and be protected from infection and illness. Edward Jenner knew this way back in 1798, when he developed the first vaccine against smallpox by scraping pus from the blistered hands of a milkmaid who had been exposed to cowpox, and injecting it into an eight-year-old boy.
But, while the theory is simple, the practice of making vaccines is anything but: The challenge – once the bug-causing illness has been identified – is to stimulate the immune system so it will create antibodies, but do so without infecting the person with the virus, or with other pathogens that might quietly go along for the ride. Scientists have spent the past 220 years trying to improve on Jenner's crude technique, with remarkable success, but with no shortage of failures and drama.
The Vaccine Race: Science, Politics, and the Human Costs of Defeating Disease focuses on the period in the 1960s and 70s when the science of vaccinology advanced at breakneck speed, and when cell biology transformed from a vocation to a big-money enterprise.
Specifically, author Meredith Wadman, a Canadian physician who is a reporter at Science magazine, zeroes in on the development of vaccines for rubella (also known as German measles) and, to a lesser extent, rabies, but more precisely on the mind-boggling history of WI-38 cells, which would revolutionize vaccine making. Prior to the development of the technique to grow non-cancerous human cells such as WI-38 in the lab, vaccines were made with monkey cells, which sometimes carried other viruses along with them, such as the SV40 simian vaccine that tainted the Salk polio vaccine.
While there is some highly technical science at the heart of this tale, the casual reader shouldn't be dissuaded by the digressions about the intricacies of cellular biology or the 50 pages of footnotes. Wadman does a superb job of making the technical comprehensible to the lay reader and, more importantly, makes the science come to life by honing in on the brilliant men and women who were driven to create new, life-saving vaccines – and profit from their discoveries.
There are three central figures in the book, all of them associated with the Wistar Institute of Anatomy and Biology at the University of Philadelphia: Leonard Hayflick, a biologist who derived WI-38 cells from the lungs of an aborted fetus, and a man who felt he was never adequately recognized (financially and otherwise) and carried a large chip on his shoulder; Hilary Koprowski, a ruthlessly ambitious virologist who headed the Wistar, where he attracted top talent and allowed scientific inquiry to flourish, determined to leave his mark on science; and Stanley Plotkin, a bookish pediatrician who developed the rubella vaccine and became a legend in the field.
Scientists who make world-beating discoveries are often portrayed as heroic figures in retrospective tomes, but Wadman takes a more journalistic approach, profiling the trio warts and all.
While the ambitions, actions and epochal feuds of the three men dominate The Vaccine Race, there is another figure, rarely mentioned, always lurking in the shadows. Mrs. X, a Swedish mother whose aborted fetus was the source of WI-38 cells, never gave her consent and has never been compensated, despite the fact that that those cells have been used to manufacturer 300 million vaccines, and the technique developed by Hayflick to grow cells in the lab has been used to manufacture six billion vaccines and generate enormous profits. (A single vaccine, Merck's MMR – measles, mumps, rubella – still has sales of $1.5-billion [U.S.] annually.)
The Mrs. X subtext has resulted in comparisons to The Immortal Life of Henrietta Lacks, a book by Rebecca Skloot that tells the remarkable story of HeLa cells, cancerous cells drawn from Mrs. Lacks, without her consent, that helped launched a scientific revolution. (Her family is suing for compensation.)
In many ways, The Vaccine Race is an unofficial sequel, because what Hayflick did was grow "normal" (non-cancerous cells) that are now the basis for vaccine production with nary a thought to the donor. And that is the least of the dubious ethical practices that are revealed.
Both Koprowski and Plotkin tested vaccines on intellectually disabled and orphaned children, as well as prisoners, something that today would probably be criminal behaviour. But Wadman does a good job of contextualizing these seemingly incomprehensible acts, explaining that the fear of childhood diseases such as polio and rubella created an almost war-like, the end-justifies-the-means mentality.
While the science is fascinating, the foibles of the main characters are what keep the reader gripped. Hayflick is ultimately the most perplexing, and in some ways pathetic, of the lot. While he was viewed very much as a lab technician by other scientists, his accomplishments were extraordinary. He not only created the first self-replicating human cells, but laid the foundations for the study of cellular aging and the biotechnology industry.
But Hayflick also behaved like a petty thief, stealing off in the night with ampoules of WI-38 cells that clearly did not belong to him, and then sold them for personal gain, however paltry. The protracted legal battle that ensued almost destroyed his career. But this occurred in an era when scientists were only beginning to commercialize their findings so he was, in many ways, slightly ahead of his time, the scientist who tried to profit from biotechnology just before that gold rush began in earnest.
Like many early explorers, these scientists left an indelible mark, and a lot of collateral damage, in their wake.
André Picard is the health columnist at The Globe and Mail. His new book, Matters of Life and Death: Public Health Issues in Canada, will be published in April.