Health

The fastest vaccination campaign in New York history


In 1947, New York vaccinated 6 million people in just one month, stopping the catastrophic wave of smallpox.

At the end of Easter weekend, April 1947, New York City reveled in a triumphal atmosphere. The trauma of World War II has fallen behind. New York, like the rest of the country, is happy and happy.

America’s future promises great things. The Polaroid camera was invented, TVs became commonplace, semiconductor radios were still active.

What was unexpected by the public, smallpox – the disaster of civilization, had suddenly returned five weeks earlier.

On March 1, Eugene Le Bar, a 47-year-old American businessman, traveled from Mexico City to New York to go to Maine. On the way, he felt tired and had to rent a hotel room in Midtown to take a break.

On May 3, Le Bar was admitted to Bellevue hospital, had a fever of 40.5 degrees C, and a rash on his face and hands. Three days later, he was transferred to the Willard Parker Infectious Hospital. Doctors looked at the diagnosis but had no results. Since Le Bar has a vaccination scar, they ruled out the possibility that he had smallpox. On March 10, he died.

Not long after, many patients at Willard Parker began to experience similar symptoms. The first was a 22-month-old baby from the Bronx, followed by a 27-year-old male from Harlem. Then, a boy nearly 2 years old also became ill.

The doctor thought they had chickenpox, but was confused because the rash was different from the disease.

On April 4, results from the US Army School of Health Laboratory showed that all had smallpox – a disease that has not appeared in New York since before the World War. Medical officials began tracing the exposure and concluded that Eugene Le Bar was patient number 0.

Smallpox is spread through fluids by coughing, sneezing or touching the rash. The rash appears early, covering the body, and then progresses to pustules. The death rate is about three out of 10 patients. Survivors often have deep scarring, blindness, or both.

New Yorkers line up for smallpox vaccination outside Morrisania Hospital, April 14, 1947. Image: NY Times

“On the list of dangerous infectious diseases, smallpox is in the top 5. It’s really horrible, disfiguring or killing anyone who gets it,” said Professor Charles DiMaggio, Grossman School of Medicine, University of New York. , said.

Thanks to a vaccine developed in the late 1700s and refined in the decades that followed, smallpox was finally under control.

In 1947, most New Yorkers were vaccinated against smallpox. They are told to have lifelong immunity. But nothing is certain. In some cases, the vaccine was ineffective. In others, immunity decreases over time. Mr. Le Bar is a testament to that.

New York Health Commissioner Dr. Israel Weinstein took office 10 months ago, has to make a tough decision. As a doctor and scientist who lived through the smallpox epidemic in 1900, he knew that as long as one person got sick, even in the vaccinated community, the outbreak would be devastating.

Dr Howard Markel, director of the Center for the History of Medicine at the University of Michigan, said: “Imagine, during the Easter parade, everyone crowded on 5th Avenue. They were all. cheering, praying and having the ability to cough or sneeze. So you get smallpox. This is a public health nightmare. “

Dr. Weinstein does not waste any time. Knowing that vaccination was the only way to deal with the virus, he took immediate action.

At 2 o’clock on April 4, he held a press conference, calling on all New Yorkers to be vaccinated immediately, even though they were vaccinated as children. He emphasized the need to be vaccinated again in case some people lose their immunity.

This decision contains risks. Announcements can create panic in the community. Besides, in 1947, the vaccine was not tested as it is today. The vaccine can cause dangerous side effects, especially in immunocompromised people or atopic dermatitis.

According to David Oshinsky, a Ph.D. at NYU Langone Health, Mr. Weinstein acted in accordance with contemporary scientific knowledge. He made the right move, which is to vaccinate as many people as possible.

“Weinstein did his job as best he could. The risk of smallpox spreading and causing death is much higher than the risk of encephalitis or a vaccine allergy,” he said.

In daily broadcasts, Dr. Weinstein focuses on one consistent message. The free vaccines, he stressed, “had absolutely no reason for anyone to be out of protection”. The streets of New York were flooded with posters that read: “Believe! Be safe! Get vaccinated!”.

“The first thing he did was to be honest with the public. He said that smallpox has spread to the city, is likely to spread and this is an extremely dangerous pathogen. He insists on providing it. enough vaccines to effectively protect New Yorkers “, Dr. Oshinsky said.

However, the city’s pharmaceutical reserves are not enough to meet the needs of 7.8 million residents.

Working in partnership with Mayor William O’Dwyer, Dr. Weinstein got 250,000 doses of vaccine from the naval medical supply store in Brooklyn, and guaranteed another 780,000 from military bases in California and Missouri. He purchased an additional 2 million doses from private manufacturers and continued to place orders thereafter.

He directed his lab to convert bulk supplies into single doses, start a tracking program to locate people exposed to the case and vaccinate them.

St.  Joan of Arc Parochial of Jackson Heights, Queens, was vaccinated with smallpox, April 1947.  Photo: NY Daily News

St. Joan of Arc Parochial of Jackson Heights, Queens, vaccinated against smallpox, April 1947. Image: NY Daily News

The deployment process is quick and straightforward. This is unlikely to happen today.

Dr Irwin Redlener, director of the Pandemic Response and Resources Initiative at Columbia University’s Earth Institute, said: “In 1947 the city was able to act unilaterally, rather than complex coordinated. with the governor of New York and the federal government. The city decided on its own plan and immediately implemented it. “

At first the public seemed indifferent. On a warm and sunny Easter Sunday, over a million New Yorkers attended the parade. That weekend, only 527 asked for the vaccine.

But a few days later, when it was reported that the wife of one of the first three patients died of smallpox, people’s psychology and the weather changed. They lined up for hours outside public and private hospitals, police stations in the cold rain, waiting to be vaccinated.

For them, vaccines are nothing new. Many were soldiers during World War II. They were vaccinated against a series of pathogens. Furthermore, the anti-vaccine movement did not exist at the time.

After the polio period, people are much more aware of the effects of infectious diseases, according to Dr. Oshinsky.

“They saw it and they feared. But they were also optimistic that science, medicine can solve this. In 1947, people had great faith in the medical community, unlike today. “, he said.

In front of the media, Dr. Weinstein vaccinated Mayor O’Dwyer. President Harry Truman also stepped in. He rolled up his sleeve to receive the vaccine on April 21, during his visit to New York.

“In today’s language, O’Dwyer and Truman are ‘influencers’. They can convey an important message to supporters. They are trustworthy,” said Lisa Sherman, president of the Ad Council, campaign group for non-profit for vaccine Covid-19, said.

The community’s positive reaction to link the city must recruit thousands of volunteers to help vaccinate. Health care workers sometimes injected up to 8 shots of vaccine per minute.

By mid-April, the city’s stockpiles were almost exhausted. Mayor O’Dwyer convened an urgent meeting with representatives of pharmaceutical companies, almost threatening them to increase supply, if not turned away from the public.

In just 48 hours, another million doses of the vaccine appeared.

In early May, 10 weeks after patient No. 0 Eugene Le Bar arrived in New York, Dr. Weinstein announced the danger was over.

Later that year, he reported the event in the American Journal of Public Health.

“In less than a month, 6,350,000 New Yorkers have been vaccinated. There have never been so many people in a city vaccinated in such a short time,” he wrote.

As a result, New York recorded only 12 cases and 2 deaths from smallpox.

“What Mr. Weinstein did in 1947 is still we researched and consulted. It’s incredible that they develop logistics, provide vaccines, set up space big enough for people to line up. , manpower addition in a short time. It is thanks to the Weinstein “.

Dr. Israel Weinstein vaccinated one of his employees, April 1947.  Photo: NY Times

Dr. Israel Weinstein vaccinated one of his employees, April 1947. Image: NY Times

This is a remarkable medical achievement, “a victory for public health,” said Dr. DiMaggio.

Dr. Weinstein resigned in November 1947, seven months after his contributions. He left behind a draft plan to prevent dangerous infectious disease.

But now, during the Covid-19 epidemic, New York faces a logistical obstacle. Public health infrastructure gaps nationwide, experts point out. They believe that the biggest challenge is not vaccine delivery, but the public’s lack of trust in government, science, and media.

Dr. Irwin Redlener said: “We have learned that politics can harm public health initiatives, especially in times of crisis. Honesty and straightforward messages, are clearly what they are. extremely necessary “.

In 1947, Dr. Weinstein only used his voice through radio. But his message was heard and trusted by everyone.

“Back then, communication was much simpler. In today’s context, media is highly fragmented. We believe in small influencers, thinking it is the voice of trust,” said Ms. Sherman. concentration.

Even as New York has begun rolling out Covid-19 vaccinations for its priority group, experts are still unsure whether the city can come close to the success it was 73 years ago.

Dr. Redlener believes that New York will face many challenges. “It is almost certain we can hardly do something so quickly and efficiently,” he said.

Thuc Linh (According to the NY Times)

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