A guide to vaccinology: from basic principles to new developments
Opinion: He Died In An Iron Lung And Showed Us The Value Of Vaccines
On March 11, a man named Paul Alexander died at the age of 78. He held the world record for number of years living inside an iron lung.
Alexander contracted polio in 1952, at the age of six. His terrified parents brought him to Parkland Hospital in Dallas, where Alexander, paralyzed below the neck, was placed in an iron lung because he could not breathe without one. Poliovirus, with its predilection for attacking the spinal cord, had stolen his ability to breathe by paralyzing his diaphragm. He spent months living in the coffin-like metal cylinder that exerted alternate positive and negative pressure on his tiny body to inflate and deflate his lungs. Later, he learned breathing techniques that allowed him to survive outside the iron lung for hours at a time, but he would never be free of it.
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Alexander was especially unlucky because just three years later, in 1955, Jonas Salk's polio vaccine was introduced, saving millions of lives as cases of polio plummeted. The vaccine also gave Americans blessed relief from crippling fear that gripped communities each summer. Fear of poliovirus' spread forced closure of theaters, swimming pools, and libraries. Public gatherings were banned. Parents kept children indoors and forbade playing with other kids. Neighbors avoided neighbors. A 1955 survey showed that Americans feared polio more than any other calamity except nuclear war.
Hospital ward with children in iron lungs. FDA photo. It should be easy for us to understand this fear because we experienced it during the COVID-19 pandemic. With both contagions, vaccines were our saviors. But whereas in the mid-twentieth century the polio vaccine was considered a godsend and doctors like Jonas Salk and Albert Sabin (who developed a separate polio vaccine) were lauded as heroes, today COVID vaccines, and vaccinations in general, have become controversial.
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Anti-vaccine activists sow doubt about the very miracle treatments that undergird the health and stability of our society. Because we are not dying from highly contagious infectious diseases like mumps, measles, and rubella, we are free to live longer, healthier lives and pursue our personal and economic goals. To forgo vaccinations is to invite disaster. We see such consequences today at schools in Florida, a shelter in Chicago, and in 15 other states where measles outbreaks among the unvaccinated have caused healthcare emergencies.
Too many have forgotten the fear, chaos, and tragedy that infectious diseases have wrought throughout history. We forget that, without a polio vaccine, any one of us could have been Paul Alexander, living 70 years in an iron lung. Four years ago, the United States went into lockdown. COVID vaccines, created at warp speed, enabled the resumption of our lives. And yet, the surgeon general of Florida has called for a halt to COVID vaccine use.
It is not only that we take vaccines for granted. We are also guilty of selfishness in the name of individualism and "personal rights." The power of vaccination in a community far exceeds the benefits to any individual. When young, healthy people eschew vaccinations because they deem their personal risk of death from infection to be slight, they forget that reducing the burden of infection in a community saves countless lives, particularly among those unable to receive or respond to a vaccine due to medical reasons. A college student may survive a bout of severe COVID, but the elderly or immunocompromised person he passes it to may not.
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In 2021, Henrique Gouveia e Melo, a Portuguese naval officer in charge of his nation's COVID vaccination drive, appealed to his countrymen's sense of duty by saying: "We are at war, and this is a war against the virus, so what side [do] you want to be on? With the virus, 'cause you are crazy and you are helping the virus to spread? Or are you on our side, the community?"
Sadly, COVID is the disease that took Paul Alexander's life this month. Despite his infirmity, he lived an inspiring life. Through homeschooling, he became the first person in Dallas to graduate from high school without attending a class in person. He earned a bachelor's degree from the University of Texas. Then he added a law degree and became a practicing attorney. In 2020, he published a memoir called "Three Minutes for a Dog: My Life in an Iron Lung," that took him eight years to dictate and write using a plastic stick to tap out words on a keyboard.
In a 2020 interview, Alexander recalled times when his disability caused him to seem invisible to the able-bodied. To those spared his affliction, he wanted to say, "You should get down on your knees and thank God it wasn't you."
Vaccines allow us to cheat death. We must use them.
Dr. Andrew Lam is a practicing retina surgeon from Longmeadow, Mass., and an assistant professor at the University of Massachusetts Medical School. He is the author of "The Masters of Medicine: Our Greatest Triumphs in the Race to Cure Humanity's Deadliest Diseases."
'Polio Paul' Alexander's Sad Final Days Revealed As He Battled COVID Inside Iron Lung — Before Death At 78
"Polio Paul" Alexander spent his final days battling COVID while struggling to eat and drink, his social media manager has revealed.
The polio survivor, famed for spending more than 70 years inside an iron lung, died Monday in Dallas, Texas, at the age of 78.
While an official cause of death hasn't been publicly disclosed, Alexander was hospitalized late last month after contracting the coronavirus.
"Last week, he was unfortunately rushed to the emergency room," his social media manager, known only as Lincoln, revealed in a TikTok posted on Feb. 26.
"Polio Paul" Alexander spent his final days battling COVID while struggling to eat and drink, his social media manager has revealed. TikTok / @ironlungman While an official cause of death hasn't been publicly disclosed, Alexander was hospitalized late last month after contracting the coronavirus. TikTok / @ironlungman"In the hospital, he tested positive for COVID, which is really, really dangerous, obviously, for someone with his condition," Lincoln continued. "Fortunately, they have an iron lung at the hospital just for him, and he was able to come home this weekend, but unfortunately he's still kind of weak."
He added that Alexander appeared somewhat confused and struggled to eat and drink.
While "Polio Paul" has been known to older Americans for many years, his TikTok page @ironlungman recently exposed him to a huge Gen Z audience.
Videos in which he discussed his illness and shared his optimism clocked tens of millions of views, inspiring many zoomers.
Thousands flocked to the page to pay tribute to Alexander upon his passing, including one who wrote: "Rest in peace Paul. You were extremely inspirational and you honestly helped me change my perspective on life. You really will be missed."
Another devastated admirer penned: "You were the most inspirational person I have had the enjoyment of following. Forever fly high."
Lincoln noted that the popularity of the TikTok account meant they were able to monetize a number of the viral videos, providing money for care in Alexander's final days.
A GoFundMe raised more than $143,400 for Alexander's healthcare costs. It allowed him to live "stress-free" in his final years. TikTok / @ironlungmanMeanwhile, Alexander's brother, Philip, thanked people on Tuesday for donating to his GoFundMe.
More than $143,400 was raised for Alexander's healthcare costs.
"I am so grateful to everybody who donated to my brother's fundraiser," Philip stated. "It allowed him to live his last few years stress-free. It will also pay for his funeral during this difficult time. It is absolutely incredible to read all the comments and know that so many people were inspired by Paul."
The organizer of the fundraiser, Christopher Ulmer, set up the page years ago, claiming Alexander had been the victim of theft.
"He was taken advantage of by people who were supposed to care for his best interests," he wrote at the time. "This theft, combined with the high cost of healthcare, has left Paul with little money to survive. He struggles to maintain his iron lung, afford healthcare and find housing that accommodates his needs. Paul lives in a small one-room apartment that does not have a window."
Alexander's brother, Philip, thanked people who had donated to his GoFundMe. Thousands flocked to TikTok to pay tribute to Alexander upon his passing, including one who wrote: "Rest in peace Paul. You were extremely inspirational and you honestly helped me change my perspective on life. You really will be missed."Alexander contracted polio in 1952, when he was 6 years old and living with his family in suburban Dallas.
"I lost everything: the ability to move, my legs would not hold me up and then I couldn't breathe," he once recalled in a video shared by Reuters.
The youngster was rushed to the hospital and placed in an iron lung, in which he would remain for the rest of his life.
The iron lung is an airtight capsule that sucks oxygen through negative pressure, allowing the lungs to expand and the patient to breathe, Medscape reports. The contraption is large and cumbersome and requires the person using it to lay fastened inside.
Ventilators — which were invented in the 1920s — lined hospital wards amid polio outbreaks that plagued the US until the second half of the last century.
In 1959, 1,200 Americans relied on an iron lung to stay alive, but the machines gradually became less common following widespread distribution of the polio vaccine. In 1979, the US was declared polio-free, and by 2014, there were only 10 Americans left using an iron lung.
In March of last year, Guinness World Records declared Alexander the longest iron lung patient ever.
Alexander contracted polio in 1952, when he was 6 years old and living with his family in suburban Dallas. Gizmodo/YouTube Pictured: an emergency polio ward at a Boston hospital in 1955 — three years after Alexander contracted the disease.Alexander defied doctors' expectations by obtaining a law degree and starting his own legal practice, all while confined to the clunky contraption.
In 2020, he published his memoir, "Three Minutes for a Dog: My Life in an Iron Lung," which took five years to complete, given that he wrote the manuscript from the iron lung.
He used a pen attached to a stick held in his mouth to write every word of the tome.
Polio Paul's 'cause Of Death' Revealed After 'The Man In The Iron Lung' Who Spent 70 Years Living In Tank Passes Aged 78
A LAWYER who lived in an iron lung for seven decades after being struck down with polio has died at the age of 78.
Paul Alexander - widely known as Polio Paul - died on Monday after contracting Covid.
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Polio Paul has died at the age of 78Credit: YouTube/SBSK5
Paul pictured inside his iron lung as a childCredit: Paul Alexander5
He was able to come out of the device for short periods, and wore a suit in a wheelchair when in courtCredit: Paul AlexanderPaul - who had 330,000 followers on TikTok - was left paralysed after suffering polio in 1952 when he was six years old.
After coming back from playing outside with a fever and headache that summer, the deadly virus took hold within a few days and Paul, from Texas, was rushed to hospital.
Doctors operated on him to clear the mucus that had filled his lungs because his body was unable to clear it.
When he woke up he was in the mechanical contraption — where he would spend the majority of his life.
Despite being mostly confined to the tank, Paul went on to become a lawyer, and was even engaged at one point.
While studying at university, he met a woman called Claire who he later proposed to.
But his hopes of marriage came to a bitter end when Claire's mother banned her from marrying Paul.
After surviving in the machine for seven decades, an update on his GoFundMe page from organiser Christopher Ulmer confirmed Paul had died on Monday.
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At least 60 dead as 'ISIS' gunmen open fire in Moscow concert hall terror attackDisability-rights activist Christopher wrote on Tuesday: "Paul Alexander, 'The Man in the Iron Lung', passed away yesterday.
"After surviving polio as a child, he lived over 70 years inside of an iron lung.
"In this time Paul went to college, became a lawyer, and a published author.
"His story traveled wide and far, positively influencing people around the world.
"Paul was an incredible role model that will continue to be remembered.
"Paul, you will be missed but always remembered."
Paul's cause of death was because of the Covid infection, according to reports.
'STRUGGLING TO EAT'His social media manager, Lincoln, had posted on his TikTok page late in February to tell his fans he had tested positive after being taken to hospital.
He told Paul's followers: "I know there has been a lot of questions and comments about where have the videos been, is Paul OK.
"Last week he was unfortunately rushed to the emergency room in the hospital, he tested positive for Covid, which is really, really dangerous for somebody with his condition.
"Fortunately they have an iron lung at the hospital just for him, and he was able to come home this weekend.
"But unfortunately he's still kind of weak, he's still got some confusion going around, he's still struggling to eat and hydrate."
Paul had used his TikTok page to answer questions from fans about polio and the iron lung in a series he called Coversations with Paul.
FROG-BREATHINGPolio is a deadly virus that attacks the spinal cord, leaving some survivors paralysed.
It caused annual epidemics through the early 1900s to 1950s, causing tens of thousands of children to lose the use of their limbs each year in the US and Europe.
Symptoms include a high temperature, tiredness, headaches, vomiting a stiff neck and muscle pain.
Many affected children had to be put in iron lungs — 7ft metal cases that use a vacuum to push air in and out of their own lungs.
What is an iron lung and how do they work?
THE iron lung was invented at Harvard University in the early 1900s as a state-of-the-art life support machine for victims of polio.
It seals a patient shut in a coffin-like metal box and uses a set of bellows to pump air in and out, allowing them to breathe despite their chest muscles being paralysed.
The bellows suck air out of the box, reducing air pressure and automatically expanding the patient's lungs to draw in fresh air to their body.
As the bellows allow air back into the cylinder, it causes the air pressure to rise and the patient exhales.
The device was first used to save the life of an eight-year-old girl at Boston Children's Hospital in 1928.
Iron lungs became common across polio wards, with around 1,000 in use in the USA by 1939.
Most patients only used one for a few weeks or months until they recovered from the illness.
However, those whose chest muscles were permanently paralysed — like Paul — faced spending their entire lives in one.
Iron lungs were largely replaced with modern ventilators since the polio vaccine was developed in the 1950s.
A vaccine was invented in 1955, largely wiping out the virus and protecting people against it.
But the vaccine came too late for Paul, who was left unable to move from the neck down.
He had a team of rotating carers to clean and look after him, and used his mouth to manipulate a pen when writing or using a phone.
Despite more modern ventilators existing since the 1960s, Paul decided to continue using the iron lung because it was what he was used to.
Other devices can also require a tracheostomy — a hole in the throat — which he never wanted again, after having to have one initially when he was first struck with the virus.
THREE-PIECE SUITHe lived in the hospital for two years but went on to finish high school, graduate from university with a law degree and practice law for decades.
Paul learnt a technique called frog breathing, which allows people to gulp air down with their throat instead of using their lungs, which gave him short periods outside the device.
He represented clients in court wearing a three-piece suit in a wheelchair that held his body upright.
But as he aged, he had been confined to the device, and lived at a facility in Dallas.
Many well-wishers have continued donating to Paul's GoFundMe page to help contribute to his funeral.
His brother Philip said: "I am so grateful to everybody who donated to my brother's fundraiser.
"It allowed him to live his last few years stress-free. It will also pay for his funeral during this difficult time.
"It is absolutely incredible to read all the comments and know that so many people were inspired by Paul."
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Nurses attend to a room full of polio patients in iron lung respirators in California in the 1950sCredit: Alamy5
He was kept alive in a 7ft iron lung for decadesCredit: YouTube/ SBSKWhat is polio?
POLIO is an infectious disease that can spread from person to person and most commonly affects children under the age of five.
The disease attacks the nervous system and in some extreme cases can lead to paralysis.
Polio is very contagious, and a person can transmit it even when they aren't sick.
There are two ways the virus goes from person to person.
The first is that people with poliovirus in their bodies shed the virus through their faeces.
The second way is the virus can then spread to other people when they swallow contaminated water or food.
This exposure is more likely in areas that have poor hygiene or weak systems to clean water.
Polio is caused by a virus called poliovirus.
The virus enters the body through the mouth or nose, getting into the digestive and respiratory (breathing) systems.
It then harvests in the throat and intestines.
From there, it can enter the bloodstream and attack the nervous system.
There are three strains of poliovirus: types one, two, and three. Types two and three have been eliminated, but type one still affects people in a few countries.
Although there is no cure, there is a safe and effective vaccine.
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