A vaccine campaign’s success is highlighted by the messaging ‘Got polio?’, but as memories of the disease fade in the US, it may create a false sense of security.

“Got polio? Me neither. Thanks, Science.”

Messages like this are used in memes, posters, T-shirts and even on some billboards to promote routine vaccinations. Because this catchy statement reminds people of once-dreaded diseases of the past, it – perhaps unintentionally – conveys the message that polio has been relegated to the history books.

Formulations that aim to encourage vaccinations by emphasizing their achievements imply that some diseases are no longer a threat.

Few people today know much about polio. By 2022, only a third of adults surveyed were in the US realize that polio has no cure. Moreover, a 2020 poll had found that 84% of adults thought it was important to vaccinate childrena 10% decrease from 2001. The COVID-19 pandemic intensified vaccine coverage, while also delay routine immunization.

Vaccine-preventable diseases are far from eradicated. Measles outbreaks in unvaccinated or undervaccinated U.S. communities have resurfaced in recent years, despite a Declaration 2000 that the virus had been eradicated in the US The number of whooping cough cases is increasingwith more than 18,000 cases reported in 2019. And in July 2022, polio resurfaced in an unvaccinated New York man — the first U.S. diagnosis since 1979. This case helped bring attention back to polio, causing at least some young adults wonder about their own vaccination status.

A focus shift to vaccination in developing countries has further lulled Americans into a false sense of security. While global approaches have been effective and are certainly needed, as the author of “Constructing the Outbreak: Epidemics in Media and Collective Memory“I suggest that the festive messages are no longer as effective as they used to be and run the risk of making it seem like polio is only in history books.

Campaigning against a devastating disease

Before vaccines, polio – called infantile paralysis or poliomyelitis – was the most feared childhood disease in the US. The disease often affected primary school children and sometimes presented as a cold or flu – fever, sore throat and headache. In other cases, pain and numbness in limbs or spine first indicated that something was wrong. Paralysis of legs, arms, neck, diaphragm, or a combination can occur and, depending on the area affected, render patients unable to walk, raise their arms, or breathe outside of an iron lung.

Only time could reveal if the paralysis was permanent or would disappear, sometimes only to return decades later Post-polio syndrome. During outbreaks in the 1930s, 1940s, and early 1950s, enough people became infected to make the effects of paralytic polio visible in everyday life in the form of braces, crutches, slings, and other mobility aids.

Thanks to the National Foundation for Infantile Paralysis, beating polio became a national priority. The NFIP grew out of President Franklin Delano Roosevelt’s Warm Springs Foundation. Roosevelt himself was partially paralyzed by polio, and the NFIP provided funds for public education, research, and survivor rehabilitation.

The campaigns were prolific and diverse, combining interpersonal and mass communication strategies.

From FDR “Birthday Ball” celebrations to parades and elementary school fundraising competitions, various groups raised money. High school students performed polio-themed plays, trying the disease itself in “The People vs. Polio.” People passed around collection boxes at movie theaters and other public gatherings.

Campaigns used every medium. Brochures and short films raised awareness of the polio threat and emphasized the need for funding to support patient rehabilitation and scientific research. The National Foundation for Infantile Paralysis generated dozens of radio scripts and hired Frank Sinatra, Elvis Presley, and other famous voices to read them. Judy Garland, Mickey Rooney, Lucille Ball and other Hollywood stars also joined the fray. Comics and cartoons featuring Mickey Mouse and Donald Duck raised March of Dimes funds to help polio patients.

Beginning in 1946, the NFIP listed children with crutches and braces who had survived polio as “children posterasking for money to help them walk again. News stories centered on outbreaks and polio epidemics, detailing the devastation of the disease on individuals, families and communities, while advising families on how to reduce risk through the “Polio Pledge for Parents,” which is a list of do’s and don’ts during the summer months.

From public enemy no. 1 to success story

The work of the National Foundation for Infantile Paralysis has produced unprecedented and sustained success, providing hospitals with equipment during epidemics and supporting vaccine development. After the largest vaccine trial in history, on April 12, 1955, the Poliomyelitis Vaccine Evaluation Center announced that Jonas Salk’s vaccine had been approved. 80%-90% effective against paralyzed polio and officially ready for general use.

Over the next decade, NFIP shifted its focus to widespread immunization, again using both mass media and local campaigns. With Salk’s vaccine and then Albert Sabin’s vaccine, the number of polio cases fell rapidly, from the peak of 57,879 cases in 1952 to only 72 cases in 1965with the last naturally occurring case in the US in 1979.

The repeated statement of what polio vaccines could and did achieve was strategically effective to convince more people to take their pictures. The American public of the 1960s and 1970s had experienced repeated polio epidemics and knew both the fear of contracting the disease and its visible consequences. From 2021, 92.7% of Americans were fully protected by the vaccine, although these rates have fallen since 2010 and fluctuate by region.

Public health rhetoric that focused on this vaccine success story worked all over the world in the late 1980s and 1990s. Gradually, however, the perceived threat in the US from polio and other vaccine-preventable diseases dissipated over generations, as vaccinations largely removed the risk. Most people in developed countries lack of first-hand experience I love how terrifying these diseases are, because I’ve never had polio, diphtheria, measles, whooping cough, or lost any family members to them.

While polio has been largely forgotten in the US, anti-vaccine messages spread misinformation that biases the risk of vaccines, ignoring the reality of the diseases they immunize against.

Rhetoric from polio vaccination campaigns in the 1950s and 1960s emphasized the risks of going unimmunized — acute illness, life-changing pain, and paralysis or even death. In the 21st century U.S., vaccine campaigns no longer emphasize these risks, and it’s easy to forget the potentially deadly consequences of skipping vaccines.

I believe that ubiquitous public health coverage can counter anti-vaccine disinformation. A reminder to the American public about this still-dangerous disease may help make “Got Polio?” not a serious question.