The Vaccine Race: How Scientists Used Human Cells to Combat Killer Viruses

by Meredith Wadman

In 1962, Leonard Hayflick created and then froze roughly 800 tiny ampules of what he dubbed WI-38 cells. Each petite glass vial contained between 1.5 million and 2 million cells. Each cell in each vial, once thawed, had the capacity to divide another 40 times. Hayflick had created a supply of cells that, for practical purposes, was almost infinite.
Hayflick’s WI-38 cells would become the first normal, non-cancerous cells available in virtually unlimited quantities to scientists, and, as a result, the best-characterized normal cells available to this day. They would become the basis for vaccines that have immunized hundreds of millions of people worldwide against polio, rubella, rabies, chicken pox, and measles. Today approximately two billion people have directly benefitted from the use of WI-38 and other cell strains created using Hayflick’s methods.WI-38 would also spawn a lifetime feud between Hayflick and his superiors at the Wistar, and an epochal fight with the US government, first over whether the cells were safe to use to make vaccines and then over who owned them.
The Cells and the Scientist combines scientific discovery, rivalry, greed and drama; abortion and vaccine politics; and timely questions about the tradeoff between socially beneficial medical research and the rights of individuals. Remarkably, both Leonard Hayflick and the 83-year-old mother of the fetus that gave rise to WI-38 are still alive. The mother lives near Stockholm. She was not asked permission for the use of her fetus and has never earned a penny from the contribution.
The tale of WI-38 is a profoundly human one, laced with real effects on untold numbers of lives. Consider this irony: cells derived from an aborted fetus have prevented tens of millions of miscarriages that otherwise would have been caused by the rubella virus, which infects foetuses in the womb.

Genres: Science, Nonfiction, History, Medicine, Medical, Health, Biology

448 pages, Paperback

First published February 7, 2017

Reviews

[Kara Babcock · Rating 5 out of 5]

This is what I knew about vaccines prior to reading this book:

* Vaccines work by delivering a killed or live, but weakened, version of a virus into the body, stimulating the body’s immune system into producing antibodies without actually causing an infection.
* Edward Jenner gets a lot of credit for using cowpox to vaccinate against smallpox, though he wasn’t the first to think about this.
* Vaccines are responsible for preventing death, disability, and disfigurement due to such diseases as smallpox, polio, measles, and even the flu. Indeed, we’ve eradicated smallpox and almost completely eradicated polio!
* Vaccines do not cause autism.

I love reading books like The Vaccine Race, because they make me realize how much I didn’t know that I don’t know about things! In this case, while I knew what vaccines were, I realized that I didn’t actually know how we make vaccines, the process used to kill or weaken the virus. Meredith Wadman explains this, along with all sorts of related developments in the science of vaccination. The title of this book is somewhat inaccurate, or at least too narrow: The Vaccine Race is really the story of virology and immunology in the 20th century. After all, the central character of this story is Leonard Hayflick, who does not himself develop vaccines but rather a critical line of “normal” human tissue cells that become integral to many vaccine efforts. This story goes far beyond the creation of vaccines, touching broadly on issues of biological research and human health.

This is a story, albeit one supported heavily by research. Wadman begins from Hayflick’s earliest days as a scientist, chronicling his studies and start at the Wistar Institute. Along the way, she takes us on digressions to talk about other important figures and the vaccines they worked on. I love the amount of detail that Wadman goes into with regards to the science being done; equally, though, this is not just a book about science but a book about history. Wadman sets out to examine how social conditions and politics in the United States influenced vaccine development, and vice versa.

The history herein is a mixed bag, and Wadman tries to celebrate the progressive aspects while acknowledging the shameful, harmful parts. She does not ignore the fact that vaccines were often tested on poor children and orphans, intellectually disabled people, prisoners, and military personnel. In so doing, she doesn’t just highlight the ethical problems with this, but the way they were embedded within the society of the time:

In 1950 Koprowski began testing his vaccine on intellectually disabled children at Letchworth Village, a filthy, overcrowded institution for people with physical and mental disabilities in the tiny town of Thiells, New York.

Wadman makes it clear here that Dr. Hilary Koprowski didn’t just happen along some intellectually disabled children—they were warehoused, making them ideal for his experiment. Of course, it’s difficult for me to say that things have gotten any better in the present day, considering we incarcerate our mentally ill when we should be helping them…. Anyway, I think the way that Wadman presents these dubious aspects of vaccine development is an important reminder that science is a human endeavour and therefore vulnerable to human flaws.

It is impossible, in fact, to separate science and politics. We must push back against people who insist this is possible, people who think that scientists have no business commenting on public policy, that the existence of global warming has no bearing on how we conduct our lives. The Vaccine Race is a potent primer on science, but it’s an even better look into the political framework in which science was done in the 20th century United States. The scientists in this book lived and died by funding, which often came in the form of grants from government institutions like the National Institute of Health. Moreover, scientists in positions of power were not above using their influence to spin things their way:

Koprowski had minimized the SV40 monkey virus problem only four months earlier, when his own monkey kidney–based polio vaccine was still in the running for U.S. approval. Now, with Sabin’s vaccine rolling quickly toward being licensed, he sounded more alarmed.

The scientific facts were that the SV40 virus existed and that it could potentially survive the vaccine-making progress—but the potential for harm that this posed was still up in the air, and as you can see, Koprowski was willing to change his tune if he thought he could benefit. Someone who was a brilliant scientist—or, more notably perhaps, had a talent for recognizing, grooming, and enabling the brilliance of other scientists—nevertheless keenly acted in his own self-interests when he should have been safeguarding the public good.

The officials in charge of government institutions could also play a huge role in aiding or standing in the way of progress. Wadman discusses how the Department of Biological Standards dragged its feet on allowing vaccines made with WI-38 cells to be licensed in the US, but the rest of the world wasn’t so conservative:

If the WI-38 cells were ignored in the United States, abroad they were increasingly embraced.… It was a sign of the esteem in which Hayflick’s WI-38 cells were held that the British vaccine authorities … decided, perhaps as a matter of national pride, to derive their own analogous normal, noncancerous human diploid cells.

I appreciate that, although largely about the US vaccine industry, the book acknowledges the global scope of medical research. In many cases, crucial advances in vaccines happened because of testing in other countries, or the participation of scientists from other countries—as is the case of Mrs. X and her aborted fetus shipped from Sweden to Hayflick to donate the cells that would become WI-38. Similarly, Wadman reminded me of the importance of scientific conferences—what might seem like a social occasion is really a chance for scientists to recombine ideas and find new, interesting avenues of exploration. If it weren’t for a meeting at a conference, Elizabeth Blackburn might not have heard of Alexei Olovnikov’s little-known theory of cellular aging and connected them to her work on telomeres. Crazy.

Much of The Vaccine Race’s political treatment emphasizes the ways in which scientific and medical research’s evolution into an industry has shaped that research, for better or for worse. The pressure on scientists to secure lucrative grants, make big discoveries, and then patent those discoveries is intense. Post-secondary institutions have essentially turned into patent machines, in a sense, and this can often have an adverse effect on the quality of teaching and learning at that institution, not to mention the actual science being done and the mental health of the scientists doing it.

Still, while I have been and remain critical of the pharmaceutical industry’s power, influence, and actions, I appreciate how Wadman shows the positive effects of nascent Big Pharma’s embrace of vaccines. At the risk of arguing counterfactually, I’m not sure how effective vaccination would be if it were not for the vaccine production industry. And I have no doubts that vaccines are good. At 27, I am old enough not to have been vaccinated with chicken pox (I have vivid memories of that itch when I was a kid, and then three occurrences of what might have been shingles in my early 20s). But I am too young to remember any kind of developed world scarred by polio, rubella, and measles:

In the end, the rubella epidemic that swept the United States in 1964 and 1965 infected an estimated 12.5 million people, or 1 in 15 Americans. More than 159,000 of these infections included joint pain or arthritis, typically in women. Roughly 2,100 people developed encephalitis, a brain inflammation with a 20 percent mortality rate.

Some 6,250 pregnancies ended in miscarriages or stillbirths. An estimated 5,000 women chose to get abortions. Still another 2,100 babies were born, and survived, with congenital rubella syndrome. Of these, more than 8,000 were deaf; nearly 4,000 were both deaf and blind; and 1,800 were intellectually disabled. About 6,600 babies had other manifestations of congenital rubella, most typically heart defects. Often babies were born with several of these disabilities.

These numbers are, at the very best, approximations. They come from a 1969 CDC report whose authors stressed that it was not until 1966 that physicians were required to report rubella cases to authorities.

Just think about that. It boggles my mind, those numbers—they are approximate, because physicians weren’t keeping track! And that was for one epidemic among a recurring cycle of epidemics every 5 years or so! Vaccines have saved literally millions of people from death or needless suffering, and The Vaccine Race is an up-front reminder of how fortunate we are for these discoveries.

The Vaccine Race is a first-rate example of science communication. Wadman is detailed but clear in her writing. I could have done without some of that detail, I think—she loves to tell me all about the backstories of every minor character in the book, and at points my eyes glazed over—but I love this blending of science and history. Moreover, this book is meticulously research, and it shows! In addition to numerous primary and secondary print sources, Wadman interviewed any key players who were still alive (a benefit to writing about recent history!). As a result, she can provide a comprehensive and intimate look at the topic, while remaining somewhat more journalistic than a book written by someone directly involved, such as Hayflick himself. I learned so many interesting things in here. I am quite thankful for NetGalley and Viking making a copy of this book available to me to review.

[Rebecca · Rating 3 out of 5]

I had hoped this would be a comparable read to Rebecca Skloot’s The Immortal Life of Henrietta Lacks and Siddhartha Mukherjee’s The Emperor of All Maladies, which are two of my absolute favorite books and were also among the first to turn me on to medical-themed literature. Instead, I found myself skimming through the book’s dense scientific and historical information: like Mukherjee’s other book, The Gene, which made last year’s Wellcome shortlist, The Vaccine Race is overstuffed with a mixture of the familiar (for me, at least – genetics), the seemingly irrelevant (cell culture techniques and scientific nomenclature), and the truly interesting (questions of medical ethics).

The unlikely protagonist of this story is Leonard Hayflick, a single-minded and resourceful researcher who is still alive in his late eighties and assented to dozens of interviews and many more e-mails as Wadman put this book together. While in high school Hayflick made a chemistry lab in his basement, and in college he built his father a dental lab: that tells you how driven he was. After graduating from the University of Pennsylvania, he worked at the Wistar Institute on its campus. He chiefly investigated whether viruses cause cancer and whether a cell line will be immortal or subject to the normal rules of aging – the Hayflick limit, named after him, is the number of cell divisions possible before a cell line dies out.

Hayflick experimented on his third child’s placenta, but also on aborted fetuses from the university hospital. Replacement fetal cell lines sourced from the Karolinska Institute in Stockholm, Sweden were used to produce the polio, rubella and rabies vaccines. In particular, he relied on the WI-38 line he developed from fetal cells taken from the Swedish “Mrs. X,” who – like Henrietta Lacks’s family – was never compensated; she did not want to be interviewed for or mentioned by name in this book. In the 1970s, with Roe v. Wade in the pipeline, the controversy over using aborted fetal tissue in research heated up*, and Hayflick was somewhat disgraced in the course of a 1976 lawsuit about his right to profit from WI-38.

But that’s not the only dubious ethical situation associated with the development of the twentieth century’s major vaccines: Hayflick’s bosses and associates had also tested early vaccines on intellectually disabled child “volunteers,” while a celebrated cancer researcher had injected cells into dying hospital patients and healthy prisoners in the name of science. Wadman writes, “by the mid-1960s, ordinary people were becoming less willing to give scientists carte blanche to tinker with human beings on a ‘Trust me, I know what’s best for you’ basis.” The question is whether these morally suspect strategies were worth it, given the alternative: rubella in pregnancy causes severe birth defects including blindness, while polio can be crippling and untreated rabies can lead to a slow and painful death.

These ethical questions are certainly worth thinking about, though the abortion history in particular is probably of much more interest to American readers. Here in Europe, abortion is a non-issue, so I don’t expect anyone to get fired up about the history of fetal tissue research. Wadman is certainly a thorough researcher and capable storyteller who doesn’t talk down when explaining science. That said, she might have scaled back on the science a bit to ensure that her work holds broader appeal for lay readers of popular science and medical history.

*More recently, Debi Vinnedge’s Children of God for Life nonprofit has opposed stem cell research despite a Vatican ruling that vaccines developed from fetal tissue are acceptable to use as long as there is no alternative.

Originally published on my blog, Bookish Beck.

[Paul · Rating 3 out of 5]

Around 60 years ago it was still possible for pregnant mothers exposed to German Measles or rubella, to have children that were born with crippling birth defects. No one really knew how the virus affected the unborn child, nor did they know the best way to fight against this disease. It was understood how you could make a vaccine to combat the virus that caused this illness and others like chicken pox, rabies, and polio, but early attempts with animal cell-based vaccines caused as many problems as the illness they were trying to cure.

In 1962, a young biologist, Leonard Hayflick, in Philadelphia extracted cells from an aborted foetus that managed to turn the tide. These clean cells allowed scientist to create vaccines that were safe for almost everyone to use, and it carried the bland description of WI-38. This tiny collection of cells would be expanded time after time to be used to protect over 150 million children in America. Some of the cells he extracted and the methods he developed to get safe vaccines have saved billions of lives around the world.

But it almost didn't happen. Given the source of the cells, there were countless political hurdles to overcome as well as complaints from pro-life groups who were incandescent with rage about it, but the scientist persevered and the vaccines got made and sent out in the world. Wadman has pieced together this story of how the cells were created, how the testing that was done on the uninformed and how that couldn't happen these days. The distribution of these medicines helped create some of the worlds largest companies as the profits poured in. Whilst getting the detail right is important, the narrative that is so crucial in these books got a little lost in amongst all the technical explanations at times. It is a very important story that Wadman is telling though, especially given that fact that we may well be on the dawn of a new era in medicine with the rise of immunity against antibiotics. The one flaw though is that the book is very American centric with little UK and European interest, which is a shame as I feel that this would have a broader audience otherwise.

[Kitty G Books]

Just had to DNF this as it was too slow going. Not necessarily a bad book, just very dense and I think aimed at someone who has prior knowledge or is passionate to learn about viruses, rather than a casual reader.

[Ian · Rating 4 out of 5]

A few statistics to start with;

In 1952 the USA was struck by a polio epidemic. In this single epidemic, within a single country, 58,000 people were infected, mostly children. 3,000 died and 21,000 were left with various degrees of paralysis.

In the early sixties, a rubella epidemic that swept the USA is estimated to have caused 30,000 stillbirths, and in addition, 20,000 cases of Congenital Rubella Syndrome, in which babies are born with (either singly or in any combination), blindness, deafness, heart problems, learning disabilities, or other health issues.


Today the fear and suffering caused by polio and rubella are all but forgotten in the Western World, something achieved through the development of vaccines. Meredith Wadman’s book takes us through their development, the intimidating difficulties that had to be overcome, and the crucial role of human cell cultures in their production. The book focuses on the vaccines for polio and rubella, and to lesser extent those for rabies and Hepatitis A. It also focuses very much on the USA (nothing wrong with that, the author is herself American).

It’s not all inspirational stuff though. These vaccines were developed using means that would be considered highly unethical today (and some people considered them so even at the time). These included injecting experimental vaccines into orphans and/or children with learning disabilities, to test their effectiveness.

The title of the book refers to a vaccine “race” and indeed there was a “race” in more senses than one. Partly it was a race to prevent the terrible harm being done to children and families by polio and rubella. Partly though there was also a race between different teams of researchers, each keen to cross the line first in developing an effective vaccine. Those who developed the vaccines were dedicated people with brilliant minds, but they were also human beings with the full range of human flaws, and part of what you get from this book is that scientists can be as greedy and petty-minded as anyone else. Personally, I found the political and business aspects of the book to be the least interesting part. The scientific story was fascinating.

[Don]

Disclaimer: I got an advance proof from Viking through a Goodreads giveaway.
The title snagged my attention because I am a science geek; but also at the thought of the story of the human cost. And the book did not disappoint. I will say the one bad thing right up front. The story jumped around a lot, making it sometimes hard to follow. But the author had so many people, places, and times to cover that I don't know that she could have avoided that in telling such a sweep of science and modern history.
There is a lot of personal background on the scientists that paints them as real people. Dr. Hayflick provides that string through the story that helps with the timeline and other flows. But even more than him, the cells that he grows in cultures are the flow from start to finish in their importance for developing and understanding vaccines and many aspects of biological progress.
The human costs aspect of the book was intriguing, since it was two-fold. There is a good bit of history of the diseases for which these vaccines were developed. The stories of children who were crippled by polio; adults killed by rabies; and babies born with defects because of rubella absolutely break your heart. And they have you rooting for the scientists developing the vaccines.
But just as you are ready to stand and cheer them on, the stories of the experiments and trials churn forward. From there you are left, mouth agape, at the thought that humans did such things to each other. I won't list the types of people they used for fear of spoiling the story for you. But it is worth the read to see what was done, and how things have changed.
And the personal cost is not ignored, in that the cells used for much of this story came from aborted fetuses. The Vaccine Race is a fascinating and worthwhile read.

[Monical · Rating 2 out of 5]

Somewhat mistitled, this book is actually about one of my favorite scientific techniques, cell culture, and one scientist who generated a valuable cell line that was subsequently used in creating some of vaccines. The author has a specific viewpoint on the topic, which colors the story is a rather negative light, not unlike Skloot's book on Henrietta Lacks. Since I am much more neutral on the subject, I was not very impressed by the book. I thought the book relied on some dubious sources (e.g., "The River," a book claiming that a polio vaccine tested in Africa was the source of HIV, now disproven) and was unduly partisan.

[Darryl · Rating 4 out of 5]

This book chronicles the life of Dr Leonard Hayflick, who rose from humble beginnings as a poor Jewish kid from Southwest Philadelphia to become the inventor of the first human diploid cell line, and to determine that these and other normal human cells can only divide a limited number of times before they die, which later became known as the Hayflick limit. One cell line, WI-38, created while he was a staff member of the Wistar Institute in Philadelphia, became the host for viruses used to create effective vaccines against rubella (German measles) by Dr Stanley Plotkin, and against rabies, by Dr Hilary Koprowski, the long time director of the Wistar Institute, and his colleagues. Hayflick is portrayed as a dedicated and driven but underrecognized researcher, whose dogged persistence and willingness to skirt established norms allowed him to gain recognition for his discoveries, but led him to fall afoul of the National Institutes of Health, which derailed his work at the height of his career.

In The Vaccine Race, Wadman also describes the devastating effects that congenital rubella had on affected infants and their parents, along with rabies, an infection that is nearly always fatal if not diagnosed in time. The book also covers the fierce internecine battles within the Wistar Institute, and amongst the research teams who worked feverishly to become the first to have their vaccines created and approved for public use, while undermining their competitors at the same time. The massive egos of these researchers and the government officials charged with approving the vaccines are on full display as well.

The Vaccine Race is an extensively researched and well written account of the major players in the development of human diploid cell lines for research, and the vaccines that were successfully created by using them, particularly Hayflick's WI-38 line. The book is written for the general public, and Wadman does a fine job of explaining detailed and complicated scientific and medical information. It is a lengthy read, but a rewarding and entertaining one as well.

[Nicky · Rating 4 out of 5]

I really enjoyed this, and I read it at a very opportune moment — at exactly the same time as I had my lab skills residential school in Milton Keynes. The techniques described were mostly not the same, but there was some crossover, and it was great to think about how I might one day contribute to the same science, if I go that route. My only quibbles with this book were with the sometimes unfocused feel; there’s a lot of scientists which it tracks quite closely, and sometimes I wondered how relevant all of the details are.

It’s also got a bit of a divide between the WI-38 cells, which were used to make vaccines, and the vaccines themselves; there’s a lot of focus on the cell line, and sometimes that wasn’t directly relevant to the vaccines. It’s interesting stuff, particularly when it comes to the commercialisation of science, but it didn’t always feel like it fit with the story of the vaccine race. In that sense, it sometimes felt like two almost-separate books. It’s also odd because Wadman clearly champions Hayflick, the creator of the cell line, despite his rather indefensible actions — dismissing them as being due to ‘stubbornness’. Sorry, but if you have a legal contract and you’ve agreed to it, you can’t just forget about it. If you object to the way things are being sorted out, you don’t abscond with the cell line — you get a lawyer.

It doesn’t sound like Hayflick meant any harm, though I am conscious of Wadman’s bias there, and it’s probably true that he deserved better from the use of his cell line — but even so, he was not in the right.

Other than that, there are also some very worthwhile discussions of the ethics of vaccine production. They were often tested on vulnerable people who couldn’t consent, and the WI-38 cell line came originally from the lung cells of an aborted foetus. It’s worth remembering these facts, even with the undoubted good done by the availability of vaccines.

Definitely recommend this one.

Reviewed for The Bibliophibian.

[Heather · Rating 4 out of 5]

This was a very interesting book. To be clear, this is much more of a science book than a political book, but the science speaks for itself. I read "Immortal Life of Henrietta Lacks" several years ago, and this book has some similar themes regarding cell lines (although not as dramatic). I learned a lot about how vaccines were developed from reading this book. I did not realize how naive I was! When I was pregnant it was determined that I would need a Rubella booster, but no one explained to me how important it was and I took it for granted. Considering I was born in the 70's I wonder now after reading this book which Rubella vaccine I received that left me unprotected as an adult. I had also previously thought that the current situation with Zika (a virus that threatens unborn babies) was a new phenomenon, but now I realize that this is not the first time our world has been faced with a virus that threatens fetal health. To clarify, I was pro-vaccine before reading this book and I remain pro-vaccine. As soon as I hit save on this review I am heading to the March for Science!

[Annie · Rating 5 out of 5]

A timely read indeed— as we’re in the midst of arguably the greatest “vaccine race” of all time (and there still remains a huge amount of undue controversy over the COVID-19 vaccine).

This is a history of vaccines in general, but most particularly on two vaccines: polio and rubella (both developed at the Wistar Institute in Philadelphia).

Major credit to the author for not erasing the role of female doctors and scientists. Because they often were refused formal positions at universities or the opportunity to publish, much of medical history has been written by men, despite the fact that a huge number of innovations were instigated by womem. This author dug deep into the research and found the largely un-glorified women scientists who changed medicine forever.

It is a little disconcerting, though, how many times it had to go wrong before we could get it right. Take the polio vaccine. First, one variety of the famous Salk polio vaccine (delivered on sugar cubes) produced by Cutter Laboratories accidentally, well, forgot to kill the virus with formaldehyde first (oops!), resulting in the paralyzation and death of a number of schoolchildren as they had live poliovirus shot directly into their intestines. (A scientist from the NIH, Dr. Bernice Eddy, had previously discovered this and warned her male supervisors, who told her not to worry her pretty little head about science and hid her report from higher-ups).

A few years later, Dr. Eddy got together with Dr. Sarah Stewart and made another major discovery: the poliovirus in the Salk vaccine was killed by formeldahyde… but the formeldahyde didn’t kill another virus that lurked in the vaccine. The monkey cells used to produce the Salk vaccine frequently carried (at least) one monkey virus that survived. They named this virus SV40, and, after some animal testing, discovered that while it’s often just a latent infection, other times it causes tumors in mammals (jury’s still out on whether it increases the risk of tumors in people, but it seems likely). If you received the vaccine between 1955 and 1963, you probably have it in your blood (90% of children who received that vaccine in that window now carry the SV40 virus).

And now for one of my favourite facts of all time: the paper that first broke that earth-shattering bit of news? The National Enquirer. Yes, THAT one. What’s more, their article was completely accurate and factually reported Dr. Eddy’s and Dr. Stewart’s findings. (The headline, in classic Enquirer format: THE POLIO SHOTS YOU HAVE TAKEN MAY KILL YOU: 70% OF HAMSTERS DEVELOPED CANCER IN LAB TESTS. Sounds like fake news. Was 100% true. This tickles me).

Anyway, this discovery is what ushered in the dawn of vaccines using human fetus cells. Fortunately, we had a number of fetal cell lines by that point, thanks to Leonard Hayflick at the Wistar Institute. The head of Wistar, Hilary Koprowski, used Hayflick’s cells to create a polio vaccine derived from human cells (rather than monkeys, thereby eliminating much of the risk of hidden other viruses). Though other scientists and the pulic were wary of fetal cell lines, and vaccines made from them weren’t really made popular until the 70s/80s. (Alarmingly but unsurprisingly, the fetal cell-derived polio vaccine was tested on the newborns of female jail inmates. Sounds legit).

This set the stage for the other major vaccine discussed in the book: rubella (aka “German measles:).

Interestingly, it wasn’t discovered that rubella caused birth defects in fetuses until 1941, when two young mothers, both with newborns born blind (with cataracts) and with heart defects, ran into each other in an Australian ophthalmologist’s waiting room (Dr. Norman Gregg) and started chatting. They realized their babies had similar birth defects and that they had both had rubella during their pregnancy.

They went to Dr. Gregg to ask whether the rubella could possibly have caused their children’s health problems. Dr. Gregg himself had noticed increased frequency in these particular birth defects, so he pursued the young mothers’ idea and made the discovery (though, really, sounds like the credit should go to those two mothers for making the connection). My uncle was a rubella baby from the epidemic of 1964 (though he was one of the 10% that ultimately suffered no health problems as a result) so this section was pretty interesting to talk about with my family.

The rubella vaccine was later developed by Stanley Plotkin, a scientist from Wistar who had helped Koprowski with his polio vaccine.

Important takeaways from this book: well, you can better understand the process of vaccine creation, which is particularly relevant right now. But you also see all the ways that concerns for consent, dignity, and autonomy get washed out in the interests of “the greatest good.” Which is something that continues to happen in the ever-present name of progress.

Can’t recommend this book enough.

[Dr. Dima · Rating 5 out of 5]

Wow, what a phenomenal and eye-opening read that covers an enormous amount of science, history, and medical ethics embedded in a captivating story. This story centres around Leonard Hayflick, who does not himself develop vaccines, but produces human cell lines that become integral to vaccine development and studying viruses as well as other aspects of biology such as ageing and cancer. The book goes beyond vaccines and their development, so I think it is the subtitle (Science, Politics, and the Human Costs of Defeating Disease) rather than the title that really captures the story and main theme of the book.⁣
⁣
The book is not an exhaustive account of all vaccines. Rather, the author focuses on a selection of viruses and their vaccines (mainly polio, rubella and rabies), the devastating diseases that these viruses cause. In addition, the author delves into a lot of ethical issues, including abortion, informed consent, and experimental research on vulnerable groups, such as dying cancer patients, premature babies, disabled children, and prisoners. ⁣
⁣
The book is dense and heavily detailed. Details about the scientists personal lives, the appearances and locations of various research institutions and hospitals, and references to many names can be distracting and you might get lost in the timeline as the author goes back and forth in history. Based on the first 3 chapters, I would’ve given the book 3 stars, but I’m glad I persevered and didn’t abandon the book, because after that, the author nicely weaves science and history into a narrative that provokes strong emotions. This book is not only about vaccine research and development, but also about the heartbreaking stories, political battles, and challenges that underlie vaccine development, as well as a masterclass in scientific thinking and discovery. ⁣

[Feisty Harriet · Rating 4 out of 5]

This was fascinating, the history of vaccine research and trial-and-error, the beginnings of fetal tissue research (which I had zero idea about and am SO fascinated by), abortion, and a whole pile of questions about medical ethics. This is perhaps a little more dense than, say, The Immortal Life of Henrietta Lacks (which I loved, btw), but it was a topic I knew very little about and really appreciated and am fascinated by Wadman's introduction.

[Pam Walter · Rating 4 out of 5]

Once upon a time scientific research was done for the well-being of mankind . Somehow during the second half of the 20th century the motivation of research scientists appears to have changed. It became much a cut-throat business. Meredith Wadman's book describes how research scientists variably supported each other, assisted each other, blocked each other, tripped each other and stole each other's ideas.

Much of the focus is on Leonard Hayflick and his development of a growth medium cells derived from fetal lung tissue (WI-38) for use in developing vaccines. He was competing with growth medium cells coming from green monkey brain and duck embryo, both likely to harbor bacteria or cancer causing agents. Hayflick fought for over a decade to have his growth medium approved. We learn how Stanley Plotkin developed his vaccine for Rubella and then others for polio, rabies, chicken pox adenovirus etc.

An ethical question that I have always tossed around was whether biomedical companies are entitled to take cells from a patient without consent and use them in experiments. In Rebecca Skloot's fabulous non-fiction book The Immortal Life of Henrietta Lacks, HeLa cells came from the cervical cancer cells of Lacks half a century ago and are still used generating billions of dollars for biotech and pharmaceutical companies, while the progeny of Henrietta Lacks are unable to afford college. I don't know the fate of Mrs. X from whose aborted fetus derived the lung cells that generated WI-38 growth cells in 1967, which are still being used today. I do know that billions of dollars have been made and that Mrs. X profited nothing.

One thing that I found interesting and heartbreaking was how scientists did, and do to this day use marginalized people as test subjects. In June 1966 Henry Beecher, a doctor who specialized in anesthesia at Harvard Medical School, published an article entitled "Ethics and Clinical Research" in New England Journal of Medicine. It shook the medical establishment.

Beecher outlined, without naming names or institutions, twenty-two human experiments chosen from the medical literature from 1948 through 1965 that, he reported, had risked the health or life of their subjects. "Grave consequences have been suffered as a direct result of experiments described here," the paper began--experiments for which, Beecher wrote, "it must be apparent that (subjects) would not have been available if they had been truly aware of the uses that would be made of them."

The experiments had been conducted by doctors at prestigious hospitals and universities, including the Clinical Center, the huge research hospital at the NIH. They had been published in top medical journals and funded by the NIH, the U.S. military, drug companies, and private foundations. What was more, Beecher had chosen the twenty-two from a far longer list of ethically suspect studies that had not been difficult to compile. The abuses are everywhere.

In one experiment doctors had withheld chloramphenicol, a treatment known to effectively fight typhoid fever, from charity patients with the disease, to see if they died at greater rates than patients who received the drug. (They did.) In another, they witheld penicillin, which was known to be effective against strep throat, from a control group of 109 U.S. airmen with the ailment, knowing that they could develop well-known, potentially life-threatening complications. Three men went on to do so after the bacteria in their throats spread. Children in an institution for the "mentally defective" were purposely infected with hepatitis A virus (This institution, it emerged, was New York's Willwbrook State School for the Retarded, another horrible holding pen, and the pediatrician who infected the children was the prominent Saul Krugman, the same man who had earlier infected children with rubella.) Separately twenty-two elderly, senile hospitalized patients were injected with living liver cancer cells and told simply that they were receiving "some cells." Leading this trial was the prominent cancer scientist Chester Southam of Memorial Sloan- Kettering Cancer Center, whose example Hayflick and Moorhead had followed in deciding to inject dying cancer patients with the new human diploid cells in 1960. The list went on.

Johns Hopkins Medical Center continues to this day to use marginalized persons for test subjects without their knowledge or consent.

http://www.baltimoresun.com/health/bs...

https://www.nytimes.com/2001/07/17/us...

One side of the Johns Hopkins campus edges on a poor black section of Baltimore where parents claim that their children have disappeared. According to Rebecca Skloot, , mothers warn their children "Be in before dark ~ Else da Hopkins'll git ya!"

[Simon De Gussem · Rating 5 out of 5]

A fantastic book about vaccines, politics, and history. It is really interesting to learn how vaccines were developed and how clinical trials were performed in the past century. It gives you a good understanding of the current regulation system in clinical trials. Books that combine medical science and history are great. This book even makes you feel like you can think along with Plotkin and others to come up with new vaccine ideas by combining insights from different chapters and building on past discoveries.

[Abhiram · Rating 5 out of 5]

Brilliant! Almost like a crime thriller!

[Andrea · Rating 3 out of 5]

This book centered around Hayflick, and his cells, although it did a good job of portraying how devastating diseases such as Rubella and Polio used to be. Wadman also spends considerable time on the shift from "doing science for the good of mankind" to the rise of the big pharma companies from today.

Although Wadman tries to bring in plenty of human interest by telling the stories of people affected by diseases (as well as the by the vaccines), I found the book a little dry. I saw it was compared to the "Immortal life of Henrietta Lacks", however, Wadman's book reads much more like a textbook than Skloot's does. Still, if you are interested in biology, science, and the history of vaccines this book is well worth reading.

[Ormarie Vazquez · Rating 5 out of 5]

I have not enjoyed a book alinvolving science as much as this one in a long time. The history of vaccine making is very interesting, and the author is able to write it like a story, while still throwing in scientific concepts for non-scientists. It was so interesting to learn how research in a lab was done without all the technological advances we have nowadays, and sad to see how clinical trials were conducted.

[Laura Lacey · Rating 3 out of 5]

This is a great non-fiction book spanning the history of the vaccine. It covers the science, the politics, the human drama and the morality.

Wadman jumped around just a little to much for me. I feel the subject matter she decided to tackle was really just too much for a single book. A little less detail (or a little more editing!) in places would have really helped this book. Perhaps an abridged version for the passingly interested? For example I didn't much care about the family life of some of the scientists, descriptions of their romantic and personal lives didn't further the story for me. She has tried to make a Henrietta Lacks style personal story but the subject is too broad to have the same impact.

This is still a solid and interesting read though. Wadman explores how this branch of medicine quickly became an industry and what that has meant for us as consumers. She discusses the far reaching effect of how that financial factor has shaped the research and lead the discussion throughout the 20th century.

Thank you to Netgalley and the publisher for the ARC in return for an honest review.

[Tommy · Rating 5 out of 5]

Helen Lazear is known for her stellar book recommendations, and this one did not disappoint. With explicit description of all things rubella (a virus I worked on), taking place largely in Philly (future Tommy city), this had personal relevance and was super interesting. It is also very comprehensive, and it spends considerable time on the history of abortion, medical ethics in research, and cell culture. Highly recommend to anyone interested in those topics. Speaking of which, I am incredibly grateful I had the opportunity to read this book while visiting my fave stem-supremacist. Not only is Keshav super smart, but also a wonderful listener and friend. It’s easy to forget that the best part of reading books is chatting about them with others. I have no doubt that I will much more readily remember the place I was reading this (San Francisco is awesome) and person next to whom I was reading this (Keshav is awesome) than the actual content of the book.

[Keen Reader · Rating 3 out of 5]

“Rubella does not seem to invoke the fascination of thalidomide despite the fact that in a single epidemic in the United States it caused more birth defects in one year than thalidomide did during its entire time on the world market.”

Wadman charts the story of Leonard Hayflick, from his humble beginnings in Philadelphia to his time at Stanford at the other end of the country, and follows his battles, discoveries and controversies along the way. In a way the real story here begins with the aborted foetus belonging to a mysterious woman by the name of Mrs X from Sweden. Hayflick would adopt the use of these tissue cultures to create his WI-38 cells, or as Wadman describes them, “Lab grown human foetal cells as clean, safe, normal, non-cancerous micro-factories for making viral vaccines.” This would eventually revolutionise the study of virology and would play a significant part in billions of vaccines around the planet.

We learn that the word virus derives from the Latin, meaning ‘slimy fluid’. Wadman gives us a tour and description of many viruses, from the relatively tame Rhinoviruses (responsible for the cold), to the more terrifying and lesser seen, Filoviruses, which include the Marburg and Ebola virus. Although based primarily in the US, this is a journey that takes us to the UK, Iran, Sweden, Germany, Australia and sub-Saharan Africa, showing us just how global this subject is.

Wadman explores many of the viral histories, like the rubella epidemic in Australia in 1940, that would have a devastating effect on pregnant women, resulting in deafness, cataracts, microcephaly, heart defects and intellectual disability. An ophthalmologist by the name of Norman McAllister Greg, was the first person to recognise congenital rubella, but his findings were largely dismissed. It was only many years later when there were a number of serious rubella outbreaks throughout the northern hemisphere, that scientist would begin to take notice and action.

Another haunting statistic is never too far away, like, “Rabies is the most lethal infectious disease to afflict humans. Once a person develops symptoms, death virtually always follows.” In 2013 the WHO estimated the virus kills someone every nine to twenty minutes. In India alone it kills between 13’000-30’000 people every year. Hilary Koprowski described the vaccines available in 1966 as, “Indisputably the crudest biological products injected under the human skin.”

We learn of the many difficulties and tragedies associated with tackling viruses in 20th Century America, like the Cutter Incident. According to the JRSM, “California-based family firm of Cutter Laboratories, had caused 40 000 cases of polio, leaving 200 children with varying degrees of paralysis and killing 10.” SV40 has also come under suspicion, apparently, “More than 98 million Americans received one or more contaminated with SV40; it has been estimated that 10-30 million Americans could have received an SV40 contaminated dose.”

Though perhaps the most chilling case, was regarding Chester Southam. He became notorious amongst medical ethicists for injecting aggressive cancer cells into healthy prisoners at the Ohio State Penitentiary. He had also injected cancer cells into dying cancer patients in the 50s. This was by no means an isolated case, there were plenty more scientists doing plenty more experiments on unsuspecting patients in many places throughout the States, right through into the 70s when the Tuskegee syphilis experiment was uncovered in rural Alabama.

“Beginning in 1980, new laws and court decisions allowed biologists to make serious money on their inventions. The changes blurred the once sacred boundaries between business and biology, and by the early 1980s they were turning some biological scientists into wealthy men.” This was triggered by the Diamond v Chakrabarty case, and the Bayh-Dole Act that opened the floodgates for a new era of commercialisation and commodification. This would change the landscape permanently and basically lead to the start of the modern age of the biotechnology industry.

Wadman also highlights the potential fatal consequences when long established vaccine programmes are withdrawn, citing the case of the military stopping their Adenovirus shots, which resulted in the death of two young men. She also shows how religious extremism in the States can and has been such a barrier to progress, tolerance and acceptance and how this creates so many difficulties.

Unlike the accepted SV40 vaccine, Hayflick used human tissue and so was free from hidden viruses, unlike the vaccines derived from animals, such as puppy kidneys (which caused arthritis and other pains), or worse, monkey kidneys (later referred to as the ‘dirtiest organ known’ by one expert), which harboured many nasty viruses, including the ruthless Marburg virus. The relevant authorities were notoriously obdurate and refused to even consider Hayflick’s vaccine for many years, even though it was being used by millions in other countries around the world.

This was a really interesting and thoroughly researched piece of medical history. It’s largely accessible, though due to the subject, it does grow a little dry in areas, but overall this shows what a phenomenal job that vaccines have done, and will continue to do. It reminds us that regardless of presumed intelligence and time spent studying, scientists are just as fallible as anyone else, they make mistakes, their companies make profit, but more importantly they make progress, and it’s us who reap the fruits of this progress. The chances are you have received at least one vaccine containing Hayflick’s WI-38 cells. This book should also give food for thought, for those still resistant to the idea of MMR vaccinations.

[Michael · Rating 4 out of 5]

Much of the work done in tissue culture by the biologists discussed in the book was the exact sort of work I did working in a clinical virology laboratory for ten years. Also, I had rubella (as a toddler and not prenatally - I was too young for the vaccine). So, double whammy there. Pretty fascinating stuff, and scary to think what it took to develop polio and rubella vaccines in the first place.

I was much less interested in the parts involving litigation and such.

[Stacy · Rating 4 out of 5]

Wow what a great read! There was this great turning point about halfway through that totally engrossed me and I could not put this book down. I loved how focused this story was and I learned so many cool things from it that I will take with me as a little baby scientist ;) very well written and a great achievement of humanity.

[SueSue · Rating 5 out of 5]

Clear explanation of why and how fetal cells are used in the production of vaccines--surprisingly common, or at least surprising to me.
A good mix of science and the personal accounts of scientists at work. But also a DENSE read. I won't retain any of this unfortunately as there was just too much.

[Carl · Rating 4 out of 5]

A bit verbose, but it is worthwhile persevering. An exceptionally interesting book, not just for the science but also the politics and ethics of early vaccine development.

[Peter Lipták · Rating 5 out of 5]

Fascinujúce príbehy vývoja niektorých z najdôležitejších vakcín a ich tvorcov. Bunkové kultúry neboli nikdy také zaujímavé.

[Shelbycat · Rating 4 out of 5]

Really interesting reading.

[Ali Thomson]

Dense but also approachable for how scientific it is. The history of vaccine making is fascinating.

[Paulina Kąt · Rating 5 out of 5]

Absolutely fascinating

[Russell Atkinson · Rating 4 out of 5]

This nonfiction account of the spectacular and life-saving advances in vaccine development over the last fifty or so years is in some ways reminiscent of The Innovators: How a Group of Hackers, Geniuses and Geeks Created the Digital Revolution by Walter Isaacson. Until you see it set out before you, it is difficult to imagine or remember how much important history has passed in this field in just the last few decades.

The book begins and ends with Leonard Hayflick, a cell biologist credited with, among other things, discovery of the Hayflick Limit, an amorphous number that identifies how many times cells, especially human cells, can split and thus reproduce in a laboratory culture. In effect he established that non-cancerous cells cannot live and expand in culture indefinitely, which was in direct contradiction to the established wisdom of the day. He developed a human cell culture known as WI-38 that had the remarkable quality of being able to culture or reproduce in the lab multiple times without becoming cancerous or developing other anomalies. He promoted these cells vigorously for the purpose of researching cell aging, and, perhaps more importantly, for use in producing "clean" vaccines.

Hayflick was a controversial figure for several reasons. He was treated as hired help at the Wistar Institute where he worked culturing cells for the virus researchers, the supposed stars, a fact that he deeply resented. His discovery of cell death was not easily accepted by the scientific community, but more than that, it was his fateful, and questionable, decision to take the WI-38 cells he had developed with a government grant to his new position at Stanford University, and eventually to begin selling them through his own corporation. Some at the National Institutes of Health (NIH) considered him a thief while others saw him as an underappreciated scientist of outstanding ability.

The book is not a biography of Hayflick, however, although he is the central figure. Other virus researchers, doctors, biologists and bureaucrats are featured at length. The process of cell culture and vaccine development is described in considerable detail in language a layman like me can understand. I was awestruck at how complex the process is. Really top-notch science is required - hands-on lab work especially - and some risky experiments and testing that raise ethical questions. Experiments of the day involved inoculating subjects with untested vaccines, including live ones that could give him the disease. Subjects were often orphans, prisoners, soldiers, babies, the mentally deficient, and others who had little or no ability to consent. Many or even most were unaware that they were even test subjects. The diseases involved included polio, rubella (German measles), rabies, and adenovirus. The WI-38 cells were derived from an aborted fetus. It is clear that the field is replete with controversial and ethically troubling issues.

The writing is clear and workmanlike, if not particularly elegant. To my taste there was too much time spent on the upbringing and background of the various figures in the book when it should have focused more on the science. The author also had an irritating tendency to repeat. Virtually every time a vaccine or person was mentioned it was followed by clause informing us for the umpteenth time who or what that was. I'm not an idiot. I can remember the person who was just the subject of a long chapter twenty pages ago and mentioned fifty times earlier in the book. It made the book overlong. It also focused too much on the intellectual property controversy over the ownership of the WI-38 cells and Hayflick's alleged wrongdoing. He was, by all accounts, a star in the field of cell biology and a decent human being whose work led to the development of new or improved vaccines preventing thousands, perhaps millions, of deaths and other suffering, and to scientific advancements that brought Nobel prizes to others who built on his work. Still, all in all, it was a well-written book on an interesting subject.