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Published online by Cambridge University Press: 04 February 2025
As an industrial science, vaccinology is susceptible to changing social, economic and political frameworks. This article reconstructs the history of the birth of the Sabin strains-derived inactivated polio vaccine (sIPV) in China. The development of this nascent vaccine can be attributed first and foremost to the circulation of knowledge and technology in the global polio research network of the 1980s, before the privatization of vaccine manufacturing and the escalation of intellectual-property protections. Tracing correspondence between Jonas Salk and a Chinese scientist, Jiang Shude, and his colleagues, we chart how institutional efforts in search of a profitable product and scientists’ motives in pursuing personal careers in the post-socialist reform era led to collaboration on many levels, centered around polio vaccines. In response to recent polio history research, we also emphasize the impact of multiple temporalities of polio dramaturgy on the vaccine manufacturer, as this article demonstrates how the confluence of shifting global polio eradication agendas and contingencies in complex vaccinology undertakings ironically helped to materialize the idea of the sIPV. Finally, stories of vaccines and scientists in China add compelling subplots to the global polio history, which reveals the need to reconsider the politicization of imported technology in broader socialist contexts.
A letter dated ‘3 June 1986’ was mailed from Jonas Salk to Jiang Shude (姜述德). Jiang had been an unknown vaccinologist working at the Institute of Medical Biology (IMB) in Flower Red Cave in the Western Hills of Kunming, in south-western China. Salk had visited two years earlier to discuss the feasibility of the IMB's proposal to manufacture inactivated polio vaccine (IPV). The initial collaborative plan had come to a halt by the time Salk wrote the letter to Jiang; still, he kindly offered Jiang an opportunity to travel to Bilthoven and then Lyon to learn IPV-related technology with a generous $10,000 grant for his one-year stay in Europe.1
1 Jonas Salk to Jiang Shude, 3 June 1986, Jonas Salk Paper, UC San Diego Special Collections & Archives, San Diego (subsequently JSP), Box 662, Folder 3.
2 Japan was the first country to approve the use of the sIPV–DTaP (a combination vaccine containing sIPV–diphtheria–tetanus–acellular pertussis), in November 2012, while the world's first stand-alone sIPV was the one the IMB launched in 2015. See Shimizu, Hiroyuki, ‘Development and introduction of inactivated poliovirus vaccines derived from sabin strains in Japan’, Vaccine (2016) 34(16), pp. 1975–85Google ScholarPubMed; Sutter, Roland W., Okayasu, Hiro and Kieny, Marie-Paule, ‘Next generation inactivated poliovirus vaccine: the future has arrived’, Clinical Infectious Diseases (2017) 64(10), pp. 1326–7CrossRefGoogle ScholarPubMed.
3 Vargha, Dóra, ‘Reconsidering the dramaturgy’, Bulletin of the History of Medicine (2020) 94(4), pp. 690–8CrossRefGoogle ScholarPubMed.
4 Blume, Stuart and Geesink, Ingrid, ‘Vaccinology: an industrial science?’, Science as Culture (2000) 9(1), pp. 41–72, 69Google Scholar.
5 Rosenberg, Clifford, ‘The international politics of vaccine testing in interwar Algiers’, American Historical Review (2012) 117(3), pp. 671–97CrossRefGoogle Scholar; Brazelton, Mary Augusta, Mass Vaccination: Citizens’ Bodies and State Power in Modern China, Ithaca, NY: Cornell University Press, 2019Google Scholar; Vargha, Dóra, Polio across the Iron Curtain: Hungary's Cold War with an Epidemic, Cambridge: Cambridge University Press, 2018CrossRefGoogle ScholarPubMed.
6 For more on the privatization of vaccine production at the Rijksinstituut voor Volksgezondheid en Milieuhygiene (RIVM) see Blume, Stuart, ‘The erosion of public sector vaccine production: the case of the Netherlands’, in Holmberg, Christine, Blume, Stuart and Greenough, Paul (eds.), The Politics of Vaccination: A Global History, Manchester: Manchester University Press, 2017, pp. 148–73CrossRefGoogle Scholar; Hendriks, Jan, ‘The privatization of societal vaccinology in the Netherlands’, in Blume, Stuart and Baylac-Paouly, Baptiste (eds.), Immunization and States: The Politics of Making Vaccines, New York: Routledge, 2021, pp. 20–43CrossRefGoogle Scholar. For an overview of China's post-socialist reform characterized by marketization, political liberalization and individualization see Yan, Yunxiang, ‘The Chinese path to individualization’, British Journal of Sociology (2010) 61(3), pp. 489–512CrossRefGoogle ScholarPubMed.
7 The majority of the historiography on polio has been in the American context. For examples see Smith, Jean S., Patenting the Sun: Polio and the Salk Vaccine, New York: W. Morrow, 1990Google Scholar; David M Oshinsky, Polio: An American Story, Oxford and New York: Oxford University Press, 2005. For further reading on recent studies of the global history of polio see Baylac-Paouly, Baptiste, Caballero, María-Victoria and Porras, María-Isabel, ‘Mobilising through vaccination: the case of polio in France (1950–60s)’, Medical History (2022) 66(2), pp. 135–54CrossRefGoogle Scholar; Renne, Elisha P., The Politics of Polio in Northern Nigeria, Bloomington: Indiana University Press, 2010Google Scholar.
8 The VAPP (vaccine-associated paralytic polio) was recognized in the early 1960s. Its incidence was one case per 2.9 million OPV doses distributed in the US from 1990 to 1999. See Henderson, D.A., Morris, J.J. Witte, L. and Langmuir, A.D., ‘Paralytic disease associated with oral polio vaccines’, Journal of the American Medical Association (1964) 190(1), pp. 41–8Google ScholarPubMed. The cVDPV has been an evident problem in many countries of the global South with a history of mass use of OPV. See Kew, O.M., Wright, P.F., Agol, V.I., Delpeyroux, F., Shimizu, H., Nathanson, N. and Pallansch, M.A., ‘Circulating vaccine-derived polioviruses: current state of knowledge’, Bulletin of the World Health Organization (2004) 82, pp. 16–23Google ScholarPubMed.
9 Baylac-Paouly, Baptiste, Hendriks, Jan and Blume, Stuart, ‘Polio vaccine struggles: FAIR and the failed reintroduction of inactivated polio vaccine, 1975–1985’, Social History of Medicine (2021) 35(1), pp. 1–19CrossRefGoogle Scholar. For more on FAIR see also Blume, Stuart S., ‘Lock in, the state and vaccine development: lessons from the history of the polio vaccines’, Research Policy (2005) 34(2), pp. 159–73CrossRefGoogle Scholar.
10 Vargha, op. cit. (5), pp. 147–79.
11 Jones, David S. and Sivaramakrishnan, Kavita, ‘Making heart–lung machines work in India: imports, indigenous innovation and the challenge of replicating cardiac surgery in Bombay, 1952–1962’, Social Studies of Science (2018) 48(4), pp. 507–39, 508CrossRefGoogle ScholarPubMed.
12 M.P. Chumakov, M.K. Voroshilova, S.G. Drozdov, S.G. Dzagurov, V.A. Lashkevich, L.L. Mironova, N.M. Ralph, A.V. Gagarina, E.E. Ashmarina, G.A. Shirman, G.P. Fleer, E.A. Tolskaya, I.S. Sokolova, L.B. Elbert and K.M. Sinyak, ‘Some results of the work on mass immunization in the Soviet Union with live poliovirus vaccine prepared from Sabin strains’, Bulletin of the World Health Organization (1961) 25(1), pp. 79–91. The story of Gu Fangzhou introducing OPV to China is also mentioned briefly elsewhere. See Brazelton, op. cit. (5), pp. 148–51; Jun Wu, Dexiang Dong and Ying Li, ‘Just for Chinese people's stood up: Prof. Fangzhou Gu, father of “sugar pills”’, Protein & Cell (2020) 11(4), pp. 231–4.
13 Vargha, op. cit. (5), pp. 165–6.
14 For further information on rhesus monkeys in polio research see Tara Suri, ‘Between simians and cell lines: rhesus monkeys, polio research, and the geopolitics of tissue culture (1934–1954)’, Journal of the History of Biology (2022) 55(1), pp. 115–46.
15 Ministry of Health, ‘Notice regarding the trial-use of the attenuated live polio vaccine (1960)’, in Department of Disease Control of the Ministry of Health of the People's Republic of China (eds.), Vaccination in China: Compilation of Documents on Planned Immunization 1949.7~1993.12 (First Volume), Beijing: unpublished, 1994, pp. 63–5.
16 Sigrid Schmalzer, ‘Self-reliant science: the impact of the Cold War on science in socialist China’, in Naomi Oreskes and John Krige (eds.), Science and Technology in the Global Cold War, Cambridge, MA: MIT Press, 2014, pp. 75–106.
17 Gu Fangzhou, Commemoration of the 40th Anniversary of the Institute of Medical Biology, special issue, Bulletin of Chinese Academy of Medical Sciences, 21 October 1998, p. 2, Jiang's Family Archival Collection, Kunming, (subsequently JFAC), unsorted.
18 In the Wade–Giles system, Gu's name is romanized as Ku Fang-chou, which has been used in several of his authored articles. F. Ku, P. Chang, Y. Cheng, H. Ch'en, Y. Shen, M. Wu, C. Mao and H. Li, ‘A large-scale trial with live poliovirus vaccine (Sabin's strain) prepared in China’, Chinese Medical Journal (1963) 82(3), pp. 131–7.
19 Interview with Yang Zhihe, Kunming, 22 November 2021.
20 Tao Hong, Zhifang Wang and Xuefen De, ‘Problems regarding freezing package of biologicals’, Chinese Jorunal of Biologicals (1999) 12(4), pp. 250–1.
21 Shanxi Provincial Health and Epidemic Prevention Station and Kunming Institute of Medical Biology (eds.), A Compilation of Materials of the 1971 Polio Prevention Workshop, Kunming: unpublished, 1972.
22 Sigrid Schmalzer, ‘Yuan Longping, hybrid rice, and the meaning of science in the Cultural Revolution and beyond’, Endeavour (2017) 41(3), pp. 94–101.
23 A recent Chinese children's picture book, part of a series titled The Most Beautiful Strugglers, written for moral and character education purposes, omits Gu's trip to the Soviet Union. In it, Gu is described as the sole player who developed the oral polio vaccine in Kunming, and none of his colleagues’ names are mentioned. See Wu Meizhen Studio (eds.) and Ran Shaodan (illustrator), ‘The Candy Dragée Grandpa’: Gu Fangzhou, Beijing: Dolphin Books, 2021.
24 Xu Yuan, The Call of Duty: Biography of Gu Fangzhou, Nanjing: Jiangsu People's Press, 2016, p. 121.
25 The official narrative of Gu's story reached broader audiences in China after the broadcast of Touching China, a popular annual television programme in which individuals who touched China with their good deeds receive an award (Gu was an awardee in 2019). See China Central Television (CCTV-1), Touching China 2019 Awards Ceremony, at https://tv.cctv.com/2021/08/25/VIDEkeeWf4Z2ypu7jzRbzSA4210825.shtml (accessed 1 August 2024). Gu's story was even recommended as an example of Chinese essay writing for China's college entrance examination. A training book on essay writing for the exam states that high-school students should memorize typical stories that are relevant to the present hot topics. A writing example in the book is a paragraph-long chronicle of Gu. It is inflected with the goal of establishing him as a role model of ‘dream and belief’ for Chinese youth, and again it does not mention the international facets of his story. See Long Xiaotong and Li Qi (eds.), Training by Master Teachers: Step-by-Step Breakthroughs for Essay-Writing Examination, Beijing: Beijing Yanshan Press, 2021, p. 156–7.
26 F. Ku, D. Dong, O. Shi, J. Niu and H. Yang, ‘Poliomyelitis in China’, Journal of Infectious Diseases (1982) 146(4), pp. 552–7.
27 Dali Ma, ‘Boundary repair: science and enterprise at the Chinese Academy of Sciences’, Social Studies of Science (2019) 49(3), pp. 381–402.
28 Zhao Kai and Zhang Yihao, A Brief History of the Development of Biological Products in China 1910–1990, Beijing: National Vaccine and Serum Institute, 2003, p. 32.
29 Interview, op. cit. (19).
30 Interview with Jiang Kunyuan, Kunming, 9 February 2022.
31 For more on the 85 per cent coverage rate in China see Maggie Black, Children First: The Story of Unicef, Past and Present, Oxford and New York: Oxford University Press, 1996, p. 47.
32 For more on the hepatitis B vaccine see Louis Galambos and Jane Eliot Sewell, Networks of Innovation: Vaccine Development at Merck, Sharp & Dohme, and Mulford, 1895–1995, Cambridge: Cambridge University Press, 1995, pp. 221–2.
33 Ministry of Health, ‘A pilot plan for national plasma-derived hepatitis B vaccine immunization (1987)’, in Department of Disease Control of the Ministry of Health of the People's Republic of China, op. cit. (15), pp. 264–8.
34 State Planning Commission, ‘Notice of state planning commission on the adjustment of prices of some biological products (1996)’, in Wang Xiuzhen (ed.), Manual for Price Regulation and Management Policy in Shenyang, Shenyang: Commodity Price Bureau of Shenyang, 1998, pp. 183–5.
35 Zhao and Zhang, op. cit. (28), p. 41.
36 Guo Ren, ‘Suggested draft’, 25 September 1984, JSP, Box 662, Folder 3.
37 William T. Liu to Jonas Salk, 8 August 1984, JSP, Box 673, Folder 2.
38 Assitant to Jonas Salk to William T. Liu, 16 October 1984, JSP, Box 673, Folder 2. For more on Salk's interest in architecture see Charlotte DeCroes Jacobs, Jonas Salk: A Life, New York: Oxford University Press, 2015, pp. 251–62.
39 World Bank, Implementation Completion Report: China – Rural Health & Preventative Medicine (English), Washington, DC: World Bank Group, 1999, pp. ii, 9–10.
40 Blume, op. cit. (6), p. 166.
41 Zhao and Zhang, op. cit. (28), p. 39.
42 André Prost, ‘Office memorandum: China – identification of the second health project’, 13 August 1984, JSP, Box 662, Folder 3.
43 Guo Ren and Dong Dexiang, ‘The plan concerning the production of inactivated polio vaccine’, 4 October 1984, JSP, Box 662, Folder 3.
44 Guo Ren to Jonas Salk, 5 November 1984, JSP, Box 662, Folder 3.
45 Institut Mérieux, ‘Delegation Chinoise en France 17–21 Dec’, 1984, JSP, Box 662, Folder 3.
46 Jonas Salk to Guo Ren, 30 November 1984, JSP, Box 662, Folder 3.
47 Jonas Salk and Darrell Salk, ‘Control of influenza and poliomyelitis with killed virus vaccines’, Science (1977) 195(4281), pp. 834–47; P. Stoeckel, M. Schlumberger, G. Parent, B. Maire, A. van Wezel, G. van Steenis, A. Evans and D. Salk, ‘Use of killed poliovirus vaccine in a routine immunization program in West Africa’, Reviews of Infectious Diseases (1984) 6(S2), pp. s463–66.
48 Jonas Salk to Guo Ren, 19 October 1984, JSP, Box 662, Folder 3.
49 Prost, op. cit. (42).
50 Salk, op. cit. (48).
51 Jonas Salk to Guo Ren, 7 January 1985, JSP, Box 662, Folder 3.
52 Jonas Salk to Guo Ren, 6 Feburary 1985, JSP, Box 662, Folder 3.
53 For more on welfare housing in China see Zhang Li, In Search of Paradise: Middle-Class Living in a Chinese Metropolis, Ithaca, NY: Cornell University Press, 2018, pp. 26–51.
54 Interview, op. cit. (30).
55 Dong Dexiang to Jonas Salk, 6 June 1985, JSP, Box 662, Folder 3; Dorothy M. Horstmann, ‘Control of poliomyelitis: a continuing paradox’, Journal of Infectious Diseases (1982) 146(4), pp. 540–51.
56 Investigation Group of the Ministry of Health, ‘Investigation report on the 1986 polio outbreak in Guangxi Zhuang Autonomous Region’, Guangxi Medical Journal (1988) 6, pp. 335–7.
57 Nong Liang was Jiang's first master's-degree student, and focused on the sIPV research. See Q. Xiao, Z. An, C. Yue, Y. Ge, P. Liu, H. Pan, L. Liu, R. Jiang, Y. Li and Y. Wang, ‘Innovative vaccines in China’, in Xiaofeng Liang (ed.), Immunization Program in China, Singapore: Springer, 2019, pp. 55–85.
58 Interview, op. cit. (30).
59 Jacobs, op. cit. (38), p. 101.
60 Shude Jiang, David Pye and John C. Cox, ‘Inactivation of poliovirus with β-propiolactone’, Journal of Biological Standardization (1986) 14(2), pp. 103–9.
61 Huang Xiaodong, Macroeconomic Effects of China's Foreign Exchange Reserve Growth, Shanghai: Shanghai Academy of Social Sciences Press, 2016, pp. 102–5; General Office of the Central Committee of the Communist Party of China and General Office of the State Council, ‘Notice on restraining the indiscriminate overseas business travel’, in Editorial Board of the Complete Book of Laws and Regulations of the People's Republic of China (eds.), The Complete Book of Laws and Regulations of the People's Republic of China, vol. 3, Beijing: China Democracy and Law Press, 1986, pp. 698–9.
62 Jiang Shude to Jonas Salk, 19 November 1985, JSP, Box 662, Folder 3.
63 Ulrich Krech, ‘The antigenic potency of non-infectious poliomyelitis virus as determined by its liberating effect on active virus neutralized by immune serum’, Journal of Experimental Medicine (1955) 101(3), pp. 331–9; Jonas Salk to E.J. Ruitenberg, 26 September 1986, JSP, Box 662, Folder 3.
64 Jonas Salk to Jiang Shude, 8 January 1985; Jonas Salk to Jiang Shude, 26 September 1986, JSP, Box 662, Folder 3.
65 Ph. Stoeckel to Jiang Shude, 4 December 1987, JSP, Box 662, Folder 3.
66 Jonas Salk to Jiang Shude, 12 October 1987, JSP, Box 662, Folder 3.
67 Jiang Shude to Jonas Salk, 14 December 1988, JSP, Box 662, Folder 3.
68 Jonas Salk to Jiang Shude, 12 January 1989, JSP, Box 662, Folder 3.
69 Jiang Shude to Jonas Salk, 14 April 1989, JSP, Box 662, Folder 3.
70 The Chinese government accused the Voice of America of fomenting the student-led demonstration in June 1989. Dingxin Zhao, The Power of Tiananmen: State–Society Relations and the 1989 Beijing Student Movement, Chicago and London: University of Chicago Press, 2001, pp. 303–4.
71 World Bank, op. cit. (39), p. ii.
72 Jiang Shude to Jonas Salk, 7 May 1986, JSP, Box 662, Folder 3.
73 J.C. Petricciani, ‘The acceptability of continuous cell lines: a personal & historical perspective’, Cytotechnology (1995) 18(1–2), pp. 9–13.
74 Hendriks, op. cit. (6), p. 39.
75 Jiang Shude, ‘Constructive suggestions on the World Bank project’, c.2000, JFAC, unsorted.
76 van Wezel, A.L., Steenis, G. van, van der Marel, P. and Osterhaus, A.D., ‘Inactivated poliovirus vaccine: current production methods and new developments’, Reviews of Infectious Diseases (1984) 6(S2), pp. s335–40CrossRefGoogle ScholarPubMed.
77 World Bank, op. cit. (39), pp. 2, 7.
78 IMB Vaccine Production and Research Department, ‘Accuracy tests of imported and domestically made plastic eye-drop tubes for vaccines’, 1996, JFAC, unsorted.
79 Jackie Fournier-Caruana, ‘A report of the visit to the Kunming Institue’, 2002, JFAC, unsorted.
80 Sabin-IPV Project Team, ‘Development of an inactivated polio vaccine based on attenuated virus strains’, 2000, JFAC, unsorted.
81 Blume, op. cit. (6), pp. 162–3.
82 Ho, Denise Y., ‘Oysterman and refugee: Hong Kong and China between the tides, 1949–1997’, American Historical Review (2023) 128(2), pp. 561–87CrossRefGoogle Scholar.
83 Baylac-Paouly, Hendriks and Blume, op. cit. (9).
84 In Fang Xiaoping's study, barefoot doctors were paid a monthly subsidy by the village where they vaccinated children. See Fang Xiaoping, Barefoot Doctors and Western Medicine in China, Rochester: University of Rochester Press, 2012, pp. 174–5.
85 Huzair, Farah and Sturdy, Steve, ‘Biotechnology and the transformation of vaccine innovation: the case of the hepatitis B vaccines 1968–2000’, Studies in History and Philosophy of Science Part C: Studies in History and Philosophy of Biological and Biomedical Sciences (2017) 64, pp. 11–21CrossRefGoogle ScholarPubMed.
86 For more on neoliberal medical science in areas other than vaccination in China see Greenhalgh, Susan, ‘Neoliberal science, Chinese style: making and managing the “obesity epidemic”’, Social Studies of Science (2016) 46(4), pp. 485–510Google ScholarPubMed.