How a heroic mass vaccination programme saved children of Hull from paralysis in an 'explosive' polio outbreak in 1961

In two autumns over 50 years apart, the city has lived in fear of a virus stalking its streets, and in both eras a new, relatively untested vaccine offered sudden hope.

Covid-19 may attack the respiratory organs and polio the nervous system - and the two viruses have very different clinical presentations - yet there are similarities between the two pandemics in that there was a vast spectrum of suffering common to both, with some of those infected barely affected, others facing a long period of recovery, and the most severe cases left fighting for their lives.

Polio could be fatal, but it is more commonly associated with the lifelong limb paralysis it caused in its unluckiest victims.

It was the scourge of cities in Europe and the USA in the first half of the 20th century, and Hull had had outbreaks in the 1940s and 50s. But by 1961, there had been no new cases for two years, after the Jonas Salk vaccine had been discovered in 1955. It appeared as if its threat was beginning to recede.

Yet that autumn the disease returned with a vengeance, felling children living in a concentrated area of streets near Hull Docks. There were 19 cases in just a few days and it was the most sudden and serious outbreak in the UK since 1959. The two-year-hiatus was down to the effects of the Salk programme, which involved the injection of a dead form of the virus and required 'top-ups' to be effective.

Like today, when Hull has England's highest Covid infection rate and 7,000 schoolchildren in the East Riding are isolating, the city was facing a public health crisis.

A second form of vaccination patented by Albert Sabin several years after Salk's discovery was a 'live' form of the virus, so it was considered more risky - yet it soon became apparent that it could be the only way of halting the Hull Docks outbreak. The Sabin vaccine was administered orally, via the 'sugar lump' method that was later to become famous.

Within days of Hull's sudden onset of cases, the Minister for Health announced that it would become the first city in western Europe to instigate a mass Sabin vaccination programme, with a target of 300,000 people to be immunised. It took less than a week for the city's officials to prepare schools and community buildings to be used as clinics, advertise the programme in the local press and recruit 3,000 volunteers.

It was thanks to Hull Council's medical officer, Dr Alexander Hutchison, that the city's children became the 'guinea pigs' - he knew about the Sabin oral vaccine and asked the government for permission to use it. At the time, it hadn't been deployed on a large scale, as there were still concerns over its safety, but he recognised that Salk's initial vaccine was not effective enough to control the outbreak.

Permission was granted on October 12, by which time there were 23 confirmed cases. The council gave themselves just five days to prepare the operation, and the newly-delivered vaccines were stored in the William Wright Docks cold storage unit normally used for fish. In the end, the vaccination centres were ready a day ahead of schedule and opened on the fourth day.

There were long queues outside churches, schools and even Hammond's department store, and in the end the target was exceeded by around 50,000 people and the RAF even had to air drop additional supplies of the vaccine to Hull. Tate and Lyle provided the sugar lumps for free.

Altogether, there had been 95 confirmed polio admissions to Castle Hill Hospital during the three-month outbreak, with two deaths but a large number of patients, many of them under the age of five, who suffered lifelong paralysis to varying degrees.

Around half of the cases were among children who had never had the Salk non-oral vaccine, and the pre-school age group did not tend to have been immunised. There were 17 children who were severely paralysed and seven with significant paralysis, and around 20 more with more minor limb deficiencies. Thirty-nine children recovered without paralysis. Some of them were sent to recuperate at a special polio hospital in Kirkbymoorside.

After the 10-day Sabin vaccination 'blitz', there were no further cases for 26 days afterwards, when two further cases were detected, but the outbreak petered out before Christmas.

The take-up rate was astonishing - it was actually more than the city's population at the time, suggesting people may have travelled from further afield to get vaccinated. And there was little patience with 'anti-vaxxers' - one woman who was vaccinated while at Newlands Girls' School remembers a fellow pupil whose family were Jehovah's Witnesses being told she could not return to the classroom until she had been vaccinated. Adults were immunised too, but children were the priority.

Dr Robb Robinson, a maritime historian at the University of Hull, was 10 years old and living in Hessle when he was vaccinated in 1961, and he remembers the urgency, efficiency and eventually relief that engulfed the city.

"There were lots of people involved from across the city and it just stopped the disease dead in its tracks. Everyone pulled together, as I'm quite sure they will this time round.

"Everybody was pulled in for the vaccine, and it was quite a treat - it was the first time I'd ever had a sugar lump! Since then, polio has come close to being eliminated, but back then it was the scourge of mankind.

"The outbreak was concentrated in the docklands, a lower income area, as many disease outbreaks are. I remember hearing about children who'd caught it, though none I knew personally did.

"An advantage Hull had was that as a port, it had a lot of cold storage facilities, warehouses where fish and fruit were kept, and these were used to store the vaccine."

Dr Robinson's maternal uncle had caught polio in the 1920s, so his mother was determined that her children would be protected.

"There was a lot of concern both in my family and the neighbourhood. I also remember there wasn't a lot of resistance to the idea, which is why I find it so hard to understand scepticism (towards Covid vaccines) today. Nobody refused, a high proportion of people had it. They realised the urgency and wanted to protect health and livelihoods."

Dr Robinson is also impressed with the foresight and dynamism of Dr Hutchison, who lobbied the government on behalf of the people of Hull.

"All tribute to him - it as a pioneering step, using oral vaccines on such a scale. It was organised effectively and very locally; they just got on and did it. Everything seems to be more centralised today, but this was a local initiative."

Hull had played its role in history - the Sabin oral vaccine was rolled out to the rest of the country and licensed a year later, and polio became a distant memory, though around 30,000 children infected during the 1940s and 50s are thought to be living with permanent disability caused by the virus. In 2020, polio is close to being only the second disease eradicated from the globe, after smallpox.

As Hull faces a second health emergency this autumn and its residents are told to pull together to save lives, it's worth remembering the incredible civic effort - and the support it generated - in 1961 that saved a generation from a bleak future.

What is polio?

Polio is spread by nasal and oral transmission and infected faeces. The infection spreads to the digestive tract and in 98 per cent of cases there are few symptoms.

However, it can pass into the bloodstream and from there attack the nervous system, causing paralysis and withered limbs. Some patients were placed in the notorious 'Iron Lung' to aid breathing, and polio was thus one of the most feared diseases of the 20th century. It mainly affected young children and teenagers, though the fatality rate is actually higher for adults - up to 30 per cent of sufferers.

Although polio had been around for millennia, it was isolated as a virus only in 1908. Epidemics became common in cities in the developed world from the late 19th century, as societies became more urbanised yet sanitation improved. In the earlier decades of industrialisation, when sanitation was poorer, it is thought that exposure to the virus was much more common and created high natural immunity, which began to decline once modern sewage systems were built. By the 1950s, the death rate was much higher than it had been in the past - over 3,000 died in a US outbreak in 1952 - and the worst-affected age group was children aged between five and nine, though a third of sufferers were over 15.

Europe has been polio-free since 2002 and today Afghanistan and Pakistan are thought to be the only countries where 'wild' polio is still circulating.