In September 1957—two years after church bells rang in celebration of the new polio vaccine, two years after people rejoiced in the streets, two years after Americans began lining up for their shots—the proportion of children fully vaccinated against polio remained at about 50 percent.
Supply was not the problem. Nor were doubts about the vaccine’s safety or efficacy, concluded a report from around that time by the National Foundation for Infantile Paralysis, now known as the March of Dimes, which had funded research into the vaccine. But the “initial excitement” had nevertheless “faded,” and vaccine proponents found themselves in an incremental slog to reach the remaining unvaccinated Americans. Well into the 1960s, doctors held “Sabin Oral Sundays,” dispensing sugar cubes dosed with a drop of the oral vaccine invented by Albert Sabin. It would ultimately take more than two decades to go from ringing church bells to polio eradication in the U.S.
Today, with COVID vaccinations stalled and rates in children particularly low, the COVID vaccination campaign has drawn comparisons, usually unfavorable, to that for polio. But history has a way of flattening lengths of time. Vaccine uptake in children has never been immediately universal—not for polio, not for measles, chickenpox, HPV, or any other childhood shot. In the past, vaccines have routinely taken years to go from FDA approval to being mandated in schools to high vaccination rates. COVID vaccines, meanwhile, have been available for kids under 16 for mere months, and only under emergency use. In this time, the most enthusiastic have gotten their two shots, amounting to some 26 percent of children ages 5 to 11 and 57 percent of teens ages 12 to 17. These rates, which are so far below that of adults that they suggest many vaccinated parents aren’t vaccinating their kids yet, have already prompted much hand-wringing for being too low.
But every successful vaccination campaign has had to go beyond the most enthusiastic—to reach for the parents who are indifferent or hesitant, those who might not have the time or easy access to doctors. In the past, a combination of persuasion and mandates has eventually managed to accomplish this, but both tactics have their limits. Three historical examples—polio, measles, and HPV—are instructive here. No past vaccine is a perfect analogue for COVID, but each illuminates the challenges of a task as gargantuan as trying to immunize every child in America.