This review paper delves into Henrietta Lacks’ significant contributions to modern research and medicine, with a particular focus on her role in the creation of the polio vaccine. It also addresses social justice implications, highlighting her contributions through the HeLa cell line and examining ethical considerations surrounding her story. By connecting Lacks’ legacy to discussions about racial injustice in medical research, the paper underscores the intersection of science and social equity.

Antiquating the Iron Lung

Henrietta Lacks Defeats Polio!

Image Generated by A.I

From childhood to adulthood, we all face receiving a set of mandatory vaccinations. However, when faced with a nauseatingly long list of unfamiliar diseases, I rarely wonder – “Why am I getting this? What is this disease I’m getting vaccinated for?” This was the case for millions of people worldwide with the Poliomyelitis (Polio) virus its near eradication in late 20^th century. Routine polio vaccinations were given to countless Americans as early as 2 months old through 6 years old with most people being unaware either why they got it or if they got it at all. Much like the unfamiliarity with polio, very few know Henrietta Lacks’ contributions to Polio and countless other scientific advancements (Beskow, 2016). The case of Henrietta Lacks’ cells (known as HeLa cells) being unethically procured and used without her consent stands as a landmark illustration of systemic racism within healthcare and research. This has led to a historical disregard for her significant role in the successful efforts towards polio eradication. With polio cases resurfacing, it becomes increasingly crucial to comprehend the historical context surrounding the vaccine and virus, emphasizing the need for broader awareness and education.

Polio is an infectious disease caused by the poliovirus, and it primarily affects peoples’ nerves in their spine and brain (Mayo 2023). While many people infected with polio do not show any symptoms, some experience flu- and cold-like symptoms such as fever, headache, muscle aches, sore throat, and fatigue. However, what made polio a terrifying disease throughout the late 20^th century was its ability to spread quickly cause paralysis, severe breathing trouble, and even death in severe cases (Mayo, 2023).

Figure 1. Iron lung (c. 1933) used to “breathe” for polio patients until 1955 when polio vaccine became available is located in the Mobile Medical Museum, Mobile, Alabama (Highsmith, 2010)

The history of polio in the United States is made up of several breakouts throughout the 20^th century. Small polio epidemics began in the early 1900s, but it wasn’t until the late 1940s and early 1950s that polio reached epidemic proportions on a frightening scale (Kumerfield, 2017). The polio outbreak in 1952 became the worst epidemic in the nation’s history, where polio peaked with 58,000 cases reported and more than 21,000 severe cases with paralysis (Kumerfield, 2017). Straight out of a Frankenstein movie, the iron lung was created in the 1930s as a mechanical device that would breathe for polio patients suffering from paralysis. Like a casket, the patient would lay flat inside this long metal tube, with only their head sticking out at the top. The machine would breathe for the patient, and the patients would be able to eat, drink, and have physiotherapy performed on them as they lay paralyzed (Barr, 2010). In the segregated health system of the early to mid-20^th century there were few effective treatments in eradicating polio. White children often got the bulk of the care as black and other “primitive” races were seen as less susceptible to polio while white bodies were considered “delicate” (Rogers 2007). It wasn’t until the introduction of effective vaccines such as the inactivated polio vaccine (IPV) in 1955 and oral poliovirus vaccine (OPV) in 1961 did polio cases indiscriminately decline rapidly (CDC, 2021). With mass vaccination, polio was eventually eradicated in the U.S and prevented nearly all around the world with the last case of wild polio in the U.S being in 1979 (CDC, 2021).

Considering the significance of the creation of the vaccine in ending the threat of polio, there are extremely few people that know how it was discovered. Dr. Jonas Salk developed the first successful IPV vaccine in 1953 which was authorized for use in 1955 while Dr. Albert Sabin is credited with developing the OPV that played a key role in nearly eradicating the disease by 1994 (Mayo, 2023). However, what made both of these innovations possible was the use of Henrietta Lacks’ HeLa cells. Henrietta Lacks was an African American woman who was infected with the human papillomavirus (HPV), a sexually transmitted disease that increases the risk for cervical cancer like in Lacks’ case (Beskow, 2016). Her cells were harvested and stored without her consent, where it was discovered that because of her HPV, they had the one in a billion mutation to be able to multiply continuously without dying out (Beskow, 2016). This was essential as cells usually last only 24 hours before they die, and even though they continuously multiply it takes a lot of resources to maintain them until each line eventually dies out (Beskow, 2016). The implications this had for scientific research quickly led to mass commercialization and distribution of the HeLa cells without any credit or compensation given to Henrietta Lacks and her family. Her cells have been pivotal in a myriad of significant breakthroughs, including the recent COVID vaccine, numerous cancer therapies, and in vitro fertilization. Despite this, her name remains unrecognized by many who utilize the advancements made possible by her cells, and this exploitation has led to distrust in minority communities surrounding science (Terrance et al., 2023).

The HeLa cells were used to create the polio vaccine as they in suspension they could be handled with greater efficiency than other cell samples (Scherer et al., 1953). By injecting HeLa cells with the poliovirus strain, researchers were able to study the mechanisms the virus uses to destroy cells as the HeLa cells underwent relatively slower progressive destruction (Scherer et al, 1953). While they were slow in destruction, when infected the HeLa cells produced at a very fast rate, and when given samples of a vaccine they were able to produce antibodies at an equally fast rate (Scherer et al., 1953). The HeLa cells were an inexpensive and efficient means of studying the effects of the poliomyelitis virus, and a vaccine was able to be made because of their unique properties.

Ultimately, the cells of Henrietta Lacks have played an essential role in medical advancements. They were crucial in the development of the polio vaccine, as they were used for quantifying the virus, measuring specific antibodies to the poliomyelitis virus using the tissue culture-neutralization technique, and producing the virus for various purposes, such as serving as antigens for complement fixation (Scherer et al., 1953). Due to factors such as lack of resources in some countries coupled with decisions to delay or defer vaccinations, such childhood illnesses like polio and measles have made a resurgence in recent years (Dreisinger & Lim, 2019). This has emphasized the relevance and history of the polio vaccine, and the need to inform people why it is essential to vaccinate their children and how these vaccines are made, particularly in minority communities where mistrust is prevalent surrounding research. The contributions of HeLa cells to the creation of the polio vaccine have not only revolutionized our understanding of these complex biological processes but also paved the way for future innovations in virology and immunology. Despite her name being unknown to many, the impact of Henrietta Lacks’ cells on modern medicine and structural racism in science is undeniable and continues to benefit humanity.

References

Barr M. (2010). The iron lung – a polio patient’s story. Journal of the Royal Society of       Medicine, 103(6), 256–259. https://doi.org/10.1258/jrsm.2010.100003

Beskow L. M. (2016). Lessons from HeLa Cells: The Ethics and Policy of Biospecimens. Annual            review of genomics and human genetics, 17, 395–417. https://doi.org/10.1146/annurev-       genom-083115-022536

Centers for Disease Control and Prevention. (2021). Poliomyelitis. In Epidemiology and   Prevention of Vaccine-Preventable Diseases (The Pink Book). Retrieved from            https://www.cdc.gov/vaccines/pubs/pinkbook/polio.html

Dreisinger, N., & Lim, C. A. (2019). Resurgence of Vaccine-Preventable Disease: Ethics in the                Pediatric Emergency Department. Pediatric emergency care, 35(9), 651–653.      https://doi.org/10.1097/PEC.0000000000001917

Highsmith, C. M., photographer. (2010) Iron lungused to “breathe” for polio patients until 1955 when polio vaccine became available is located in the Mobile Medical Museum, Mobile,        Alabama. Mobile United States Alabama, 2010. [Photograph] Retrieved from the Library             of Congress, https://www.loc.gov/item/2010637071/.

Kumerfield, C. (2017, August 22). Remembering the polio epidemic of the 1950s: Part I. Argus   Leader. https://www.argusleader.com/story/news/dell-rapids/2017/08/22/remembering-      polio-epidemic-part/104718400/

Mayo Foundation for Medical Education and Research. (2023, January 5). Polio. Mayo Clinic.    https://www.mayoclinic.org/diseases-conditions/polio/symptoms-causes/syc-20376512

Rogers N. (2007). Race and the politics of polio: Warm Springs, Tuskegee, and the March of       Dimes. American journal of public health, 97(5), 784–795.         https://doi.org/10.2105/AJPH.2006.095406

SCHERER, W. F., SYVERTON, J. T., & GEY, G. O. (1953). Studies on the propagation in vitro of poliomyelitis viruses. IV. Viral multiplication in a stable strain of human malignant             epithelial cells (strain HeLa) derived from an epidermoid carcinoma of the cervix. The     Journal of experimental medicine, 97(5), 695–710. https://doi.org/10.1084/jem.97.5.695

Terrance, T. C., Sugarwala, L., McIntosh, S., Bisbee-Burrows, M., Castillejo, L., Evans, A., …     Cullen, J. P. (2023). Structural racism in healthcare and research: A community-led model     of curriculum development and implementation. Journal of Clinical and Translational             Science, 7(1), e18. doi:10.1017/cts.2022.499

Below is the initial drafting process (Submitted as Homework Post #4) for the Informative Review Paper, which involved selecting the topic and planning out the nuances and strategies that would be needed to write a paper involving the persistent structural racism within science and research.

1. What is the science topic/advancement described in the article and why did you select the topic? How might it be derived from studying HeLa cells?

The article/topic I selected discusses the use of HeLa cells in the discovery of a vaccine for the polio virus. I selected the topic of the polio virus because of its relevance and historical significance in medicine, as there had been several polio epidemics in the 19th and 20th centuries. Henrietta Lacks’ HeLa cells were groundbreaking in their one in a billion mutation to be able to continuously replicate in laboratory, which would allow for quick replication of genetic material used for the development of vaccines.

2. Why would the general public be interested in the science advancement?

The general public would be interested in the development of the polio vaccine because of its the major public health impact and historical significance. Polio was once a widespread and devastating disease that was extremely feared. The development of a successful vaccine for it represents a significant advancement in public health. Furthermore, it is also a landmark achievement as the disease was nearly completely eradicated. Many people have received the vaccine without knowing what its significance was, so understanding how HeLa cells contributed to these achievements highlights the role of biomedical research.

3. How does the writer inform readers about the topic without taking a position? Is the writer taking a position? Explain.

The writer does a very good job of presenting the topic in a very objective manner. The writer doesn’t really take a position on anything and uses facts and data to provide a sequence of events for each step of the advancement. They detail through figures, data tables, and prose how the poliomyelitis virus destroyed the HeLa cells and how the HeLa cells were capable of producing large quantities of the virus. This approach helps to enhance the clarity and credibility of the article, allowing readers to follow the scientific processes involved in the research.

4. What type of adaptive measures the writer uses to convey scientific concepts to readers? Are they effective? Explain.

The article is overall very heavy in its use of scientific jargon to discuss viral multiplication in HeLa cells. However, it makes good use of visual aids and simplification in order to convey these scientific concepts to readers. The article utilizes basic graphs and tables in order to illustrate the data that the article references. Furthermore, they provide a simplification in each discussion, for instance using a list to describe the results of the experiments:
“The experiments demonstrate further that strain HeLa cells can easily, inexpensively, and effectively be employed (a) for the quantification of virus, (b) for the measurement of specific antibody to poliomyelitis virus by the tissue culture-neutralization, and (c) for the production of virus for a variety of purposes, for example, to serve as antigens for complement fixation.”

5. What type of audience is likely to read the article? How would you present the science topic to your mother/father or grandparents?

The type of audiences that are likely to read the article are science enthusiasts with interest in research, people studying the history of medicine, and the general public that are trying to learn more about public health. In presenting this topic to my parents or grandparents, who may not have a background in science, I would focus on simplifying the concepts and referring to the visual aids used in the article to make sense of the information. In my case, my family would also have the additional language barrier, so it would be important to find a way to translate the content in an understandable manner.

6. What reservations or concerns people might have about the science topic? Does the writer address these/or any concerns?

The primary ethical concern people might have about the topic is the use of Henrietta Lacks’ cells without informed consent and proper authorization. Her story raises many questions about patient rights and privacy and how well ethics are upheld in the context of biomedical research. They would also have reservations about the long-term implications of using the advancements for commercialization, and the long-term implications of the vaccine and how it was made.

7. Do you think the treatment/advancement described in the article is economically accessible to all people who might need it? Explain.

I think that the polio vaccine created from the HeLa cells was and is economically accessible to all of the people who might need it. This is because there was a severe epidemic and the primary goal of developing the vaccine was to eradicate the disease, so the goal would be to inoculate as many people around the world as possible despite the cost. Furthermore, the article mentions that with the use of HeLa cells it was inexpensive to create the advancement, making it economically accessible to the majority of populations.