Health
How Lagging Vaccination Could Lead to a Polio Resurgence
Most American parents hardly give thought to polio beyond the instant their child is immunized against the disease. But there was a time in this country when polio paralyzed 20,000 people in a year, killing many of them.
Vaccines turned the tide against the virus. Over the past decade, there has been only one case in the United States, related to international travel.
That could change very quickly if polio vaccination rates dropped or the vaccine were to become less accessible.
Robert F. Kennedy Jr., a longtime vaccine skeptic who may become the secretary of health and human services, has said the idea that vaccination has nearly eradicated polio is “a mythology.”
And while Mr. Kennedy has said he’s not planning to take vaccines away from Americans, he has long contended that they are not as safe and effective as claimed.
As recently as 2023, he said batches of an early version of the polio vaccine, contaminated with a virus, caused cancers “that killed many, many, many, many, many more people than polio ever did.” The contamination was real, but research never bore out a link to cancer.
Aaron Siri, a lawyer and adviser to Mr. Kennedy, has represented a client seeking to challenge the approval or distribution of some polio vaccines on the grounds that they might be unsafe.
Those efforts appear unlikely to succeed. And there is widespread support for vaccination among prominent Republicans, including President-elect Donald J. Trump and Senator Mitch McConnell, who had polio as a child.
But the secretary of health and human services has the authority to discourage vaccination in less direct ways. He or she could withdraw federal funds for childhood vaccination programs, hasten the end of school mandates in states already disinclined toward vaccines or fuel doubts about the shots, exacerbating a decline in immunization rates.
If polio vaccination rates were to fall, scientists say, the virus could slip into pockets of the country where significant numbers of people are unvaccinated, wreaking havoc once more. The virus may be nearly eradicated in its original form, but resurgence remains a constant threat.
Any decision the Trump administration makes regarding the polio vaccine is likely to ripple across the globe, said Dr. David Heymann, an infectious disease physician at the London School of Hygiene and Tropical Medicine and former leader of polio eradication at the World Health Organization.
“If the U.S. takes away the license, then many other countries will do the same thing,” he said. To have polio resurge when it is so close to eradication “would be very, very, very, very sad.”
Before 1955, when the vaccine was introduced, polio disabled more than 15,000 Americans each year and hundreds of thousands more worldwide. In 1952 alone, it killed 3,000 Americans after paralysis left them unable to breathe.
Many of those who survived still live with the consequences.
“People really underestimate how horrific polio was,” said Dr. Karen Kowalske, a physician and polio specialist at University of Texas Southwestern Medical Center in Dallas.
Many who recovered now suffer “post-polio syndrome”: Some of the original symptoms, including muscle weakness and respiratory problems, return.
Dr. Kowalske tends to about 100 post-polio patients who need braces, wheelchairs or other devices to cope with progressive weakness. Some are older adults who became infected before the vaccine was available; others are middle-aged immigrants from countries where polio remained a problem for much longer than in the United States.
To some survivors, the idea of polio’s return is unfathomable.
Carol Paulk contracted the disease in 1943, when she was just 3. Her right leg never recovered, and for the rest of her life she has walked with a pronounced limp and has been in near-constant pain.
Ms. Paulk is among the luckier ones. Until recently, she did not suffer the breathing, swallowing or digestive problems that often torment polio survivors.
She has had “a wonderful, wonderful life” with a husband and three daughters, a law degree and extensive travel abroad.
But always, everywhere, she is calculating how far away the next seat is, how long her energy will hold out and whether a given activity is worth debilitating pain the next day.
She didn’t participate in the 1963 March on Washington or play sports, as she desperately wanted to, or go hiking, skiing and bicycling with her husband.
If there were a public hearing about the polio vaccine now, “I would go, and I would take off my brace, and I would let them see my leg and ask them, is that what they want for their children?” she said.
Polio disables many fewer children now. Vaccination has scrubbed the virus from most of the planet, slashing the number of cases by more than 99.9 percent and preventing an estimated 20 million cases of paralysis.
Still, the virus has turned out to be a stubborn enemy, and eradication has been set back over and over again.
In 2024, 20 countries reported polio cases, and the virus was detected in wastewater in five European countries, decades after its official elimination from the region, and in Australia.
“Any reduction in coverage rates increases the risk of polio anywhere,” said Oliver Rosenbauer, a spokesman for the World Health Organization’s polio eradication program.
There are three types of polioviruses, and eradication requires that all three disappear. For years, the goal has been tantalizingly close.
Type 2 was declared vanquished in 2015, and Type 3 in 2019. Type 1 now circulates only in Afghanistan and Pakistan. In 2021, the two countries together had just five cases; in 2024, they had 93.
But those figures tell only part of the story. In a surprising twist, an oral vaccine used in some parts of the world has kept poliovirus circulating long after it should have died out.
In most low- and middle-income countries, health officials still rely on an oral vaccine given as two drops on the tongue. It is inexpensive and easy to administer, and it prevents transmission of the virus.
But it contains weakened virus, which vaccinated children can shed into the environment through their feces. When there are enough unvaccinated children to infect, the pathogen slowly spreads, regaining its virulence and eventually causing paralysis.
The problem is this: Since 2016, the oral vaccine used for routine immunization has not protected against Type 2 virus. Global health authorities made a deliberate decision to reformulate the vaccine on the grounds that naturally occurring Type 2 virus had disappeared.
That turned out to be premature. More Type 2 virus had been shed by orally vaccinated children in some parts of the world than officials had anticipated. When some nonimmunized children, or those given the newer oral vaccine, encountered this “vaccine-derived” Type 2 virus, they became infected and paralyzed.
Vaccine-derived poliovirus now paralyzes more children than naturally occurring virus does. For example, Nigeria eliminated all so-called wild-type polio in 2020. But in 2024, the country saw 93 cases of Type 2 vaccine-derived virus, more than one-third the global total.
None of this is a problem for Americans — as long as they are vaccinated.
The inactivated polio vaccine (I.P.V.) used for routine immunization of American children protects against all three types of polio. These formulations contain dead virus, and so cannot cause disease or revert to a dangerous form.
But like some other vaccines for infectious diseases, they do not fully prevent infection or transmission of the virus. This aspect is among the criticisms of Mr. Siri, Mr. Kennedy’s adviser.
Still, it is less important than the vaccines’ near-perfect power to prevent paralysis, experts said.
“Yeah, yeah, it’s true, I.P.V. doesn’t prevent transmission,” said Dr. William Petri, an infectious diseases physician and past president of the W.H.O.’s polio research committee. “But, boy, that’s the best thing since sliced bread at preventing paralysis.”
It does mean, however, that people vaccinated with I.P.V. can keep the virus circulating, even when they themselves are protected against illness and paralysis.
So here’s a realistic scenario that worries researchers: Someone who was vaccinated with the oral polio vaccine in another country might bring the virus into the United States and then shed it, in its weakened form. This has already happened in other countries.
So long as most of the population remains vaccinated, this is not likely to set off an epidemic. But if the virus makes its way into communities with low vaccination rates, it may spread, and then revert to a virulent form that can cause paralysis.
That is what happened in New York in 2022, when polio struck a 20-year-old unvaccinated member of an ultra-Orthodox Jewish community in Rockland County.
The vaccination rate in that county was just over 60 percent, compared with the national average of 93 percent.
The virus that paralyzed the young man had been circulating for months, and it was later detected in the sewage of multiple New York counties with vaccination rates hovering around 60 percent, prompting the state to declare an emergency.
Genetically related polioviruses were detected in wastewater samples in Britain, Israel and Canada, suggesting widespread transmission. The authorities later found two distinct vaccine-derived Type 2 polioviruses in New York wastewater, suggesting two separate importations.
If polio were to re-emerge in the United States, it is unlikely to be as horrific as it was in the pre-vaccine decades. Many older adults still remember that as children they were not permitted to swim in rivers or pools, or anywhere the virus might lurk.
“The reason we weren’t allowed to play in rivers in the ’50s is because raw sewage was dumped into the rivers,” Dr. Heymann said.
That is no longer the case, so there “wouldn’t be massive transmission immediately in the U.S.,” he added.
But even if just a few children were to become paralyzed, “it would be awful.”
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Sitting next to a window may help people with type 2 diabetes control their insulin levels, according to new research.
The study, published in Cell Metabolism, found that exposure to natural light — even indoors next to a window — changes how the body processes glucose and uses energy.
People in Western societies spend 80% to 90% of their time under artificial lights, which are much dimmer and less dynamic than sunlight, the researchers noted. Natural daylight is a powerful cue for the body’s internal clock, also known as the circadian rhythm.
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The body’s internal clock influences many processes, including digestion, hormone release and metabolism, according to research. When it gets out of sync, it can worsen insulin resistance and blood sugar control, which are two of the main issues caused by type 2 diabetes.
Typical lighting in homes and offices is much dimmer and lacks the biological signals provided by natural daylight. (iStock)
To test the effects of daylight on blood sugar, scientists recruited 13 adults with type 2 diabetes. Each person spent two separate 4.5-day periods in a controlled office setting, according to a press release.
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In one period, they worked in front of large windows with natural daylight streaming in. In the other period, participants worked in the same room with the windows covered and were exposed only to typical indoor lighting.
Daylight isn’t a replacement for medication or traditional management strategies like diet and exercise, the researchers noted.
Everyone ate similar meals, followed the same schedule and continued their usual diabetes medications in both conditions.
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While average blood sugar levels didn’t differ drastically between the two conditions, people spent more time in the healthy glucose range when they were exposed to natural daylight — their blood sugar fluctuated less and stayed within a desirable range for a greater portion of the day.
Participants who were exposed to daylight burned more fat and fewer carbohydrates, a metabolic pattern linked to better blood sugar regulation. (iStock)
Exposure to natural light also affected metabolism. In daylight, participants burned more fat and fewer carbohydrates for energy.
Muscle biopsies and laboratory tests further showed that the genes responsible for the body’s cellular clocks were more synchronized under natural light conditions, the study revealed.
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Better alignment of these genes can improve nutrient processing and how cells respond to insulin, the researchers concluded.
Sitting near windows or spending more time outdoors could support diabetes management alongside standard treatments, researchers say. (iStock)
However, daylight isn’t a replacement for medication or traditional management strategies like diet and exercise, according to the team.
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The study did have some limitations, including that the group of patients was small. The researchers cautioned that larger studies are needed to confirm these results and determine how much natural light exposure is optimal.
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“This study also highlights the often unnoticed impact of the built environment on our health, and raises further concerns about the prevalence of office environments with poor (natural) daylight access,” the researchers noted.
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For most people, heartburn is an occasional annoyance and source of temporary discomfort. But for some, chronic heartburn can lead to more dangerous conditions — potentially even pre-cancerous ones.
About 10% of people with chronic gastroesophageal reflux disease (GERD) will develop Barrett’s esophagus, a condition where the lining of the lower esophagus is replaced with abnormal cells that are more prone to cancer, according to medical experts.
Some studies have shown that among those with Barrett’s esophagus, between 3% and 13% will go on to develop cancer, but most will not.
POPULAR SLEEP POSITIONS COULD BE DAMAGING YOUR NERVES, ACCORDING TO EXPERTS
When acid reflux becomes dangerous
“Your stomach is designed to handle acid. Your esophagus is not,” Dr. Daryl Gioffre, a Florida-based gut health specialist and certified nutritionist, told Fox News Digital.
About 10% of people with chronic acid reflux will develop Barrett’s esophagus, a condition where the lining of the lower esophagus is replaced with abnormal cells that are more prone to cancer. (iStock)
“With reflux, the danger is not the burn in the chest or throat — the real danger is the constant backflow of acid traveling the wrong way.”
In most people, the lower esophageal sphincter — which Gioffre refers to as the “acid gate” — keeps acid in the stomach, which is lined with thick mucus and specialized cells designed to protect it.
“With reflux, the danger is not the burn in the chest or throat — the real danger is the constant backflow of acid traveling the wrong way.”
“But when the gate gets weak, it relaxes or stays slightly open, and acid slips back up the wrong way,” he said. This “gate” can weaken with magnesium deficiency, high stress, alcohol, poor sleep, dehydration and late-night snacking, all of which can disrupt healthy digestion.
When acid hits the esophagus, it irritates tissue that was never designed to withstand it, according to the doctor.
“Every time acid comes back up the wrong way, it injures the lining like a slow chemical burn,” said Gioffre, who is also the author of “Get Off Your Acid” and “Get Off Your Sugar.” Over time, that irritation erodes the lining, drives inflammation and can change the cells.
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“These new cells are no longer normal esophageal cells — they begin to shift into cells that look more like stomach lining, because those cells can tolerate the acid,” the doctor said. “That change is called metaplasia, or Barrett’s esophagus.”
Once the cells start changing, the risk of further mutation goes up. If that process continues, Gioffre warned, it can progress to dysplasia, which is the stage right before esophageal cancer.
Some studies have shown that among those with Barrett’s esophagus, between 3% and 13% will go on to develop cancer. (iStock)
“So the real danger is not the heartburn you feel,” he summarized. “It is the repeated acid exposure forcing the esophagus to adapt in ways it was never designed to. Fixing reflux at the root stops this entire cascade before those cellular changes begin.”
Men at higher risk
Men generally have a higher risk because they burn through magnesium faster, tend to carry more visceral fat pushing upward on the stomach, eat heavier meals and snack late at night, Gioffre cautioned. These activities all weaken the acid gate and shut down healthy digestion.
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“Eating within three hours of lying down almost guarantees the stomach does not empty, and that is one of the biggest drivers of nighttime reflux,” he said. “On top of that, men often ignore symptoms, or mask them with PPIs and antacids instead of fixing the root cause.”
All of these factors contribute to a “perfect storm” for chronic inflammation and long-term damage, according to Gioffre.
Warning signs
There are certain red flags that indicate when acid reflux has gone beyond an occasional annoyance and has progressed to constant and chronic.
“If that burn becomes more frequent or more intense, or starts showing up even when you have not eaten, your body is waving a giant warning flag,” Gioffre said.
Difficulty swallowing, a feeling that food is “stuck,” chronic hoarseness, a constant cough, throat clearing or the feeling of a lump in the throat are all indicators that the acid is moving upward into areas it should never reach. (iStock)
Difficulty swallowing, a feeling that food is “stuck,” chronic hoarseness, a constant cough, throat clearing or the feeling of a lump in the throat are all indicators that the acid is moving upward into areas it should never reach, according to the doctor.
EXPERT WARNS OF ‘SILENT EPIDEMIC’ THAT PUTS MEN’S HEALTH AT SERIOUS RISK
“Ulcers in your throat, or even in your mouth, are another sign that the acid is doing real damage,” he warned.
“Another major warning sign is when reflux goes from something you notice occasionally to something you feel every day or every night, or when PPIs and antacids stop helping,” Gioffre said. “That usually means the lining is irritated and eroded, and may already be changing on a cellular level.”
Nighttime reflux is the most dangerous because the acid sits on the esophagus for hours, causing deep inflammation and long-term cellular changes, the doctor said. (iStock)
Unexplained weight loss, vomiting blood and black stools are all serious symptoms that demand immediate attention, the doctor added.
“The bottom line: When reflux becomes consistent, chronic and starts impacting swallowing, your voice, or the tissues in your mouth or throat, it is no longer just a nuisance,” Gioffre told Fox News Digital. “That is the point where the esophagus may be moving toward a precancerous state, and men especially cannot afford to wait on it.”
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3 key ways to prevent reflux
Gioffre shared the following essential steps to preventing acid reflux and improving digestive health.
No. 1: Follow the 3-hour rule
“Stop eating three hours before bed,” the doctor recommends. “When you eat late, the stomach does not empty, pressure builds and the acid gate relaxes, guaranteeing that acid travels upward into your esophagus while you sleep.”
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Nighttime reflux is the most dangerous because the acid sits on the esophagus for hours, causing deep inflammation and long-term cellular changes, he warned. “This one rule alone can dramatically lower acid reflux and cancer risk.”
No. 2: Strengthen the acid gate
When stomach acid is low, the lower esophageal sphincter loses its tone, allowing acid to travel upward instead of staying in the stomach, Gioffre said.
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“The fastest way to tighten that gate is to build your mineral reserves, especially magnesium,” he said.
The best way to do this is to load up on magnesium-rich foods like avocado, spinach, pumpkin seeds, chia seeds, quinoa and almonds, and consider adding a clean magnesium supplement.
No. 3: Remove or neutralize daily triggers
The fastest way to protect your esophagus, according to Gioffre, is to eliminate or neutralize the foods and habits that weaken the acid gate and push acid the wrong way.
For people who can’t fully eliminate these triggers, certain habits can help neutralize their impact by reducing acid strength and pressure before it reaches the esophagus.
The doctor recommends cutting back on alcohol and caffeine, both of which relax the acid gate and increase the risk of acid reflux. (iStock)
“Drinking most of your water earlier in the day helps, because pounding water at night stretches the stomach and relaxes the acid gate, making it much easier for acid to flow the wrong way once you lie down,” he said.
He also recommends cutting back on alcohol and caffeine, both of which relax the acid gate instantly.
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Some other major triggers that fuel the reflux cycle include chocolate, spicy foods, garlic, onions, sugar, ultraprocessed foods and heavy nighttime meals, according to the doctor.
“These foods and habits weaken the lower esophageal sphincter, drive up inflammation and push pressure upward,” he said. “That’s exactly how a little heartburn turns into chronic reflux, and slowly causes the kind of damage that puts the esophagus at risk for cancer.”
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