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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The holidays are known to be a source of stress, between traveling, preparing for family gatherings and indulging in lots of food and drinks.
The uptick of activity can actually put a strain on the heart, a phenomenon known as “holiday heart syndrome.”
Cardiothoracic surgeon Dr. Jeremy London addressed this elevated risk in a recent Instagram post, sharing how heart attacks consistently rise around the holidays.
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“Every year, like clockwork, we see a spike in heart attacks around Christmas and New Year’s,” the South Carolina-based surgeon said. “In fact, Christmas Eve is the highest-risk day of the year.”
This is due to a shift in behavior, specifically drinking and eating too much, moving less and being stressed out, according to London. “Emotional stress, financial stress, the increased pace of the holidays, increased obligations,” he listed.
Cold weather also causes vasoconstriction (narrowing of blood vessels), according to London, which increases the risk of plaque rupture and the potential for heart attack.
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Dr. Glenn Hirsch, chief of the division of cardiology at National Jewish Health in New York, noted in an interview with Fox News Digital that holiday heart syndrome typically refers to the onset of an abnormal heart rhythm, or atrial fibrillation.
This can happen after an episode of binge-drinking alcohol, Hirsch said, which can be exacerbated by holiday celebrations.
Binge-drinking at any time can drive atrial fibrillation, a cardiologist cautioned. (iStock)
“It’s often a combination of overdoing the alcohol intake along with high salt intake and large meals that can trigger it,” he said. “Adding travel, stress and less sleep, and it lowers the threshold to go into that rhythm.”
The biggest risk related to atrial fibrillation, according to Hirsch, is stroke and other complications from blood clots. Untreated atrial fibrillation can lead to heart failure after a long period of time.
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“The risk of atrial fibrillation increases with age, but also underlying cardiovascular disease risk factors increase the risk, such as high blood pressure, obesity, diabetes, sleep apnea and chronic kidney disease,” he added.
Christmas Eve is the “highest risk day of the year” for heart attacks, according to one cardiologist. (iStock)
Preventing a holiday heart event
Holiday heart syndrome is preventable, as Hirsch reminds people that “moderation is key” when celebrating.
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The expert recommends avoiding binge-drinking, overeating (especially salty foods) and dehydration, while managing stress levels and prioritizing adequate sleep.
“Don’t forget to exercise,” he added. “Even getting in at least 5,000 to 10,000 steps during the holiday can help lower risk, [while] also burning some of the additional calories we are often consuming around the holidays.”
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London agreed, stating in his video that “movement is medicine” and encouraging people to get out and move every day.
The various stresses of the holidays can have physical consequences on the body, doctors warn. (iStock)
It’s also important to stay on schedule with any prescribed medications, London emphasized. He encourages setting reminder alerts, even during the holiday break.
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“Prioritize sleep and mindfulness,” he added. “Take care of yourself during this stressful time.”
London also warned that many people delay having certain health concerns checked out until after the holidays, further worsening these conditions.
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“Don’t ignore your symptoms,” he advised. “If you don’t feel right, respond.”
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Flu season is among us, and a new strain has emerged as a major threat.
Influenza A H3N2, or the subclade K variant, has been detected as the culprit in rising global cases, including in the U.S.
In an interview with Fox News Digital, Dr. Neil Maniar, professor of public health practice at Boston’s Northeastern University, shared details on the early severity of this emerging strain.
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“It’s becoming evident that this is a pretty severe variant of the flu,” he said. “Certainly in other parts of the world where this variant has been prevalent, it’s caused some severe illness, and we’re seeing an aggressive flu season already.”
Influenza A H3N2, or the subclade K variant, has been detected as the culprit in rising global cases. (iStock)
The variant seems to differ from prior strains of the flu, with heightened versions of typical symptoms like fever, chills, headache, fatigue, cough, sore throat and runny nose.
Subclade K is the “perfect storm” for an aggressive flu season, Maniar suggested, as vaccination rates overall are down and this year’s flu vaccine does not address this specific strain.
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“The vaccine is very important to get, but because it’s not perfectly aligned with this variant, I think that’s also contributing to some degree to the severity of cases we’re seeing,” he said. “We’re going in [to this flu season] with lower vaccination rates and a variant that in itself seems to be more aggressive.”
“There’s a lot of concern that this could be a particularly difficult flu season, both in terms of the total number of cases [and] the severity of those cases.”
Staying indoors during the colder months increases the risk of exposure to winter illness. (iStock)
Because subclade K is “quite different” from prior variants, Maniar said there is less natural immunity at the community level, further increasing the risk of spread and severity.
Those who are unvaccinated are also at risk of experiencing more severe symptoms, as well as a higher risk of hospitalization, the doctor emphasized.
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In addition to getting vaccinated, the doctor recommends washing hands frequently and properly. While the flu can spread via airborne transmission, a variety of other illnesses, like norovirus, can stick to surfaces for up to two weeks, he added.
The holiday season also boosts the risk of infection, as gatherings, large events, and packed planes, trains and buses can expose people to others who are sick.
The flu vaccine can help to prevent hospitalization and reduce severe symptoms, doctors agree. (iStock)
Those who are not feeling well or exhibiting symptoms should “please stay home,” Maniar advised — “especially if you think you are in that contagious period of the flu or any of these other illnesses that we’re seeing … whether it’s norovirus or COVID or RSV.”
“If you’re not feeling well, stay home. That’s a great way to recover faster and to ensure that you’re not going to get others around you sick.”
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For those who are unsure of their health status or diagnosis, Maniar recommends seeing a healthcare provider to get tested. Some providers may be able to prescribe medication to reduce the severity and duration of the illness.
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“It’s important that everyone stays vigilant and tries to take care of themselves and their families,” he added.
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As snow blanketed parts of the U.S. this week, heart health experts have shared warnings of the physical strain shoveling can take — particularly for older adults.
A 2025 Mayo Clinic review found that just 10 minutes of heavy snow shoveling can push the heart to about 97% of its maximum rate. Exposure to cold air was also found to increase blood pressure and reduce coronary blood flow.
While there isn’t an official age that’s “too old” to shovel, some cardiologists recommend that individuals over 45 should exercise more caution to lower their chances of a cardiac event.
When to take caution
“While there’s no strict age cutoff, generally above the age of mid 40s and above, we tend to be a little more cautious — particularly in people who are less active [without] regular exercise,” Dr. Navjot Kaur Sobti, M.D., an interventional cardiologist at Northwell’s Northern Westchester Hospital in Mount Kisco, New York, told Fox News Digital.
Heart health experts have shared warnings of the physical strain shoveling can take — particularly for older adults. (iStock)
“Certainly in people who are above the age of 65 — and who have risk factors for heart disease, such as high blood pressure, high cholesterol, diabetes, obesity or sedentary lifestyle — we recommend being very, very cautious about shoveling snow,” she advised.
Dr. John Osborne, M.D., a practicing Texas cardiologist and volunteer for the American Heart Association, shared similar guidance for people older than 45, especially males over 65.
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“Unless you are in good cardiovascular shape and conditioned, it may be a good idea to ask someone for help,” he said in an interview with Fox News Digital.
The impact of snow removal is especially concerning for those with existing cardiovascular risks and a history of heart attack or stroke, according to the cardiologist. “People with these characteristics and those who have had bypass surgery or coronary angioplasty simply should not be shoveling snow in any conditions,” he said.
Just 10 minutes of heavy snow shoveling can push the heart to about 97% of its maximum rate, a 2025 Mayo Clinic review found. (iStock)
Osbourne said he often sees cardiac episodes in people who are typically sedentary and sit at a computer most of the day with little or no exercise. “Then once or twice a year, they go out and try to shovel the driveway after a heavy snowfall, and that unexpected exertion can unfortunately lead to tragedy.”
Hidden strain
The stress that is placed on one’s heart while shoveling snow is similar to what occurs during a cardiac stress test, Sobti pointed out, and may even exceed it.
Cold temperatures can cause blood vessels to constrict and blood pressure to spike — which, coupled with existing hypertension and the exertion of lifting snow, can significantly tax the heart, she warned.
“It’s almost like an at-risk person is putting themselves through an unsupervised maximal exertion stress test without a cardiologist actively monitoring them,” Sobti told Fox News Digital.
The stress that is placed on one’s heart while shoveling snow is similar to what occurs during a cardiac stress test. (iStock)
In addition to the exertion of shoveling, frigid temperatures can also strain the heart. Recent research has shown that cold exposure accounts for nearly twice as many cardiovascular deaths as heat exposure, including heat exhaustion.
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That study, published in the Annals of Internal Medicine last month, also found that those over age 65 had higher rates of temperature-related deaths.
“So the risk is very, very high,” Sobti cautioned. “It’s really that sudden rise in blood pressure coupled with the physical stress of snow shoveling itself.”
Safer shoveling tips
The cardiologist said it’s ideal to have someone else help with snow removal — but if you do choose to use a shovel, she recommends pacing yourself and using a “pushing or sweeping” motion instead of heavy lifting.
Recent research has shown that cold exposure accounts for nearly twice as many cardiovascular deaths as heat exposure. (iStock)
To protect against the cold, Sobti also recommends covering your mouth, nose and extremities, wearing a hat and gloves, and using extra caution in windy conditions.
Using an automated snow blower can still raise the heart rate — up to 120 beats per minute, compared to 170 while shoveling, the American Heart Association states on its website.
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It is also important to be aware of any symptoms of a potential cardiac issue while shoveling, Sobti emphasized.
If a person starts to experience warning signs such as chest pain, shortness of breath, a racing heart or palpitations, those should not be ignored.
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Even if the symptoms resolve after a few minutes, a person “could still be experiencing symptoms of a heart attack” and should call 911 for evaluation, Sobti said.
“It’s better really to be safe than sorry.”
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