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By JOANNE KENEN
With help from Tyler Weyant
A final check on iron lungs before they are loaded onto a plane headed for Belgium to combat polio in 1945. | AP Photo
LOST IN TRANSLATION — Alarmed by a polio case in New York state and detection of the virus in wastewater in the region, White House and state health officials are developing ways to monitor, detect and try to halt any spread of polio decades after the virus was declared eradicated in the United States.
Any strategy they set will center on vaccination. There is no cure or treatment.
But unlike the 1950s and ‘60s, when the public largely embraced new vaccines as salvation from a disease that terrified communities and condemned paralyzed children to iron lungs, public health officials today have to deal with rising anti-vax misinformation and disinformation. So the last thing they need is a particularly inartful and confusing expression — “vaccine-derived polio” — to make their job even harder, several worried experts told Nightly.
It’s so easy to think “vaccine-derived” means that people contract polio from the vaccine itself. That’s not the case, stressed Heidi Larson, a medical anthropologist who is one of the world’s leading experts on vaccine hesitancy and founding director of the Vaccine Confidence Project at the London School of Hygiene and Tropical Medicine.
“You do not get the virus from taking the vaccine,” she added.
“Vaccine-derived polio” is what afflicted a 20-year-old man in Rockland County, outside New York City. He is unvaccinated and he lives in an area with particularly low vaccination rates, estimated at around 60 percent or lower. He is now partly paralyzed. And traces of polio have been found in wastewater in his region, at other sites in New York and nearby states. New York Gov. Kathy Hochul declared a state of emergency, calling for stepped-up vaccination efforts in a state where polio immunization rates have dropped below 80 percent.
To make things even more complicated, the global “polio eradication campaign” refers to “wild” or “endemic” polio — where Afghanistan and Pakistan are the two remaining trouble spots (although even they’ve made lots of progress recently). The U.S. ended “wild” polio in 1979 and was declared polio-free about 15 years later. In glowing international eradication updates from public health groups, “vaccine-derived” polio doesn’t count — even though it still paralyzes and kills people.
So what does this pesky term, “vaccine-derived polio,” actually mean? The United States, and many wealthy countries, use a polio injection that contains zero, zilch, nary a drop of live polio virus. Many lower-income countries, for a variety of economic and logistic reasons, use an oral vaccine that contains a teeny, tiny trace of a weakened, or “attenuated,” form of the virus. People who are immunized that way (usually babies and young children) are not “deriving” polio from it. They are getting protection from it. The oral vaccine is extremely safe, Larson said.
But people who get the oral version do excrete minute traces of the virus, which can reach the water supply and sometimes mutate. Exposure to that mutated version is how people “derive” polio.
Those water-borne traces “don’t infect anyone when people are vaccinated,” Larson told Nightly. “Where it thrives … is where there’s low vaccination.” During Covid, vaccination programs lagged across the world, for polio and other childhood diseases. The spread of anti-vax sentiments isn’t helping.
A recent cluster of cases in Nigeria are vaccine-derived. A case identified in Malawi a few months ago was genetically linked to the wild strain in Pakistan, so travel probably played a role. “Polio isn’t eradicated until it’s eradicated everywhere,” Larson said.
The polio case discovered in the Rockland County man has been genetically linked to strains of vaccine-derived virus found in water in Israel and the U.K. How it traversed the globe and reached a New York suburb is still being investigated.
While most of us think of polio as causing paralysis or trapping children in iron lungs, those severe cases are relatively rare. For every paralytic case of “wild” polio, there are probably 100 to 200 more mild cases. For the vaccine derived type that the patient in Rockland County, as few as one in 2,000 could suffer paralysis, according to one expert familiar with CDC work on the case. These milder cases may not be recognized as polio but they can still spread to other people. And while doctors are still taught about polio, many of them have never seen a case — and it’s not necessarily the first thing they think of when they see a patient with flu-like symptoms. Plus, some cases are so mild that people don’t seek medical care, but they could still infect the unvaccinated.
The Centers for Disease Control on Sept. 1 offered a webinar to refresh U.S. doctors on polio history and diagnosis — and a reminder to check that their patients are up to date on vaccination.
In an era when we’re still dealing with Covid, monkeypox and possibly a bad flu outbreak this year, the last thing we want to see befall people is polio. Don’t let confusing “vaccine-derived” terminology “deter you from protecting yourself,” said my Johns Hopkins colleague Josh Sharfstein, who, as a former FDA deputy commissioner and a former Maryland and Baltimore health commissioner, has learned a thing or two about public health crisis communication.
Most Americans are already vaccinated — but for anyone who wasn’t, or who can’t access childhood vaccination records to find out — getting another shot as an adult is not dangerous, both Sharfstein and Larson stressed.
Meanwhile, the number of counties with vaccine-derived polio had been declining. This year it’s up again, to around 30, according to the CDC. This month, the U.S. was added to the list.
Welcome to POLITICO Nightly. Reach out with news, tips and ideas at [email protected]. Or contact tonight’s author on Twitter at @JoanneKenen. The FDA today warned about the dangers of cooking chicken in NyQuil as part of a broader update on the dangers of social media challenges. Yes, really.
— White House and Delaware prepare for migrants from Texas: Officials with the White House and Delaware governor’s office today readied for the potential arrival of migrants flown from Texas to President Joe Biden’s home state. The flights are believed to be facilitated by Florida GOP Gov. Ron DeSantis, who last week transported about 50 mostly Venezuelan migrants from San Antonio, Texas, to Martha’s Vineyard, an elite vacation spot in Massachusetts with a short stopover in Florida.
— Special master expresses skepticism with Trump team’s assertions: The senior federal judge tasked with reviewing the materials seized by the FBI from Donald Trump’s Mar-a-Lago estate sharply questioned the former president’s attorneys today during their first hearing before his courtroom. Judge Raymond Dearie pushed Trump’s lawyers repeatedly for refusing to back up the former president’s claim that he declassified the highly sensitive national security-related records discovered in his residence. “You can’t have your cake and eat it too,” said Dearie.
— Jackson water crisis spurs calls to bring the federal hammer down on Mississippi: Advocacy groups that see racial bias as a major cause of the water crisis in Jackson, Miss., are debating new strategies for taking the Republican-controlled state government out of the lead role when it comes to steering federal spending in its capital city. Those tactics could include filing a federal civil rights complaint accusing the state of shortchanging the Black-majority city of 150,000 people when distributing federal water infrastructure dollars. Another option under consideration, people involved in the discussions said, is getting Congress to steer additional water funding to Jackson without Mississippi’s involvement.
JOIN THURSDAY FOR A GLOBAL INSIDER INTERVIEW: From climate change to public health emergencies and a gloomy global economic outlook, the world continues to deal with overlapping crises. How do we best confront all of these issues? Join POLITICO Live on Thursday, Sept. 22 at 10:30 a.m. EDT for a virtual conversation with Global Insider author Ryan Heath, featuring World Bank President David Malpass, to explore what it will take to restore global stability and avoid a prolonged recession. REGISTER HERE.
British Prime Minister Liz Truss speaks in New York City as world leaders begin to gather for the 77th UN General Assembly. | Toby Melville – Pool/Getty Images
DEAL OR NO DEAL — On the eve of her arrival in New York for the U.N. General Assembly, Liz Truss admitted a U.K. trade deal with the United States is unlikely to happen for many years to come, writes Esther Webber.
The British prime minister, who flew to the U.S. directly after attending Queen Elizabeth II’s funeral, told journalists on the plane in answer to a question on trade: “There [aren’t] currently any negotiations taking place with the U.S. and I don’t have an expectation that those are going to start in the short to medium term.”
A U.S.-U.K. trade deal was once trumpeted as a post-Brexit prize by politicians in London but now looks a very distant prospect with the Biden administration unwilling to move before the next presidential election, if at all.
The British government has long been managing expectations on this front, but Truss’ comments marked the frankest admission yet that such an agreement is beyond their reach. A No. 10 official said Truss’ change of message reflected “the reality that Biden is not doing any deals.”
The amount of money that federal authorities allege 47 people in Minnesota stole from a federal program started during the pandemic that provides meals to low-income children. The U.S. Department of Justice has already brought charges in more than 1,000 criminal cases involving losses in excess of $1.1 billion related to pandemic fraud.
IN THEATERS — There’s a new film in theaters called “The Woman King” starring Viola Davis as the leader of an all-women fighting force in West Africa. The project is based loosely on a group of fighters known as the Agojie, who were known for their “prodigious bravery.” Meilan Solly has you covered on the full backstory of the fighting force over at Smithsonian Magazine.
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Cameron Smith of Australia during the final round of the LIV Golf Invitational — Boston at The Oaks golf course in Bolton, Massachusetts. | Andy Lyons/Getty Images
HILL TO LIV ON — Deputy Congress Editor Tyler Weyant emails Nightly:
When Greg Norman thinks of 1994 these days, he probably doesn’t think of Ace of Base’s “The Sign” topping the charts, or “Interview With A Vampire” doing well at the box office. He might not even spend much time thinking about his victories or No. 2 ranking in the world that year. No, his 1994 thoughts probably look a lot like his thoughts on today: an effort to start a global renegade golf league, complete with global intrigue and antitrust investigations, that ends up in the mire of Washington.
Norman, the CEO of the Saudi-backed LIV Golf efforts that have thrown the highest levels of the sport into a monetary and political maelstrom, is headed to Capitol Hill this week, planning to meet with the conservative Republican Study Committee at their weekly lunch on Wednesday. He’ll also meet with Rep. Nancy Mace (R-S.C.) who also chairs the “congressional golf caucus” (and people say Congress is wasteful).
But the visit, one LIV spokesperson says, will be used “to educate members on LIV’s business model and counter the Tour’s anti-competitive efforts,” comes at a time when both sides of the professional golf world will need to bolster their D.C. bona fides to come close to what the PGA Tour had nearly 30 years ago.
Back then, as Norman was working to launch a World Golf Tour to take on the PGA Tour, new commissioner Timothy Finchem heard antitrust lawyers at the Federal Trade Commission were about to take actions that would rock the very foundations of how the tour operated. Finchem, a former Carter White House lawyer, took quick action and mobilized a Washington response more familiar in a pitched policy fight than at the local pitch-and-putt.
“We decided to raise the profile a little bit,” Finchem told the Los Angeles Times then in a detailed now-time-capsule of the Tour’s campaign. “We just wanted the [FTC] commissioners to understand this was a very important matter.”
And the PR onslaught was on: Sponsors wrote to the FTC. Individual members of Congress on both sides wrote to the FTC. Bob Dole spoke on the floor of the Senate: “I question whether the public interest would be served by eliminating the foundation for the success of the tour.” In the end, FTC commissioners voted 4-0 to reject the lawyer’s recommendations to move against the PGA Tour.
Today? The D.C. fight is revving again, and LIV seems to be grabbing up all the PR help it can get. POLITICO has reported in recent months on LIV Golf’s contacts with Edelman and their signing of Hobart Hallaway & Quayle Ventures to lobby. And the PGA Tour has been on a campaign of its own, paying law firm DLA Piper $120,000 earlier this year to lobby on “Saudi Golf League proposals.” The backdrop of it all? A DOJ investigation of the PGA Tour for … antitrust issues.
Yes, it seems like we’re right back where we were in the ‘90s, but this time, everyone is gearing up for battle. Today’s PGA Tour Commissioner, Jay Monahan, isn’t the creature of Washington Finchem was, making a full-court press a more challenging and expensive proposition if they want the same decisive result they got in the ‘90s. And their opponent this time has the seemingly never-ending pockets of the Saudi Public Investment Fund. (None of this even takes into account the Trump-alignment of it all.)
But history has weird ways of rhyming and echoing. Norman’s teammate in starting up his new league in 1994 was an Australian media mogul those of us today might have heard of: Rupert Murdoch.
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