Tribute to Maurice Hilleman (1919-2005): Immunization pioneer
By David Glassman, RN, MPH
This spring marks an unheralded milestone in immunization history. The work of one man 50 years ago has improved the health and well-being of people worldwide; a man who at the age of eight nearly died from diphtheria, a disease that would later be virtually eradicated in the United States through immunization. After Maurice Hilleman’s death, Ralph Nader wrote “Yet almost no one knew about him, saw him on television, or read about him in newspapers or magazines.” The name Maurice Hilleman is unfamiliar to most of us, but now in the 21st century, 95 percent of American children receive the MMR vaccine that Dr. Hilleman developed, starting with the mumps strain he collected from his daughter when she became ill in 1963.
In fact, this was most certainly not his only contribution. Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, credits him with having saved more lives than any other scientist in the 20th century. Over his career, Hilleman devised or substantially improved more than 40 experimental and licensed animal and human vaccines, including eight of the routinely recommend children’s immunizations: measles, mumps, hepatitis A, hepatitis B, varicella, meningitis, pneumonia and Haemophilus influenzae (including Hib). He also played a role in the discovery of the cold-producing adenoviruses, the hepatitis viruses, and the cancer-causing virus SV40, and was the first to purify interferon, as well as discovering the genetic changes that occur when the influenza virus mutates, known as shift and drift.
In the spring of 1963, the FDA awarded the first license for a measles vaccine. This was based on the early work done by John F. Enders at Boston Children’s Hospital, but Dr. Hilleman’s contribution was instrumental in decreasing side effects by giving gamma globulin in one arm and the measles vaccine in the other. At the time of this development, in the U.S. the disease sickened a reported average of 400,000 people (although the actual number of cases was much higher, as virtually all children acquired measles) and killed more than 500 children every year. Dr. Hilleman continued to refine the vaccine over the next four years, culminating in the much safer Moraten strain that is still in use today. It was the beginning of the end of the disease in this country.
At the same time, an epidemic of rubella began in Europe and quickly swept around the globe. According to the CDC, in this country rubella’s devastating effect on first-trimester pregnancies caused about 11,000 newborns to die and an additional 20,000 suffered birth defects. As the epidemic ended in 1965 Dr. Hilleman was already testing his own vaccine and by 1969 had obtained F.D.A. approval and prevented another rubella epidemic. As 1971 was beginning he put vaccines for measles, mumps and rubella together to make MMR, replacing a series of six shots with just two. Then in 1978, having found a better rubella vaccine than his own, Dr. Hilleman asked its developer, Dr. Stanley Plotkin, if he could use it in the MMR.
By all accounts Dr. Hilleman’s was obsessed with safety and effectiveness. It must have been a surprise when in 1998, toward the end of his life, his vaccine became the focus of scrutiny after The Lancet’s publication of Dr. Andrew Wakefield’s now-infamous article alleging that MMR caused autism. Parents began to stop immunizing. In place of a Noble Prize in Medicine he received hate mail and death threats. Dr. Wakefield’s work has been widely discredited after numerous independent studies demonstrated that there is no link between MMR and autism. The Lancet retracted the 1998 article and in 2010 the British medical authorities stripped Wakefield of the right to practice medicine. Sadly, Dr. Hilleman died of cancer in 2005 before being vindicated.
However, there are reasons to be encouraged, particularly by large-scale initiatives aimed at eradicating these common but easily preventable childhood diseases. The Measles and Rubella Initiative (MRI) is a global partnership devoted to “ensuring no child is born with congenital rubella syndrome or dies from measles.” It’s led by the United Nations Foundation, UNICEF, the World Health Organization, the American Red Cross, and the U.S. Centers for Disease Control and Prevention. The MRI has given the MMR vaccine to a billion children in this century, in 80 countries, preventing millions of deaths from measles alone. The Initiative is focused on supporting the goals of reducing global measles mortality by 95 percent by 2015 and eliminating measles and rubella in at least five of the six World Health Organization regions by 2020.
As a postscript, in this country, the strain that Dr. Hilleman collected from his daughter in 1963 has reduced the incidence of mumps from 186,000 cases a year to fewer than 1,000. For more on this incredible pioneer read co-inventor of the rotavirus vaccine Dr. Paul Offit’s 2007 biography of Hilleman, Vaccinated: One Man’s Quest to Defeat the World’s Deadliest Diseases.
Dr. Hilleman (Courtesy of Hilleman Laboratories)
Top image source: The Measles and Rubella Initiative