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Back Hager contracted what the Centers for Disease Control and Prevention call ``Vaccine Associated Paralytic Polio,'' or VAPP. It was passed on to him from his then-infant son who had been recently vaccinated with the oral polio vaccine. Now, 63, Hager is paralyzed from his hips down and has been confined to a wheelchair for the last quarter century. In that time he rose to be senior vice president at American Tobacco Co., was voted in as lieutenant governor, serves as chairman of Virginia's Disability Commission, has been on 30 boards and commissions, and has competed in dozens of wheelchair racing marathons. ``I live a super active life,'' said Hager. But at the outset of his affliction, his future seemed more uncertain. In August 1973, all was going well for Hager. He had an engineering degree from Purdue University and an MBA from Harvard. He had been married for two years and was a new father to the first of his two sons, Jack, then 3 months old. Hager was a third-generation tobacco executive and had just been promoted to executive vice president of American Tobacco Co., a tobacco giant that made Lucky Strike and Pall Mall cigarettes. Hager and wife, Margaret, were preparing a move to the company's headquarters in New York when their son received his first doses of vaccines, including the Sabin oral polio vaccine. The oral vaccine, referred to as OPV, was developed by Albert Sabin and put into first use in 1961, six years after Jonas Salk's inactivated, injected polio vaccine, IPV, came on the market. OPV is a live vaccine that is shed in a healthy child's intestines and larynx for about three to four weeks. It can be passed on to others through fecal-oral transmission, or contact with other body fluids. Within a week of his son's vaccinations, Hager developed flu symptoms and severe back pain. It was so bad, he had to lie down on the floor in his Richmond office to make phone calls. Colleagues urged him to go home and get to bed. He did. ``The next time I left the bed I was in a stretcher, paralyzed up to my neck,'' Hager said. He was rushed to St. Mary's Hospital in Richmond, Va., where doctors detected two slipped disks and did exploratory back surgery to find an answer for his paralysis. He spent seven weeks there before being moved to the Rusk Institute in New York. Once there, lab culture results taken weeks earlier by a physician and personal friend of Hager confirmed a polio diagnosis. Dr. Howard Rusk said the diagnosis was ``good news,'' according to Hager. The polio virus ``would do its damage and leave, you will be fine.'' Hager said he was never warned by his son's pediatrician of the risks involved with the oral vaccine. After four months in hospitals, Hager ``chose to forget and get on'' with his life. He gradually recovered use of his upper body, but the virus paralyzed a nerve that sent signals to his legs. While he has full feeling in his legs, he has no motor control over them. His promotion was revoked by American Tobacco, but he was kept on as a department manager. Eventually, he became the company's senior vice president. Hager recalled that at the time of his paralysis the company did not want an executive vice president in a wheelchair. Hager contacted the oral polico vaccine manufacturer, then Lederle Laboratories, now Wyeth-Lederle Vaccines, the sole supplier of oral polio vaccine at the time in the United States. Today, it's a $230 million industry. Officials were unresponsive, Hager said. ``I began to become frustrated because we got very little positive response from the drug companies,'' Hager said. ``It seemed political that they (policy- makers) wrote off `X' number of people for the general good.'' Hager, recalling several misses at his diagnosis, thinks the official federal figure of 316 vaccine-associated polio cases since the 1961 advent of the oral dose is understated. Hager mastered use of a wheelchair and has performed in dozens of wheelchair marathons. He can drive a specially outfitted car with hand controls. Hager's wife, Margaret, joined him in his campaign for disabilities causes and served on the 15-member federal commission, the National Council on Disability, that helped write the Americans with Disabilities Act. It was signed by President Bush in 1990. ``We have coped with it ... but it took me 25 years to work my way back up from the bottom of the business ladder and to lead a normal life,'' Hager said. ``I felt like I could make my maximum contribution by showing that disabled people can perform and achieve just like everyone else.'' Others, like Hager, have had to fight back. Miriam Fadayel. Two years ago, when scientists and federal public health officials were trying to determine if they should switch childhood vaccine schedules from the oral polio dose to a safer injected polio vaccination, or IPV, the American Medical Association said that switching to an IPV-only -- or even to a mixed schedule of shots -- was not ``cost-beneficial.'' Try explaining that to Victor Fadayel, whose daughter Mariam, now 4, contracted a severe case of polio from the oral vaccine. The cost to keep her alive is nearly $400,000 a year. Fadayel is on a personal quest to stop the use of the oral polio vaccine in America. Mariam was the sixth child of Victor and Amal Fadayel, a Daly City, Calif., couple originally from Bethlehem, Israel. In November 1994, Mariam got her first round of immunizations, which included a dose of the oral polio vaccine. Mariam was immune compromised at birth, a fact unknown by her parents or pediatrician. For the next eight months, Mariam's seemingly unrelated reactions ranged from severe skin rashes, vomiting, and calcium and potassium deficiencies to pneumonia, life-threatening seizures, paralysis and misdiagnosed Epstein-Barr disease. ``We were told: You have a quadraplegic baby here; she will never walk, she will never use her hands,'' said Fadayel, who owns a small grocery store in San Francisco. It was eight months before the Fadayels were told by Dr. Moses Grossman, a retired physician and former professor at the University of California-San Francisco hospital, that Mariam had polio. ``He said to us, `Your worst nightmare is true. This child has polio,''' Fadayel said. Grossman said the only way Mariam would survive is through a feeding tube inserted in her stomach and be placed on a respirator. He also said it would cost millions to keep Mariam alive and suggested the Fadayels should file a claim with the National Vaccine Injury Compensation Program. Mariam Fadayel spent 10 months in the intensive care unit of the hospital. During that time, she underwent 65 operations -- most of them diagnostic biopsies. The attached price tag was $4 million, much of it picked up by the Fadayel's health insurance. After securing a diagnosis, Victor and Amal Fadayel, against the advice of the hospital, took their daughter home. The insurance carrier agreed to create a hospital-like setting at their home, and Amal, a registered nurse, would provide primary care for Mariam. With the aid of John Salamone, president of Informed Parents Against Vaccine-Associated Paralytic Polio here, and of the Vienna, Va.-based National Vaccine Information Center, the Fadayel's found a lawyer, Andrew Dodd of Torrance, Calif., who filed a petition for them with the National Vaccine Injury Compensation Program. `I asked them how to get the baby to live a respectable life, that is all we want,'' Victor Fadayel said. ``We did not bring this child into the world to throw her away.'' Once home, Mariam began regaining muscle strength, and her hair and skin grew back. She began walking with braces and a walker, talking and could recognize numbers and letters. The Fadayel's received a $1 million lump sum settlement from the compensation program last year, and an additional sum of nearly $400,000 a year to cover the medical expenses necessary to keep Mariam alive. ``My goal,'' said the father, ``is to see a stop to the use of this vaccine that can cause polio.'' If his daughter could talk, he said, ``She would be screaming this out every day of her life.'' Mick Rowe. Rowe, 44, of Hagerstown, Md., became wheelchair bound two years ago. He had received the original Salk vaccine shot at age 5, so polio did not pop up as an obvious cause. But he was told by doctors that he contracted the disease from changing his daughter Salina's diaper. She had received the oral version of the polio vaccine, developed by Albert Sabin and in use since 1961. Nearly a month after Salina was vaccinated, Rowe developed flu symptoms and soon after lost all use of his limbs. ``After 36 hours I could only move my head back and forth three inches,'' Rowe said. It was five weeks later before his physician suspected it was polio. ``I asked how did I get polio?'' Rowe recalled. ``We were never informed of any risk involved with the vaccine. Who would have imagined getting polio in this day and age?'' Over the next six months, Rowe was admitted to three different hospitals, which ran several tests that turned up negative for polio. But Hager's doctors were convinced that paralytic polio was Rowe's correct diagnosis, although it is often difficult to pinpoint. His wife Sally put in a call to the Centers for Disease Control. CDC officials told her Rowe was the ninth person in 1996 to contract the disease from the vaccine. ``They say, `What is eight or nine people per year catching it?''' she reflects. ``Well, to me it is a lot.'' Rowe, a former manager of a truck garage, can no longer work. His former hobbies, car racing and playing the drums, are an impossibility. Sally Rowe had to quit her job as a supervisor at Friendly's Ice Cream shop to care for Rowe and daughter Salina full time. ``The doctors told me I had two options: Put Mick in a nursing home or in a state hospital,'' Sally Rowe said. ``I said, no, I have three options. I am taking him home.'' The Rowe's filed a claim in 1997 with the National Vaccine Injury Compensation Program. The program's medical experts at the Department of Health and Human Services recommend denying compensation to Rowe. They suggest he has Guillain-Barre syndrome, a mysterious disease that can also cause paralysis. Rowe's attorney, Neil Fick of Towson, Md., has several neurologists who say it is polio. Under the compensation act Guillain-Barre syndrome is not a compensable injury as a result of the oral polio vaccine. The program director, Thomas Balbier, says that a case will be
compensated if the clinical findings correlate with polio: ``If the medical
findings correlate with something else, then it is not a vaccine-related
injury.'' |
