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AthleteI am Minda Dentler, a polio survivor and the first female wheelchair athlete to complete the Ironman World Championship. I’m working to end polio. AMA!

Jun 23rd 2017 by MindaDentler • 7 Questions • 42 Points

On June 12, Rotary and the Bill and Melinda Gates Foundation announced an extension and increase of their financial commitment in an effort to eradicate polio worldwide once and for all. Additionally, 16 governments and several organizations have just pledged $1.2B to eradicate polio. Rotary has already contributed over 1.6 billion U.S. dollars and hundreds of thousands of hours of volunteer time to the eradication of polio. When we succeed in eradicating polio, it would become only the second disease to be eradicated by vaccines, the other being smallpox.

Personally, I have known Dr. Salk, creator of the inactivated polio vaccine, and Dr. Sabin, creator of the oral polio vaccine through my work at the National Institutes of Health. In 1979 the last case of endemic polio was reported in the U.S. I, along with Rotary International president, Clem Renouf, brought to Rotary the idea to make it our chief goal to eradicate polio worldwide. For the last 11 years, I have been carrying on the visions of Drs. Salk and Sabin as the vice-chairman of Rotary International’s PolioPlus program, which helps oversee Rotary’s polio vaccination efforts worldwide.

Context:

In 1916, polio was an epidemic in the United States with over 27,000 cases and 6,000 deaths. Following the availability of Dr. Salk’s inactivated vaccine in 1955 and Dr. Sabin’s oral polio vaccine in 1962, polio began to decline in developed countries where they were used. That decline began to accelerate as groups such as Rotary International began to champion the issue in the early 1980s.

Today, polio is nearly eradicated globally, as we’ve seen a 99.9% reduction – from an estimated 350,000 cases in 1988 to just 6 reported cases so far in 2017. Polio is virtually eradicated, but there is still so much more to do. If we don’t continue to vaccinate, we could see 200,000 new cases every year – giving polio an unprecedented resurgence.

Proof: https://i.redd.it/8b4euv7l1n4z.jpg

EDIT: Thanks very much for all of your questions today. I enjoyed the conversation. For more information, please visit:https://www.endpolio.org/

Q:

What do you think about anti-vaxers?

A:

Doctor, thank you very much for your tireless work.

As a fellow Rotarian, supporter of the Polio Plus program for over 10 years and someone who has contact with polio survivors through work and personal life, I have one question.

What would be the best way to communicate the importance of continued support for this program to younger generations that we interact with and recruit as Rotarians everyday?

While I am very excited by the support, I am concerned that with this influx of support from the Gates Foundation that some may think, "oh that should do it." When the truth is this is a long road we are going down.

I apologize for the run-on sentences.


Q:

It's something I've written about. http://time.com/3701392/polio-survivor-vaccinate-children/ Here is a link to the article. Universal childhood vaccines are something I am really passionate about.

A:

I remember vividly the fear of polio when I was young and when my own cousin developed paralytic polio and the great sadness in my family because of this.  I remember her need to have multiple surgeries and braces in order to walk.  But, in general, each summer the swimming pools would be closed and contact between children kept to a minimum because of the fear of polio.  And my father was a practicing physician and I remember going with him and seeing homes where there was a sign on the door: Quarantine and Keep Out Because of Polio.  Younger generations won’t remember this. This experience is a distant memory in the U.S. but is still very real for those living in polio-impacted countries.  I think that we need to communicate that struggle to younger generations.I think it is important to emphasize in meetings and literature the value of eradicating polio. We have almost reached the point of accomplishing the goal of eradication, but we need to push over the finish line to accomplish the goal.  In some regions, like Afghanistan and Nigeria, they’re still having experiences with paralytic polio, which the United States hasn’t since the 1980s.  That’s why it’s important to stay engaged with this effort across the world.


Q:

what modifications do you make to your chair for athletic use? are there specialized chairs for this purpose?

A:

Hello Dr. John Sever,

Thank you for your service. My questions are :

  1. There have been outbreaks of vaccine-associated polio in the past. How difficult was it to restore people's faith in the vaccines?

  2. Are there any goals for eliminating oral polio vaccine, and using only injectable polio vaccine?


Q:

Yes, there are specialized equipment for a wheelchair athlete like me to bike and run. I use a custom handcycle for the bike and a racing wheelchair for the run discipline.

A:

There have been outbreaks of vaccine associated polio, but they are extraordinarily rare - 1 in about 2.7 million doses of the vaccine administered. And these have been met with intensive immunization in the areas.  With that approach the outbreaks have been put under control.  There is an acceptance of the immunization program to proceed. In most areas of the world, parents are eager to protect their children from paralysis and there is strong acceptance of the vaccine.

Once the wild poliovirus has been shown to no longer be present, we anticipate we will transition to using only the injectable polio vaccine. But until that time, it is necessary to continue with intensive immunization with the oral polio vaccine. A combination of both vaccines (oral and injectable) is necessary to eradicate polio.  


Q:

What's the best advice you've ever received? Thanks for doing this AMA and sharing your amazing story!

A:

Do asymptomatic carriers exist for polio and would we need to continue to inoculate even after zero cases? And for how long?


Q:

Hi! I'm really happy to be doing this AMA. The best advice I ever received was from my mom, who told me to always take risks. As a person with a disability, she didn't want me to be limited in my thinking and want be open to all the possibilities as any of the rest of my siblings.

A:

Most people infected with polio don’t exhibit symptoms. Only about 1 in 200 people infected with polio are paralyzed by the disease. We will need to continue inoculation for at least three years after we reach zero cases and the virus is eradicated – very likely for several years beyond that time. 


Q:

Your mom sounds great, thx for sharing her wisdom:) Good luck with all your work with Rotary and the UN!

A:

What got you interested in the eradication of polio?


Q:

Thank you! (Love my mom!)

A:

In 1979, polio was no longer active in the United States and a few other countries.  So, we knew that it could be controlled and eradicated.  But most countries in the world were not immunizing for polio.  So, it was important that immunization be taken to all of the children of the world.  And Rotary was interested in accepting this opportunity and helping to immunize the children of the world.  


Q:

Congratulations!! Did you find encouragement throughout you preparation? Which were the biggest obstacles you had to face?

A:

Dr. Sever, early in your career you worked with Jonas Salk. How did that shape your thinking about polio, your career and your life?


Q:

The biggest obstacle I had to face in the Ironman in Kona was making the swim-bike cut-off time. I knew going in that I had to prepare with that in mind because my day would be done if didn't make the cut-off time. My biggest encouragement were the support of my family, friends and my coaches who kept reminding me that I could do it and made sacrifices with their time to help me prepare.

A:

I was at the National Institutes of Health doing research in infections in children and pregnant women and prevention of these infections.  I knew Doctors Salk and Sabin because of their work on polio vaccine.  Both doctors visited my office at NIH and discussed immunization.  Dr. Sabin was particularly interested in mass immunization to eradicate polio.  And we discussed this frequently.  With Rotary, I saw the opportunity to take this approach to the international level and to eradicate polio throughout the world.  I invited Dr. Sabin to join me in meetings with Rotary on this topic.  Rotary accepted the eradication of polio as their main program of international service.  


Q:

Do you have a family? Would you vaccinate your kids?

A:

Hey Doc, what can people without that kind of money do to help and what's in your cross-hair after Polio ?


Q:

Yes, I'm married and my husband and I have a 2 year old daughter. When getting her vaccinated against polio, it turned out to be one of the most meaningful days of my life. It was a bit emotional for me. I texted my best friend afterwards listing all of the ways my daughter's life would be different from mine simply she had access to a vaccine.

A:

Rotary is working actively to raise $50 million dollars per year for the next three years.  Even small donations will help to reach that goal.  People can also help raise awareness of the problem within their personal networks.  Consider contacting your local Rotary club to get involved as a volunteer. We are dedicated to completing the eradication of polio before moving on to other projects.  


Q:

What is the very best dessert?

A:

Thank you so much for your service, and doing this AMA. Apologies in advance if any one of them is inappropriate, but I've got three questions for you:

  1. Many people from a select few third world countries are violently opposed to getting their children vaccinated against polio. This opposition is primarily based on different conspiracy theories. A simple discussion with them isn't enough. They refuse to even consider. How can we overcome this, given that they are a hurdle in eradicating polio globally?

  2. The rivalry between Dr. Salk and Dr. Sabin is quite famous. Was Dr. Salk ever bitter that Dr. Sabin had violently opposed him?

  3. Whom did you spend more time with? Dr. Salk or Dr. Sabin?


Q:

My mom's homemade rasberry pie!

A:

Rotary has thousands of members in places like Pakistan. Since they are friends, neighbors and leaders in local communities, they are trusted community voices. Parents trust these members when they talk about the safety and importance of the vaccine. Rotary and its partners also work closely with other trusted community voices. For example, Rotary hosts regular workshops for Ulemas (religious leaders) to educate them on the importance of the vaccine. They then become advocates who go back to their communities and talk about why the polio vaccine is important. Overall, trust and demand for the vaccine in other parts of the world is high. 

Both Dr. Salk and Dr. Sabin were brilliant and highly committed to vaccines for polio.  The inactivated vaccine was used in the U.S. from 1955.  We switched to the live vaccine in 1962.  Today we are using both vaccines together toward the eradication of polio.  Both Drs. Salk and Sabin met with me in my office at NIH and Dr. Sabin moved to NIH in his retirement.  So I saw him very frequently and we worked together on the polio eradication program as well as on developing a new aerosolized measles vaccine.