If you were born before the early 1960s, only a small miracle could have prevented you from getting a childhood disease. Every year at least a quarter of a million children contracted the mumps, a highly contagious viral disease that caused fever, swollen glands and exhaustion. This year, thanks to vaccines to prevent the disease, less than 5,000 cases were reported. Mothers used to know at a glance whether their child had measles—after all, most contracted it by the age of 15. During a particularly bad rubella outbreak in 1964, more than 12.5 million cases of the infection were reported, and thousands of children died or were born with severe disabilities.
These diseases didn’t go away on their own. Virologist Maurice Hilleman dedicated his life to creating vaccines to eradicate childhood illnesses. By the time of his death in 2005 at the age of 85, he had developed more than 40 vaccines including Measles Mumps and Rubella (MMR), chickenpox, meningitis, pneumonia, hepatitis A and hepatitis B.
The virologist’s legacy is the subject of the 2016 documentary Hilleman: A Perilous Quest to Save the World’s Children, which was screened recently at the Smithsonian’s National Museum of American History as part of the museum’s Antibody Initiative. A panel of public health experts, including Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, reflected on how Hilleman’s vaccines helped to prevent a future of pandemics and childhood deaths, though few today know his name. After all, Hilleman had spent his professional life avoiding the limelight in favor of something more important: results.
“He didn’t really care at all about fame,” said Fauci, Hilleman’s longtime friend. “The only thing he cared about was saving the lives of children. And he was amazing. You had to know the guy to know that’s the way he felt.”
From an early age, Hilleman experienced firsthand the effects of a pandemic that reached even his rural Montana hometown. Shortly after his birth in 1919, the deadly Spanish flu epidemic killed almost five percent of the world’s population—sometimes death would come within hours of the first symptoms. As Hilleman grew up, he became obsessed with science; he preferred books, like Darwin’s On the Origins of Species, over church sermons and the religious services his Lutheran family dragged him to as a young boy. With a scientist’s passion for evidence, he once asked a disgruntled priest to actually prove that wine turned to Christ’s blood.
Tenacity and intellect netted him a scholarship to college and then admission in 1941 into a Ph.D. program at the University of Chicago, the top scientific research school in the country at the time. There, he began to study virology intensely, discovering that chlamydia was caused by curable bacteria, not a virus. But instead of entering the world of academe and teaching classes, he turned to instead to industry.
Academia, full of paper-writing and lecturing, didn’t allow him to use his skill set for practical applications. “The goal of industry very much matched Maurice’s desires to get to something that worked,” Fauci said. “Not necessarily the first person to publish something.”
When Hilleman started his first job at the pharmaceutical company E. R. Squibb & Sons in 1944, American soldiers deployed in Japan had been contracting Japanese encephalitis from infected mosquitoes. The U.S. government tasked the company with developing a vaccine to bring transmissions to a halt. It was “an impossible task,” as researchers like Paul Offit put it, but Hilleman got to work. He set up shop in a barn where he and his research team dissected mouse brains, put them in a blender and harvested the vaccine. It wasn’t pretty, but it worked. That year, vaccines were given to thousands of U.S. soldiers and likely prevented many of them from contracting the disease.
Not resting on his laurels, Hilleman moved to the Walter Reed Army Institute of Research, where he continued his pioneering approach to looking at virus mutations. He learned how quickly a virus could mutate its form; because of this, once-effective vaccines could become totally useless within short periods of time. This could spell trouble for virologists trying to develop vaccines for fast-moving diseases, especially ones that could reach pandemic level.
His approach proved vital in the spring of 1957 when Hilleman saw an article in the New York Times about flu deaths in Hong Kong describing glassy-eyed children lining up outside a clinic in Hong Kong. Something about their eyes tipped him off. His gut told him that these deaths meant the next big flu pandemic. He requested a sample of the virus to be shipped from Hong Kong so manufacturers could get started on a vaccine that could be rolled out by the time American children started school in the fall. It was an expensive gamble; the vaccine's developers would waste millions of dollars if the disease didn’t end up hitting the U.S., but health officials risked thousands of needless deaths if they waited for more evidence.
Luckily, their gamble paid off. Although 70,000 people died in the U.S. from the Asian flu between 1957 and 1958, scientists believe that the Hong Kong flu easily could have killed one million without the vaccine.
From there, Hilleman moved to the Merck pharmaceutical company and continued his laser-focus attention on the prevention of other diseases. Some of them hit particularly close to home. When his daughter Jeryl Lynn came down with the mumps in 1967, he swabbed her throat and collected the virus specimens to take back to his lab. His other daughter, one-year-old Kirsten, was among the first to take the experimental vaccine. “There was a baby being protected by a virus from her sister, and this has been unique in the history of medicine, I think,” Hilleman remembered in an interview.
Colleagues and admirers attributed his success to his tenacity, but Hilleman insisted that his success couldn’t have happened without gallus gallus domesticus—the humble chicken. He had become familiar with their care and upkeep while working on his family’s Montana farm as a child. When the time came to use fertilized chicken eggs to incubate vaccines, he knew them well. “I got to know chickens and in my early career, chickens became my best friends,” he deadpanned to the camera in a rare television interview he did with The Vaccine Makers project.
For much of Hilleman’s life, people celebrated vaccines and the people who developed them. However, there was a sea change in the years leading up to his death. Pharmaceutical companies making vaccines dwindled as more profitable drugs like Viagra or Lipitor that people took every day became available.
In 1998, a widely-discredited study claimed a link between the MMR vaccination and autism, a misperception that has since challenged the public trust in childhood vaccinations. Hilleman began to receive hate mail and death threats from those who bought into the study’s claims. Alexandra Lord, a curator at the American History Museum, said that these anti-vaccine attacks signified societal amnesia about the significant numbers of children lost to now-preventable diseases. “In many ways, we don’t understand the threat anymore, in part because Maurice Hilleman had been so successful,” she says.
The museum’s Antibody Initiative is based in part on retelling the stories of pioneers like Hilleman as a reminder of why vaccinations are still crucial in early childhood healthcare. “I think it’s the historian’s obligation to remind people of what didn’t happen as well as what happened,” says Lord.
Editor’s Note, October 26, 2017: Corrections have been made to this article. Hilleman's mother died of child bed fever, a condition caused by unsterile birthing conditions, not the flu; his daughter Kristen was among the first to receive the mumps vaccine, not the first; and the 1957 New York Times article that prompted Hilleman's 1957 revelation did not include a photograph.