VACCINE VISIONARIES

		The “Great Race of Mercy”—
	Vaccine delivery logistics during the early 1920s

Vaccine delivery in the 1920s was very different from what it is today. “In 1925, 20 mushers and about 150 sled dogs relayed diphtheria antitoxin 674 miles (1,085 km) by dog sled across the U.S. territory of Alaska in a record-breaking five and a half days, saving the small city of Nome and the surrounding communities from an incipient epidemic.”

Nome was the largest town in northern Alaska with a population of around 1435 inhabitants, which included both native Alaskans and settlers. Located very close to the Artic Circle, the town was cut off from civilization during the winter months. “From November to July, the port on the southern shore of the Seward Peninsula of the Bering Sea was icebound and inaccessible by steamship, and the days shortened with the onset of the polar night. The only link to the rest of the world during the winter was the Iditarod Trail, which ran 938 miles (1,510 km) from the port of Seward in the south, across several mountain ranges and the vast Alaska Interior before reaching Nome.” In fact, during these months, mail and supplies could be reached to Nome only through the dog sled.

In the summer of 1924, Curtis Welch, the only doctor in Nome discovered that his supply of 8000 units of diptheria vaccine had expired. He placed an order for fresh stocks but they did not arrive and the port closed for winter.

When a two-old in a nearby village displayed the early symptoms of diphtheria, Curtis first identified it as tonsillitis. The child died the next morning. Soon the number of ‘tonsillitis cases increased drastically and there were more casualties. On January 20 the first case of diphtheria was diagnosed. Welch had the vaccines but was not assured of their efficacy and therefore did not administer it. The boy died. But when another case was detected he took the risk but could not save the patient.

Welch then called the Mayor George Maynard, and arranged an emergency town council meeting. He told them that he required ‘at least one million units to stave off an epidemic’.

On January 22 telegrams were dispatched to alert all major towns in Alaska including the governor in Juneau of the public health risk and to the U.S. Public Health Service in Washington, D.C., which read:

An epidemic of diphtheria is almost inevitable here STOP I am in urgent need of one million units of diphtheria antitoxin STOP Mail is only form of transportation STOP I have made application to Commissioner of Health of the Territories for antitoxin already STOP There are about 3000 White natives in the district.

By then, there were 20 more confirmed cases and 50 others at risk.

Once excess stocks had been identified at hospitals in the US, the question was how was the 300,000 units were to be delivered. There was a heated debate about aircraft versus dog sleds. ‘The only planes operating in Alaska in 1925 were three World War I vintage Standard J-1 biplanes belonging to Bennet Rodebaugh's Fairbanks Airplane company The aircraft were dismantled for the winter, had open cockpits, and had water-cooled engines that were unreliable in cold weather.’ Finally the authorities settled on dog sleds as the most reliable form to transport the vaccines.

As the relay proceeded, the number of diphtheria cases continued to increase. Braving subzero temperatures and blizzard-like conditions, ‘together, the teams covered the 674 miles (1,085 km) in 127 and a half hours. It was a world record.’

A month later, a second relay delivered the additional stocks that were required. Though air transport was authorised, the plane failed to start and once again the dog sleds came to their rescue. But this time the epidemic was already under control. The mushers and their dogs became heroes and occupied front-page space in newspapers across the country. The nascent medium of the radio covered the news extensively. ‘Balto, the lead sled dog on the final stretch into Nome, became one of the most famous canine celebrities, and had a statue installed in New York City's Central Park to commemorate his courage. The publicity also helped spur an inoculation campaign in the U.S. that dramatically reduced the threat of the disease.’

	Statue of Balto in Central Park: Frederick Roth