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  MAURICE HILLEMAN DIED ON APRIL 11, 2005. THE DAY AFTER HIS death his obituary appeared on the front page of the New York Times. Lawrence Altman wrote it. While writing his story, Altman asked prominent scientists and doctors why Hilleman wasn’t better known to the public. Shock-jock Howard Stern read Altman’s article and asked his listeners why they knew about Britney Spears’s pregnancy but didn’t know about Hilleman. That same day, public health officials, epidemiologists, clinicians, and members of the media gathered at the University of Pittsburgh’s Alumni Hall to celebrate the fiftieth anniversary of Jonas Salk’s polio vaccine. At a party following the ceremony, one of the participants told a group of pediatric infectious disease specialists that Maurice Hilleman had died. No single group of doctors was better positioned to appreciate the impact of Hilleman’s work, but after hearing the news, all looked up with blank expressions, unmoved. Not one of them had ever heard his name.

  Hilleman’s relative anonymity can be explained in several ways. Despite his self-confidence; profane, confrontational style; and domineering, occasionally frightening manner, Maurice Hilleman was a humble man.

  When Anton Schwarz made his measles vaccine in the mid-1960s—one designed to compete with Hilleman’s—he called it the Schwarz strain. When Jennifer Alexander took liver cells from a man dying from liver cancer, and later found that they produced Australia antigen, she called them Alexander cells. And when D. S. Dane looked through an electron microscope and saw hepatitis B virus particles circulating in human blood, he called them Dane particles. Hilleman was different; not one of his discoveries bears his name. He named his measles vaccine the Moraten strain (Mor e At tenuated En ders), in recognition of the work of John Enders. He named his rubella vaccine the HPV77-duck strain, in recognition of the High Passage Virus originally developed by Harry Meyer and Paul Parkman. He named his two hepatitis B vaccines the plasma-derived and recombinant vaccines, noting the starting material and scientific process used to make them. After being the first to identify hepatitis A virus, he called the strain CR326. After finding that a previously unknown strain of monkey virus had contaminated early lots of polio vaccines, he called it simian virus-40. Hilleman allowed himself only one conceit: he named his mumps vaccine the Jeryl Lynn strain. But he didn’t name it the Jeryl Lynn Hilleman or JLH strain. And few people today reading the package insert know that Jeryl Lynn was Maurice Hilleman’s daughter.

  “He was interested in the result and the product, not in taking credit for [it],” recalled Tony Fauci, director of the National Institute of Allergy and Infectious Diseases within NIH. “When he had a vaccine or a discovery, his attitude was more, ‘Isn’t this an interesting discovery,’ rather than, ‘I, Maurice Hilleman, did this.’ It’s almost like it never crossed his mind. He didn’t really care about that. He just did [the work] and he let his accomplishments do the talking. So people know an incredible amount about what he did, but they don’t know that it was he who did it. And when the obituaries and the eulogies came out, that’s when people said, ‘Oh, my God, this one guy did all of this?’”

  “Despite his astounding accomplishments,” recalled Walter Strauss, “Maurice carried himself with great humility. [We all] know many scientists with enormous egos that rest upon the smallest achievements. Maurice was different. Coming from a hardscrabble childhood in the Depression, he realized how much he had to be thankful for. Many of his childhood friends no doubt spent their adult lives working Montana cattle farms, wearing their bodies down for little reward. Maurice looked back on that alternative and considered himself tremendously lucky to be able to devote himself to something that was so much fun.”

  Because most people view industry researchers as being different from academic researchers, Hilleman’s choice to work for a pharmaceutical company also contributed to his anonymity. Scientists, teachers, and researchers in academia believe that they are pursuing a higher calling, free from the bonds of commercialism. The public believes it too: people want scientists to be so dedicated and idealistic that they can live on air. In 1902 Wilhem Conrad Röntgen won the first Nobel Prize in physics for his discovery of X-rays. Röntgen believed that scientific knowledge was “to be freely shared for the good of humanity,” not rewarded with something as base and common as money. Röntgen gave the Nobel Prize money—seventy thousand gold francs—to charity. Twenty years later he died, penniless.

  In the late 1950s Samuel Katz was part of John Enders’s research team at Boston Children’s Hospital, involved in the quest to make the first measles vaccine. The Enders group never patented its vaccine. In 2005, Robert Kennedy Jr., in his article for Rolling Stone magazine, accused Sam Katz of having profited from a patent on the original measles vaccine. Katz was incensed: “I am cited personally as having a patent for a measles vaccine. That is just a total lie. I was part of the group of three who developed measles vaccine and brought it to licensure in 1963. However, our leader and mentor, John Enders, was a scientist who believed fully that the more people who are able to work on a problem, the more rapidly and likely it will be solved. Therefore, throughout our more than seven years of research we gave freely to any legitimate investigator who came to our laboratories. Dr. Enders was firmly opposed to patenting a biological product such as a vaccine, and we absolutely did not.” Katz wanted Kennedy to know that the Boston researchers would never have debased themselves by financially profiting from their work; they were academicians, guardians of the public good, not industrialists out for profit.

  Jonas Salk also made it clear to the press and the public that he would not profit from his polio vaccine. In April 1955, on the television program See It Now, Edward R. Murrow asked Salk, “Who owns the patent on this vaccine?” Salk thought for a moment and said, “Well, the people, I would say. There is no patent. Could you patent the sun?”

  As reflected in popular culture, today’s press and public share the disdain of Röntgen, Katz, and Salk for scientists interested in financial gain. A 1996 movie, Twister, subtly mirrors this belief. Twister is the story of two rival research groups trying to understand the physics of tornadoes. Each hopes that by placing small robotic measuring devices in the center of tornadoes it can better predict when and where the next one will appear. One research team is from academia, the other from industry. The academia group, led by Bill Paxton and Helen Hunt, consists of men and women of European, African, and Asian descent; all wear bright, colorful clothing that collectively looks like an entertaining patchwork quilt. The industry group, led by actor Cary Elwes, consists of white men in dark clothing; they look like a platoon from Darth Vader’s home ship. The academia group is funny, childlike, and irreverent. The industry group is serious, formal, and humorless. The implications are clear. Academic research is fun, pursued by those with the curiosity of children who are naïve and pure at heart; they seek knowledge because knowledge alone is rewarding. Industry research, on the other hand, is serious, pursued by grim, faceless adults; knowledge is obtained solely for the money it can bring. We are much more comfortable touting the accomplishments of scientists in academia than of those in industry. “[Maurice] got enormous peer recognition,” said Robert Gallo, codiscoverer of HIV. “But do we know anyone as a scientist in the corporate world who became well known? I don’t think so.”

  “When Maurice came to work at Merck, it was wonderful,” recalled Maurice’s wife, Lorraine. “You had people to wash your pipettes and to wash your glassware. You didn’t have to do any of that yourself. He couldn’t believe that. And there was money to spend to do what you needed to do. Money wasn’t an object. You could do your research.” But Hilleman understood that most people saw pharmaceutical company scientists as inferior to those who worked in academia. He sarcastically referred to his working for “dirty industry.” But he also knew that with the resources provided by industry he could have an impact on human health that would never be matched by the greatest academic centers. And that was a trade he was perfectly willing to make.

  Hilleman’
s choice to get a doctorate in microbiology, not a medical degree, also contributed to his lack of recognition. When Hilleman finished weakening his daughter’s mumps virus in the laboratory, he asked Robert Weibel and Joseph Stokes Jr. to test it. After Weibel and Stokes published their findings, and children in the United States began to receive the vaccine, Merck distributed a heart-warming picture to help physicians understand the vaccine’s origins. In the center of the picture is two-year-old Kirsten Hilleman, getting a shot of the new vaccine. Tears are coursing down her face, and her mouth is open in a wide circle, screaming. Her sister, Jeryl Lynn, stands to her right. “I was telling her that everything was going to be all right,” remembers Jeryl. To Kirsten’s left—giving the vaccine—is Robert Weibel. Merck made thousands of copies of this photograph and distributed it to media outlets throughout the United States and the world. Although both of his daughters were in the photograph, Hilleman was nowhere to be found. Many people interpreted this photograph to mean that Robert Weibel had developed the mumps vaccine. Because Hilleman was a PhD working behind the scenes—not an MD on the front lines, giving vaccines and explaining them to the press and the public—few knew his name or his contributions.

  Hilleman’s lack of recognition didn’t end with the mumps vaccine. After Wolf Szmuness completed the trial of Hilleman’s blood-derived hepatitis B vaccine, he published his findings in one of medicine’s most prestigious journals, the New England Journal of Medicine. Newspapers and magazines declared the importance of Szmuness’s work. Radio stations interviewed him about his findings. Television stations showed video clips of Szmuness inoculating men who had volunteered for the trial—footage provided by Merck. When professional societies held meetings to discuss the hepatitis B vaccine, they called Wolf Szmuness. When advisory bodies wanted to determine exactly how the hepatitis B vaccine should be used in the United States, they called on Szmuness for answers. As far as the press, the public, and public health agencies were concerned, Wolf Szmuness had developed the hepatitis B vaccine.

  But Szmuness hadn’t developed the hepatitis B vaccine. Maurice Hilleman had. Szmuness’s seminal publication in the New England Journal of Medicine contained the names of nine authors; Hilleman’s wasn’t among them. As a consequence, the press didn’t seek Hilleman out, and doctors, nurses, and public health officials had no idea that he was the inventor. “I wanted to stand back and let Wolf determine whether the vaccine worked or not,” recalled Hilleman. “I thought that if my name appeared on the paper, or if I was the one put in front of the television cameras or radio microphones, people would think that I was selling something. Because I was in industry and it was an evaluation of my work, ethically I felt that I had to stand back.” Because of his own reticence and his company’s discomfort about promoting him, few people recognized Maurice Hilleman for what he considered to be his greatest accomplishment.

  Hilleman’s work on the measles vaccine has also been largely ignored. Between 1989 and 1991 measles virus reemerged in the United States; about ten thousand people were hospitalized, and more than one hundred were killed by the virus. In response to the epidemic, the CDC recommended that all children receive a second dose of measles vaccine during childhood. The recommendation worked. In 2005, federal advisors, vaccine makers, the media, and the public gathered in Atlanta to hear the results of the new recommendation. The CDC reported that during the previous year only thirty-seven new cases of measles had occurred; no one had been hospitalized, and no one had been killed by the virus. Public health officials were excited about the possibility of finally eliminating measles from the United States. During the meeting, the chairman of the federal advisory committee recognized Sam Katz as the developer of the measles vaccine. Katz was a liaison member of the committee. “I’d just like to take a moment to recognize the contributions of Sam Katz,” said the chairman. “He is the man who gave us the measles vaccine.” Katz received an ovation. A humble, honest man, Katz held his hands up and tried to quiet the audience. “That’s enough,” he said.

  Sam Katz and the Boston team made an important contribution by isolating measles virus and weakening it in their laboratory. They deserved an ovation. But their vaccine wasn’t weak enough; it caused high fever and rash in as many as four of every ten children who received it. A better vaccine was made by Maurice Hilleman, who, unfortunately, never received a standing ovation for his achievement.

  FOR ALL OF HIS ACCOMPLISHMENTS, MAURICE HILLEMAN NEVER WON the Nobel Prize. Because the prize cannot be awarded posthumously, he never will win it.

  Alfred Nobel decided to create his prize after reading his own obituary. Born on October 21, 1833, in Stockholm, Sweden, Nobel was interested in explosives—specifically those that could be used in coal mines. At the time, miners used black powder, a form of gunpowder. But Nobel was interested in a much more powerful, volatile explosive: nitroglycerin. In 1862 he built a small factory to make it. One year later, Nobel invented a practical detonator that consisted of a wooden plug inserted into a metal tube; the plug contained black powder, and the tube contained nitroglycerin. Two years later Nobel improved his detonator by replacing the wooden plug with a small metal cap and replacing the black powder with mercury fulminate. This second invention, called a blasting cap, ushered in the modern age of explosives.

  Nitroglycerin, however, remained difficult to handle. In 1864 Nobel’s nitroglycerin factory blew up, killing Nobel’s younger brother Emil as well as several others. Undaunted, Nobel continued to work with the volatile chemical. By 1867 he had found that he was able to stabilize nitroglycerin by adding dirt containing large quantities of silica. He called his third invention dynamite, from the Greek dynamis, meaning “power.” Dynamite provided armies with a new deadly weapon and made Alfred Nobel a very rich man.

  In 1888 Alfred’s brother Ludvig died in Cannes. French newspapers—confusing Ludvig with Alfred—printed Alfred’s obituary under the headline “Le marchand de la mort est mort” (The merchant of death is dead). Nobel had always believed that his explosives, apart from their practical value, would be used as weapons of peace, not war. “My dynamite will sooner lead to peace,” he said “than a thousand world conventions. As soon as men find that in one instant whole armies can be utterly destroyed, they surely will abide by golden peace.” (Where have we heard this before?) After reading “his” obituary, Nobel realized that he was wrong; he would be remembered as a war maker, not a peacemaker. So on November 27, 1895, Nobel revised his will. “The whole of my remaining real estate shall be dealt with in the following way: the capital shall be annually distributed in the form of prizes to those who, during the preceding year, shall have conferred the greatest benefit to mankind [and it will be] divided into five equal parts: physics, chemical discovery or improvement, physiology or medicine; the field of literature; and the best work for fraternity between nations and promotion of peace.” One year after revising his will, on December 10, 1896, Alfred Nobel died of a stroke in San Remo, Italy. Five years later, the king of Sweden awarded the first Nobel Prize. Today, no award is more coveted.

  In accordance with Nobel’s will, scientists working at the Karolinska Institute in Stockholm determine the winner of the Nobel Prize in physiology or medicine. But scientists are often more enamored with technological innovations than with public health achievements. As a consequence, the most important discoveries in the field of medicine have not been given to those who have saved the most lives.

  Hilleman’s accomplishments in the field of vaccines weren’t the only ones snubbed by the Nobel Prize committee. Jonas Salk’s polio vaccine caused a dramatic decrease in the incidence of polio in the United States and eliminated polio from several other countries. Within days of the announcement that his vaccine worked, Salk was honored at the White House. During a ceremony in the Rose Garden, in a voice trembling with emotion, President Dwight Eisenhower said, “I have no words to thank you. I am very, very happy.” But Jonas Salk never won the Nobel Prize. Months after Salk’s death, Renato
Dulbecco, winner of the Nobel Prize in medicine in 1975 for his work on viruses that cause cancer, wrote Salk’s obituary for the scientific journal Nature. “For his work on polio vaccine, Salk received every major recognition available in the world from the public and governments. But he received no recognition from the scientific world—he was not awarded the Nobel Prize, nor did he become a member of the U.S. National Academy of Sciences. The reason is that he did not make any innovative scientific discovery.” Although Salk’s vaccine was one of the greatest and most anticipated public health achievements of the twentieth century, the Nobel Prize would never be his.

  A few years later, Albert Sabin developed his polio vaccine. By 1991 Sabin’s polio vaccine had eliminated polio from the Western Hemisphere and much of the world. By 2015, if Sabin’s vaccine continues to be given in India, Africa, Indonesia, and Asia, it will likely eliminate polio from the face of the earth. Sabin was a genius. Recognized by his colleagues, he won many awards and honors, including induction into the National Academy of Sciences. The Sabin Vaccine Institute in Washington, D.C., stands as a permanent shrine to honor the man. But Albert Sabin, like Jonas Salk, never won the Nobel Prize. The only Nobel Prize for the development of a polio vaccine was given to the Boston research team of John Enders, Fred Robbins, and Tom Weller. And that’s because it was the Enders team that figured out how to grow polio virus in cell culture, allowing both Salk and Sabin to make their vaccines.

  Maurice Hilleman made his measles, mumps, and rubella vaccines by weakening viruses in laboratory cells. His efforts led to the virtual elimination of those diseases in the United States. But Hilleman wasn’t the first person to figure out how to grow viruses in cell culture, and he wasn’t the first person to find that human viruses could be weakened in animal cells. That person was Max Theiler. So it was Theiler, in 1951, who won the Nobel Prize.