Live virus vaccines predated polio—that's how we vaccinate against smallpox

Most polio cases today are vaccine-derived rather than naturally occuring

Weakened, live virus vaccines—which aren't offered in the US—carry a risk of virus being shed in the stool. Rarely, the shed virus mutates and leads to vaccine-derived polio infections. Most recent polio cases are genetically linked to those vaccines. As shown in this graphic, there are typically hundreds of vaccine-derived polio cases annually.

Before vaccines, there was 'variolation': what was it?

Before the technology behind vaccinations was discovered, some keen observers of medicine around the globe noticed how previous infections could impact future ones. Learn about the techniques early physicians used before they had vaccines.

Inactivated polio virus vaccine is the only one offered in the US—it contains no live virus

Inactivated polio virus vaccines cannot cause illness because the virus isn't alive. It's been the only polio inoculation offered in the United States since 2000 and provides almost complete protection

The oral, live virus vaccine is the most robust but carries more risks

The live virus vaccine, delivered via oral drops, induces the best protection in the body. Because it includes a live, weakened form of the virus there's an extremely small risk it can sicken recipients and potentially cause paralysis. Recipients also shed the virus in their stool, which can rarely lead to vaccine-derived cases of the virus if the virus mutates. (Some users may experience a paywall.)

Oral polio vaccines cause approximately 250 to 500 polio cases per year globally

Live, weakened polioviruses in the oral vaccine can very rarely mutate into a disease-causing form and lead to vaccine-associated paralytic poliomyelitis. This oral vaccine is not available in the United States.

View this timeline of polio milestones and vaccine development

Polio has a long history in art and medicine, dating back centuries. It includes a representation of an apparent polio survivor with a shriveled leg in ancient Egyptian art. See milestones in the history of polio in this timeline.

A major US-designed polio vaccine was first tested in the Soviet Union

Albert Sabin's live attenuated virus vaccine—requiring two drops in the mouth—didn't garner political support in the US, so it was tested in the Soviet Union in the late 1950s.

Jonas Salk developed the first successful polio vaccine—and tested it on himself

The American medical researcher developed the inactivated virus vaccine from 1952 to 1955 and proved that it could prevent disease. He tested the virus on himself and his family in 1954 and then carried out formal clinical trials on more than 1.3 million children.

Needle-free polio vaccines were offered in Afghanistan for the first time in 2026

Fear of needles has been one barrier to eradicating polio in Afghanistan. Vaccinators are now using a needle-free jet injector to deliver the vaccine through the skin—an approach that's previously been used in other locations. The inoculation includes the inactivated virus vaccine (the vaccine without any live virus in it).

Mpox, formerly known as monkeypox, does not come from monkeys but it was first identified in laboratory monkeys in 1958.

Wastewater testing has detected genetic evidence of polio, triggering vaccine boosters

Sampling of wastewater in London in 2022 detected fragments of polio virus, suggesting a vaccine-derived version of polio may be circulating. No one became ill, but the finding did trigger calls for a renewed booster inoculation campaign.

A 1954 outbreak at a Boston boarding school allowed scientists to isolate the measles virus and formed the basis for the first measles vaccine.

Variola: the second-deadliest virus on Earth

Because it was declared eradicated in 1980, many forget smallpox is one of history's deadliest diseases—in its final century, it's estimated to have claimed 500 million lives. This 11-minute video from production studio Kurzgesagt takes a look at...

Improved 19th-century sanitation meant kids encountered polio later, with worse results

Almost all children likely used to contract poliovirus, but scientists suggest that when infants encountered it very early in life—due to poorer conditions and hygiene—they still had some maternal protection from pregnancy or through breastmilk, so the symptoms were more flu-like.

Attenuated vaccines introduce a weakened version of the virus into the body

Some vaccines, like those for measles, rely on weakened versions of a virus. These weakened pathogens are introduced into the body, triggering an immune response and helping the immune system learn to protect itself against stronger versions of the virus. (This also explains why some vaccines make you feel under the weather.)

The flu vaccine has evolved alongside discoveries of new virus strains

After influenza B was identified in 1940, researchers created a two-strain vaccine by 1942. The WHO later built a global surveillance system to track mutations, enabling vaccines to be updated annually to target the strains most likely to circulate.

Only one strain of wild poliovirus continues to infect humans

Three strains of polio used to regularly infect humans, but two of the strains were declared eradicated in 2015 and 2019, respectively. In 2019, world health leaders estimated complete polio eradication—if achieved—would save $14B by 2050.

See colorized mpox virus particles grown in culture at Fort Detrick, Maryland, where high-biosecurity pathogens are studied.

See when the last case of wild poliovirus was found in each country

This chart shows when wild polio cases were last reported in each country worldwide. Beyond wild poliovirus, rare outbreaks can occur related to mutated strains of oral polio vaccine.

Measles infection, which was nearly universal during childhood in prevaccine era, was described by the Persian physician Rhazes in the 10th century as "more to be dreaded than smallpox."

Most flu vaccines are still produced using chicken eggs

For decades, influenza vaccines have been made by growing viruses inside fertilized chicken eggs. Though newer methods using cell cultures or recombinant technology exist, egg-based production remains the primary global manufacturing process.

Polio is currently circulating in only two countries but it remains difficult to eradicate

Wild polio virus is only endemic in two places. Afghanistan and Pakistan are the last two countries with naturally occurring polio cases. Vaccination campaigns have been plagued by misinformation, Taliban bans on vaccines, distrust of public health workers, and violence, including the killing of vaccinators.

Polio commonly spreads when virus-laden feces gets into our mouths

This highly infectious disease is transmitted from one person to another, mainly when we eat virus-laden poop particles. Less frequently, contaminated food or water can transmit the virus, or people can be infected via respiratory droplets (from coughing or sneezing).

Two Lyme disease vaccines were in development in 2026

As of early 2026, there was no vaccine for Lyme disease available. One candidate vaccine, VLA15, was in later-stage clinical trials. Another designed to provide seasonal protection was licensed to a pharmaceutical company in 2025, and was planned for human clinical trials.

An Ebola vaccine was developed during the 2018 west African Ebola outbreak, but the 2026 Ebola outbreak is with a different species of the virus, not the one that the vaccine is approved to treat.

Edward Jenner, the father of vaccinations

The British physician was the first to attempt to inoculate someone from smallpox using its milder cousin, cowpox. His innovations and documentations would prove crucial to the deployment of widespread vaccinations.

Marburg virus, related to Ebola, is also extremely deadly, and has no available vaccine.

Poliomyelitis is derived from Greek

Polio, formally called poliomyelitis, comes from the Greek words for gray (polios) and marrow (myelos)—a reference to the spinal cord tissue that, when infected by the virus, causes paralysis.

Humans are the only known reservoir of poliovirus

The virus has not been found in any other species, which makes humans the only known reservoir for polio. In laboratory settings, nonhuman primates have also been infected with the virus, but there's no evidence that they contract the virus in nature.

The COVID-19 pandemic led to a decrease in immunizations in the US and worldwide

Public health funds and resources that were diverted to COVID-19 response reduced efforts to combat polio and vaccinations for polio and other diseases declined during the pandemic, putting more people at risk for polio.

What are universal vaccines?

As viruses mutate and develop, vaccines have to adapt, leading to regular recommended injections like flu shots. Researchers are working to develop universal vaccines that aim to protect against multiple virus variants if not entire virus families. These vaccines work by creating broadly neutralizing antibodies (bnAbs) that target aspects of viruses that don't typically mutate and are integral to the virus' survival.

How the 1918 pandemic spurred developments in virology and vaccines

This article provides an in-depth historical account of the 1918 Spanish Flu pandemic, including its impact on the global population and how its occurrence spurred significant advancements in the study of viruses—laying the groundwork for the...

See the polio cases that occur worldwide each year by region

Worldwide, the number of cases of polio reported each year from 1980 to 2024 has declined. This graphic depicts regional trends and declines by year.

Diphtheria was once a leading childhood killer before antibiotics and vaccines

In 18th- and 19th-century outbreaks, some New England families lost as many as eight children to diphtheria, and fatality rates in hospitals often topped 60%. The invention of antitoxins, penicillin, and vaccines dramatically reduced deaths.

Every virus is classified into 7 groups based on genetic differences

Viruses infecting humans have been named based on symptoms ("chickenpox") or the location or animal in which they were first discovered ("Bolivian Haemorrhagic Fever" and "Monkeypox"). For clarity among scientists and to reduce stigma, virologists classify the 15,000 known viruses (270 of which infect humans) by their basic genetic material.

Paralysis from polio occurs in under 1% of infections

About 1 in 200 cases of infection causes paralysis. For paralysis to occur, the virus travels from the throat, intestines, and gut to infect specific cells within the spinal cord and brain stem that control movements. Within hours of invading the nervous system, paralysis can occur. The virus can be present in bodily secretions and stool for multiple weeks post-infection.

The measles vaccine has saved an estimated 94 million lives since its introduction.

See the evolution of Ebola vaccine and treatment development.

'Our greatest responsibility is to be good ancestors.'

- Polio vaccine developer Jonas Salk (1914–1995)

Breaking down the different types of vaccine technologies

There are several different types of vaccines. Each type is designed to teach your immune system how to fight off germs—and the serious diseases they cause. This short overview breaks down the differences between the types.

In 1933, the influenza virus was first identified through 'ferret flu' experiments, which proved that the disease was viral—not bacterial.

Explore a technical look at the measles virus and its toll on humanity through the ages.

Small genetic changes that accumulate over time force flu vaccines to be updated regularly.

mRNA vaccines teach the immune system how to respond to a threat, using a molecule called messenger RNA.

Malaria vaccines are not routine because they have limited effectiveness.

Approximately 70% of all polio infections in children are asymptomatic

Most polio infections are asymptomatic or appear with only flu-like symptoms. Infected individuals can still shed the virus in their stool and mucus for days or weeks

Measles evolved from an ancient cattle disease, branching off as recently as 3,000 years ago.

The 2026 Ebola outbreak in the DRC is spurring new Ebola vaccine development for the Bundibugyo species.

Watch how viruses like Ebola can spill over from animals to humans—and vice-versa.

Cholera vaccines can protect people from disease for months—or even years

There are three recommended cholera vaccines on the market. The number of required shots and the period of protection they provide vary, but each of them can be life-saving.