The Cutter Incident: Consequences of a Public Health Crisis

在过去的两个世纪里，公共卫生创新极大地延长和改善了人们的生活。然而，这段旅程并非没有失误，这些错误似乎影响了公众对科学医学的信心和对公共卫生事业的支持。我们研究了卡特事件，这是美国历史上最严重的疫苗灾难，1955年首次释放的脊髓灰质炎疫苗导致超过10万名儿童接种了活的，致命的脊髓灰质炎病毒。结果，数百名儿童瘫痪或死亡。我们将使用档案数据来了解卡特事件如何影响未来的疫苗接种和疫苗公平。我们还将使用历史报纸来研究政府和其他关键行为者如何对这一事件负责，以及曝光如何影响通过当地媒体传播有关科学医学和公共卫生的叙述。我们的最终目标是研究公共卫生危机对健康和寻求健康行为的直接影响，并利用我们独特的报纸数据来显示其对社会和政策的更广泛影响。为了估计卡特事件暴露的影响，我们将疫苗分布的外源性变化与新数据结合起来。我们将比较给儿童接种受污染疫苗的社区与只接种安全疫苗的社区。我们还将利用疫苗相关（但不是疫苗引起的）脊髓灰质炎病例的变异。我们的第一组成果包括卫生成果，如脊髓灰质炎疫苗接种和麻疹疫苗接种以及疫苗公平。我们的第二组结果来自历史报纸。我们在方法论上进行了重大投资，将深度学习的先进技术应用于文档布局分析，从当地报纸的1000多万相关页面中提取标题、文章和图像。我们将使用自然语言处理（NLP）来衡量卡特事件是否影响了公众人物、联合专栏作家和其他文化偶像在社区中传播的突出叙述。我们特别感兴趣的是人们对科学医学和公共卫生的可信度和问责制的看法。该奖项反映了美国国家科学基金会的法定使命，并通过使用基金会的知识价值和更广泛的影响审查标准进行评估，被认为值得支持。

Public health innovations have greatly extended and improved life over the past two centuries. However, the journey has not been without missteps, and these mistakes have plausibly affected public confidence in scientific medicine and support for the public health enterprise. We study the Cutter Incident, the worst vaccine disaster in U.S. history, in which the initial release of a polio vaccine in 1955 led over 100,000 children to be vaccinated with live, virulent polio virus. As a result, several hundred children were paralyzed or died. We will use archival data to understand how exposure to the Cutter Incident influenced future vaccination and vaccine equity. We will also use historical newspapers to study how the government and other key actors were held accountable for this incident and how exposure conditioned the diffusion of narratives about scientific medicine and public health through local media. Our ultimate goal is to study the immediate impact of a public health crisis on health and health seeking behavior and leverage our unique newspaper data to show its wider impact on society and policy. To estimate the impact of exposure to the Cutter Incident we combine exogenous variation in vaccine distribution with novel data. We will compare communities where children were given contaminated vaccines to communities that only received safe vaccines. We will also exploit variation in vaccine-associated (but not vaccine-caused) polio cases. Our first set of outcomes includes health outcomes such as polio vaccination and measles vaccination as well as vaccine equity. Our second set of outcomes come from historical newspapers. We have made significant methodological investments to apply advances in deep learning to document layout analysis to extract headlines, articles and images from over ten million relevant pages from local newspapers. We will use natural language processing (NLP) to measure whether the Cutter Incident conditioned how prominent narratives voiced by public figures, syndicated columnists, and other cultural icons diffused into communities. We are particularly interested in sentiments about the trustworthiness and accountability of scientific medicine and public health.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.