The Story Of The Rhesus Vaccine

Dr. William Pollack was a senior scientist in the research laboratory of Ortho Pharmaceutical Company in Raritan, N.J., in the early 1960s when he began collaboration with two Columbia University researchers, Dr. Vincent J. Freda and Dr. John G. Gorman, to conceive a novel treatment for erythroblastosis fetalis, a blood disorder commonly called Rh disease.

Prior to that, researchers had developed other approaches to treating Rh blood disease, including potentially dangerous intrauterine transfusions, before the idea of a vaccine emerged.

The ailment is caused by seemingly superficial differences in the blood types of pregnant women and their fetuses.

Besides the biochemical traits that define the major blood types — A, B, AB and O — the blood of 85 percent of people carries a cluster of surface proteins known as the Rh factor, named for the rhesus monkeys in which it was first identified in 1940. Blood transfusions between people who have the Rh factor (known as Rh positive) and people who do not (Rh negative) cause severe immune reactions.

Rh disease occurs when a pregnant woman is Rh negative and her fetus is Rh positive. In the mixing of blood between the two during pregnancy, the mother’s Rh-negative blood cells produce antibodies that attack the blood cells of the fetus. Depending on the strength of the mother’s immune response, the effects on the baby can range from mild anemia to stillbirth.

Dr. Pollack and his partners devised an “ingenious” counterattack, as it was described in an introduction to their work in “Hematology: Landmark Papers of the Twentieth Century,” a collection published in 2000 by hematologist organizations.

The three men produced a vaccine that patrols the mother’s body, dispatches invading Rh-positive cells and causes no harm to the fetus. The vaccine was made from a passive Rh-negative antibody, which soon wears out. It not only solves the mother’s temporary immunity problem but also, more important, prevents her immune system from mounting a full-fledged response of its own, which would endanger the fetus she was carrying as well as any future ones.

The vaccine, a gamma globulin solution known generically as Rh immune globulin and later by its brand name, RhoGAM, was first tested on volunteers at the Sing Sing Correctional Facility in Ossining, N.Y., and later on 600 Rh-negative women in clinical trials. It worked 99 percent of the time, was approved by the Food and Drug Administration and went on the market in 1969.

In 1971, the World Health Organization recommended to its 193 member nations that Rh testing and treatment with immune globulin be made part of the standard protocol of medical care for pregnant women. In a follow-up report in 1998, the organization said the incidence of Rh blood disease, once estimated at 200,000 cases a year worldwide, had become rare.

Among his other contributions, Dr. Pollack was credited with devising the process in which the blood components needed to make the vaccine are isolated and recombined in a liquid solution.

William Pollack Dies at 87; His Vaccine Saved Infants

By PAUL VITELLO, New York Times, November 12, 2013