LIVE POLIO IRUS VACCINES

Vaccination of Pregnant Women and Young Infants With Trivalent Vaccine 213
TABLE 7.
SUMMARY OF IMMUNOLOGIC RESPONSE OF 39 PREGNANT WOMEN WHO WERE FED TRI-
VALENT ORAL ATTENUATED POLIOMYELITIS VACCINE 1 Two OR THREE TIMES AT 4-6 WEEK INTERVALS
POLIOVIRUS
Antibody
Titer Change
Tvo
I
y J
Z
E
1
TyDe II
s y
o 1
Typ* III
Totals
m
78
i
t.fOld or greater increase
18 2 0
12
2 i
17 4 1
47 8 2
a
1
Sa&
2-fold increase
2-fold decrease
11 13 2
6 10 o
4 10 3
15 21 3
8 6 0
4 8 0
14 14 0
6 5 c0
1 14 2
40
20
48
21
9 32
5
o
4-fold or greater decrease
0 4 0
39 39 5
0 2 1
39 39 5
i 2 2
39 39 5
1 8
117 117
15
4r-fold or greater increase
46.2 5.1 0
31.0 5.1 20.0
43.6 10.2 20.0
40.1 6.8
13.3
4 -fold or greater increase 13 1 0 6 1 0 14 1 1 33 3 1
41
Eu 0=
Sane 2 1 1 1 1 1 1 2 0 4 4 2
2-fold ircrease 1 0 0 3 2 0 1 1 0 5 3 0
2-fold decrease 0 1 2 0 2 0 0 3 1 0 6 3
4 -fold or greater decrease 0 0 0 0 1 0 0 0 0 0 0 0
16 3 3 10 7 1 16 7 2 42 16 6
> 4-fold or greater increase 81.3 33.3 0 60.o 14.3 0 87.5 14.3 50.0 78.6 18.8 16.7
5 fed 0.5 cc X 3 at monthly intervals.
3 fed 1.0 cc X 2 at 4-6 week interval.
31 fed 2.0 cc X 2 at 6 week interval.
(10 ; 58 TCDo0 each type virus/cc)
to vaccination than one with a high titer, all prevaccination
titers of 1:64 or less were separated
from the total group and analyzed separately.
The lower one half of Table 7 shows the responses
to vaccination and revaccination of this low-titer
group. Although the numbers are small the
results from revaccination in this low titer group
are no better than those for the larger group.
In general, those women with poor antibody responses
to the first feeding were the same who
failed to respond to revaccination.
To determine if there is a teratogenic risk to
the fetus when the pregnant woman is fed oral
live attenuated viruses during early pregnancy, a
follow-up of infants born of women vaccinated
in this study and an earlier study by two of the
authors s was done. Hospital newborn examination
records were available and examined for all
infants born in BMH, CIH, or at University of
Minnesota Hospitals. In addition to the infants
born of women vaccinated in this and the other
study referred to, those born of women who were
known to have been pregnant and fed oral poliomyelitis
vaccine in the studies conducted by Barr
and associates 9 were followed. The status of
most of these infants was determined by a questionnaire
sent to the physician attending the
delivery. Some of these infants were delivered at
University of Minnesota Hospitals or known personally
by one of the authors. There were 69
women fed trivalent or one or more monovalent
strains of oral poliomyelitis vaccine prior to the
20th week of gestation as measured from the last
menstrual period and in whom the outcome of the
pregnancy was known. Of these 69 women, 58
had a significant antibody titer response to one or
more immunotypes after feeding of the vaccine.
In this group there were five spontaneous abortions.
Four occurred among women who were
pregnant for ten weeks or less at the time of vaccination.
One of these, a patient of one of the authors
(KAP) was fed the vaccine at a time when