LIVE POLIO IRUS VACCINES

3. VIROLOGICAL FINDINGS AND ANTIBODY RESPONSE OF
INFANTS FED MULTIPLE TYPE ORAL POLIOMYELITIS
VACCINE. A PRELIMINARY REPORT*
SONNIA LEVINE AND NATAN GOLDBLUM
The Virus Laboratory
Ministry of Health, Tel Aviv-Yaffo, Israel
DR. GOLDBLUM (presenting the paper): Paralytic
poliomyelitis in Israel, as in certain other
areas of the world, is of a strictly infantile
character, and a high incidence of paralysis occurs
in infants, four to 12 months of age.' 2 Antibody
studies on infants of this age group have
shown that they are usually devoid of maternal
antibodies. 3 Thus, active immunization against
poliomyelitis at this age is highly desirable.
Attention has recently been called to the effect of
single-and multiple-type oral poliomyelitis
vaccines for immunization of infants. 4- 7
In view of our specific interest to investigate
the advisability of early age immunization with
an attenuated oral vaccine under local conditions,
the present study was set up with the purpose
of determining the following:
1. Effectiveness of a multiple type vaccine
when fed to newborns.
2. Effectiveness of the vaccine when fed to
infants, 1-4 months of age.
3. Immunological response to one or two
feedings.
4. Intestinal resistance to repeated feedings.
5. Possible interference between poliomyelitis
types fed.
6. Possible interference by naturally occurring
enteroviruses with implantation of fed
polioviruses.
Location of the field trial. The experiment is
being carried out in Kyriat Shmone, a newly
developed settlement in upper Galilee. This
somewhat isolated town has a population of
14,000 composed of new immigrants representing
many ethnic groups. A health center, under
* Aided by a grant from the Lederle Laboratories,
Division of the American Cyanamid Company, Pearl
River, New York.
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the auspices of the Ministry of Health, covers
preventive health services. A maternity ward
and child welfare clinic are attached to the
center. An average of 50 infants are born
monthly in the maternity ward. Seven infantwelfare
subclinics serve the population. Physicians
and qualified public health nurses are in
charge of the child welfare work in both the
health center and subclinics. This work was
carried out with the full cooperation of these
physicians and public health nurses.
Plan of the study. The study involves approximately
500 newborns and infants. Virological
and immunological follow-up was carried out
according to the following schedule:
Infants, 1-4 months old. There were approximately
200 infants of this age group in Kyriat
Shmone when this work was initiated. During
the month of December 1959, these infants were
brought to the health center and fed the oral
vaccine after pre-feeding blood and stool specimens
were taken. Infants, one to two months
old, at the initial feeding were re-fed in April,
1960. Post-feeding stool specimens were collected
at weekly intervals for a period of four
weeks from all infants fed. Second blood specimens
were collected when the infants reached the
age of six to seven months, which is three months
after feeding.
Newborns. Approximately 300 newborns are
included in this study. Prior to discharge from
the maternity ward, the newborns, three to five
days old, were fed the oral vaccine. Those born
in December 1959 and January 1960 were re-fed
in February and March, respectively, two months
after the initial feeding. Post-feeding stool
specimens were collected at weekly intervals for
a period of four weeks. Cord blood was collected