LIVE POLIO IRUS VACCINES

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Experimental Infection with CHATAttenuated Poliovirus in Premature Infants 293 4. Pagano, J. S., Plotkin, S. A., Janowsky, C. C., and Koprowski, H.: Routine immunization with attenuated poliovirus of 850 children living in Philadelphia-Preliminary report (See this volume pp. 277-283). 5.- , - , and Koprowski, H.: Variation of response in early life to vaccination with living attenuated poliovirus and lack of immunologic tolerance. Lancet. To be published, 1960. 6. Koprowski, H.: Discussion of Dr. Sabin's paper "Properties of attenuated polioviruses and their behavior in human beings." New York Academy of Sciences, Monograph No. 5, pp. 128-133, 1957. 7. - , and others: Clinical investigations on attenuated strains of poliomyelitis virus. J. Am. M. Assn. 160: 954-966 (March 17) 1956. 8. Gard, S.: Immuno-inactivation of poliovirus. Arch. ges. Virusforsch. 7: 449-460, 1957.
6. VACCINATION OF FULL-TERM INFANTS WITH ATTENUATED <strong>POLIO</strong>V<strong>IRUS</strong>ES* STANLEY A. PLOTKIN, M.D., JOSEPH S. PAGANO, M.D., AND HILARY KOPROWSKI, M.D.t The Wistar Institute of Anatomy and Biology Philadelphia, Pennsylvania DR. PLOTKIN (presenting the paper): For vaccination with living attenuated polioviruses perhaps the most important age group is infants less than six months old. If not vaccinated, these infants become highly susceptible to poliomyelitis after they lose the passive protection of transplacentally acquired antibodies. Furthermore, from a public health point of view, vaccination in hospitals shortly after birth would be maximally effective in reaching groups refractory to vaccination campaigns. Previous studies from this laboratory have shown that it is possible to vaccinate infants successfully in the presence of maternal antibody,j even on the day of birth.' However, when performed at ages under two months, vaccination was found to be less effective than when done in older infants. 2 This relative resistance has been further explored s and is the chief subject of the present communication. The subjects of these studies were infants living in the nursery of an institution, under close supervision. Because of their young age, contacts between infants included in these trials rarely occurred. Specimens consisted of stools and pharyngeal swabs collected twice weekly and blood specimens obtained at approximately monthly intervals. Isolation of virus from the stools and tests for neutralizing antibodies against poliomyelitis were performed in the manner just described by Dr. Pagano. These studies were supported by grants from the National Institute of Allergy and Infectious Disease. t Dr. Plotkin and Dr. Pagano (Epidemic Intelligence Service Officers, Communicable Disease Center, U.S. Public Health Service, Atlanta, Georgia, on assignment at The Wistar Institute); and Dr. Koprowski (Director, The Wistar Institute). The participation of Drs. Plotkin and Pagano in this study does not imply endorsement by the Public Health Service; the opinions are those of the authors. The viruses used were CHAT (Type 1), 4 P-712 (Type 2),5 and W-Fox (Type 3) ;4 all feedings were done by allowing the infant to ingest, by means of a dropper, the virus diluted in milk. A successful antibody response, as in the case of the premature infants, was judged by the presence of an antibody titer after vaccination, which was at least four times greater than the titer which would be predicted from the uninfluenced normal decline of transplacental antibodies. The normal rate of decline was determined from paired serum specimens obtained before vaccination. The arithmetic and geometric means determined from these data are given in Table 1, from which it was computed that the average half-life of transplacental antibodies is approximately three weeks. Variability in the half-life figure was moderate, the standard deviation being eight days. 294 These data may be compared with the half-life values of 23 days which we have observed in premature infants; 21 days reported by Perkins and colleagues in England; 25 days in a paper which Dr. Gelfand very kindly allowed us to read, to be published shortly; 21 half-day life of gamma globulin reported by Dixon et al.; and the 37-day figure reported by Dr. Martins da Silva and associates. Age at Vaccination. The success of vaccination in infants of different ages is summarized in Tables 2 and 3. Intestinal infection with living virus was established in more than 90 per cent of infants fed during the first week of life and also those fed beyond the age of 70 days. Paradoxically, between eight and 70 days of age, intestinal infection occurred at the significantly lower rate of approximately 70 per cent (Table 3).
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LIVE POLIO IRUS VACCINES Papers Pre
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SECOND INTERNATIONAL CONFERENCE ON
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Preface The accumulation of informa
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Dr. Ghislain COURTOIS Director, Pri
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Dr. Edith PETTE Institute for the R
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50 Discussion sages of neurovirulen
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Application of Genetic Markers to D
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Discussion 67 TABLE 1. INCIDENCE OF
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Experimental Studies on Animals wit
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6. DETECTION OF A "NON-DETECTABLE"
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Detection of a "Non-Detectable" Sim
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Discussion 87 Dr. Koprowski's state
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Discussion 89 recognize its effects
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Laboratory Investigations of Attenu
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Discussion 99 In the case of Table
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8. BEHAVIOR OF COLD MUTANTS OF POLI
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Behavior of Cold Mutants of Poliovi
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DISCUSSION CHAIRMAN BURNET: Thank y
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114 Safety-Field Evidence of Safety
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118 S afety-Field Evidence of S af
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122 Discussion 122 Discussion~~~~~~
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10. LABORATORY INVESTIGATIONS OF TH
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126 VIRUS 1 MAhONEY Safety-Field Ev
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DISCUSSION CHAIRMAN ZHDANOV: This p
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11. EPIDEMIOLOGICAL AND VIROLOGICAL
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12. SPREAD OF A VACCINE STRAIN OF P
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148 Saf ety-Field Evidence of Saf e
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152 Saf ety-Field Evidence of Safet
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DISCUSSION CHAIRMAN ZHDANOV: The pa
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158 Discussion 158 Díscussion~~~~~
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160 Discussion specimens. We were u
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. . . 168 Safety-Field Evidence of
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14. THE CAPACITY OF LIVE ATTENUATED
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176 Saf ety-Field Evidence of Saf e
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Field, Laboratory Experiences With
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16. STUDIES ON LIVE POLIOVIRUS VACC
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Studies on Live Poliovirus Vaccine
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Da. HORSTMANN: If I may answer for
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Discussion 205 Discussion 205 tried
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Vaccination of Pregnant Women and Y
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Development and Persistence of Poli
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Virologic, Serologic Investigations
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Minnesota Studies with Oral Poliomy
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13. USE OF ATTENUATED LIVE POLIOVIR
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Use of Attenuated Live Poliovirus V
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Use of Attenuated Live Poliovirus V
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Discussion 375 -~ ~~~~isuso 7 DR. C
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i 14. EFFECTS OF RAPID MASS IMMUNIZ
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Live Poliovirus Immunization-Condit
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Use of Sabin's Live Poliovirus Vacc
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TABLE 14. Use of Sabin's Live Polio
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Course of Mass Immunization in USSR
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, _ _ Course of Mass Immunization i
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436 Efficacy-Field Evidence TABLE 1
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460 460 Discussion Discussion~~~~~~
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462 Discussion one was sponsored by
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Vaccination with CHAT Strain Type 1
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Live Virus Vaccine Studies in South
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Poliomyelitis Vaccination in Poland
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25. VACCINATION AND CHALLENGE-POLIO
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Discussion 575 ence last year. The
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Large-Scale Practical Trials, Use o
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602 Summary of the Conference 602 S
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Appendix The following letter was r
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608 Index Antibodies-continued half
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610 Index Bulychev, N. P., paper, 4
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612 Index Coxsackie--continued B-3
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614 Index Epidemics-continued intro
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616 Index Genetic stability-continu
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618 Index Infants-continued source
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620 Index Laboratory surveillance d
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622 Index Monkey neurovirulence, 95
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624 Index pH neutralization test, 6
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626 Index Poliomyelitis virus-conti
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628 Index Serological response-cont
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630 Index T marker-continued T- str
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632 Index Vaccine, Attenuated-conti
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634 Index Virus isolations and anti
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LIVE POLIO IRUS VACCINES

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