LIVE POLIO IRUS VACCINES

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Response of Newborn Infants to Vaccination with Living Type 1 Poliovirus 307 titers of 512 or higher excreted virus for one week or more. Relatively few of the newborn infants showed a significant rise in neutralizing antibody three months after feeding (three of 20), as compared to approximately 21 of 16 three-month-old infants who responded with an eightfold or better rise in antibody titer. However, it is postulated that the high levels of passive antibody in the serum of most of the infants studied, masked the antibody produced by the infant, and only later observations will give the true picture in regard to serologic response of these infants. Family spread from newborn infants did occur to young siblings in two families. but was limited in extent.
8. PRELIMINARY REPORT ON THE SUSCEPTIBILITY OF NEWBORN INFANTS TO INFECTION WITH POLIOVIRUS STRAINS IN AN ATTENUATED VIRUS VACCINE HENRY M. GELFAND, DOROTHY R. LEBLANC, ALFONSO H. HOLGUIN, AND JOHN P. Fox* DR. GELFAND (presenting the paper): A number of studies have been reported during the past several years wherein the efficacy of oral vaccination of infants with attenuated poliovirus vaccines was investigated.? - If practicable, the practice of routine infant vaccination would provide the easiest solution to the problem of maintaining the immunity of a community against poliomyelitis after safety and efficacy of a live virus vaccine has been assured and it has been received by the majority of the general population. In previous studies, use was made of virus strains developed by Dr. Hilary Koprowski and by the Lederle Laboratories, administered in monotypic or trivalent form, and under various conditions of infant age, dose, and method of evaluation. Nevertheless, it was generally demonstrated that infection may be induced in very young infants, even in the presence of high titers of maternally-derived neutralizing antibody. It had been suggested, however, that there may be relative resistance to infection in the intestinal tracts of very young infants, a resistance which might be overcome by the administration of larger doses than are required by older individuals. The present investigation was undertaken to extend these observations by a study of infant susceptibility to infection with the "set" of attenuated poliovirus strains developed by Dr. Albert B. Sabin. By means of the administration of graduated doses of each of the three types separately, we hoped to perform infectivity titrations in newborn infants in order to determine the smallest effective doses which would result in * Dr. Gelfand and Dr. Holguin (Communicable Disease Center, U.S. Public Health Service, Department of Health, Education, and Welfare, Atlanta, Georgia); Miss LeBlanc (Division of Epidemiology, Tulane University School of Medicine, New Orleans, Louisiana); and Dr. Fox (Division of Epidemiology, Public Health Research Institute, New York, N. Y.). 308 virus excretion and subsequent antibody response in a satisfactory proportion of babies of an age which would be suitable for routine use. In addition, the course of infection following trivalent vaccination was to be examined in detail, and certain other variables of age and inoculation regime were to be investigated. MATERIALS AND METHODS Study group. The original plan called for the recruitment of 230 mothers and their two- to three-day-old infants at the time of discharge from the maternity ward of a hospital in New Orleans, and 45 mothers and their 30-day-old babies at the time of the first post-partum visit. Only lower-economic-group Negro mothers and babies who were in good health following an uncomplicated pregnancy and delivery were selected. The program was fully explained and written agreement to participate was obtained from the mothers by the nurse-epidemiologist (D.R.L.). The entire group of babies was divided into the subgroups shown in Table 1. Groups 1, 2, and 3 act as the basic titration of each of the vaccine types separately, and group 5 serves to compare older infants with the younger with reference to Type 1 vaccine virus. Group 4 was established to determine whether multiple feeding of the same virus type on three successive days and in maximum concentration would increase the likelihood of infection. Group 6 consists of babies who received trivalent vaccine either once or on three successive days. Group 7 received no vaccine, and serves as an illness and "wild virus" infection control. Since groups 1-5 were fed only one virus type, they also serve as built-in "wild virus" infection controls for the types not being fed. Only babies of group 6 were selected on the basis of birth order. Since these infants received
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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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Page 6. Vaccination of Full-Term In
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Page 23. Vaccination against Poliom
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Dr. Ghislain COURTOIS Director, Pri
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Dr. Edith PETTE Institute for the R
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4 Introductory Remarks 4 Introducto
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6 General Considerations immunity a
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8 General Considerations from accep
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10 General Considerations 10 Genera
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- 26 Safety-Laboratory Evidence of
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DISCUSSION CHAIRMAN ANDERSON: There
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30 Discussion CHAIRMAN ANDERSON: Th
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32 TABLE 1. Safety-Laboratory Evide
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40 Discussion Of the 22 monkeys inf
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DISCUSSION CHAIRMAN ANDERSON: Thank
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46 Discussion a paralytic case. Thi
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48 Discussion + - + + I + - I + + 1
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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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128 Safety-Field Evidence óf Safet
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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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NOTE: The Spanish translation of th
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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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Page 274 and 275: 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 CHAIRMAN LÉPINE: The tw
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Discussion 373 -~~~~~~ics o 7 domin
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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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- Use of Sabin's Live Poliovirus Va
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TABLE 14. Use of Sabin's Live Polio
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Discussion 411 DR. ANDERSON: My que
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Course of Mass Immunization in USSR
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, _ _ Course of Mass Immunization i
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DISCUSSION CHAIRMAN LÉPINE: Thank
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Discussion 431 DR. STUART-HARRIS: I
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436 Efficacy-Field Evidence TABLE 1
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438 Efficacy-Field Evidence Adminis
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444 Effcaey-Field Evidence 44 Efiay
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446 Efficacy-Field Evidence 446 Eff
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448 Efficacy-Field Evidence 448 lEf
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450 Efficacy-Field Evidence m Co 0
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452 Efficacy-Field Evidence ] ~~ ~
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454 Efficacy-Field Evidence It is n
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456 Efficacy-Field Evidence M.G. C
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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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Discussion 481 the ages of the five
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Immunological and Epidemiological E
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Further Observations on First Field
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Poliomyelitis Vaccination in Poland
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Live Poliomyelitis Vaccine-Small-Sc
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25. VACCINATION AND CHALLENGE-POLIO
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Vaccination and Challenge-Poliomyel
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Vaccination with Attenuated Poliovi
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Discussion 575 ence last year. The
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Large-Scale Practical Trials, Use o
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594 Discussion 594 Disenísion ~ ~
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596 Discussion 596 Díscussion~~~~~
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598 Discussion 598 Discussion high
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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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