LIVE POLIO IRUS VACCINES

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Recent Experience with Lederle Trivalent Oral Poliomyelitis Vaccine 339 per cent. Conversion rates of this order were also obtained in the triple negatives in a similar short span of time, but comparable conversion rates were not attained in the Salk vaccine study of Gelfand et al., 3 until primary immunization liad been followed by a booster injection more than 11 months later. The purpose here is not to detract from the good that the Salk vaccine has accomplished, but only to compare the results given by a new method of vaccination with those of the old-for it should be remembered that we here are concerned with matters of life and limb as well as with pride and treasure. The relatively poorer response rate to the Type 2 strain in the present trivalent vaccine can certainly be improved by additional research and development. However, the magnitude of its deficiency must be judged in the light of our knowledge regarding the relative minor import. ance of Type 2 virus as a cause of paralytic poliomyelitis. The ideal poliomyelitis vaccine is still a thing of the future, perhaps the somewhat distant future, but this need not and should not mean that progress must await perfection. Many problems still remain in the field of oral poliovirus vaccination. It is the obvious hope of everyone that a single feeding may be all that is required. However, in areas where maternal antibody levels are high, repeated feedings of vaccine may be necessary in the newborn and very young. Optimum conditions regarding the relationship of diet and the physiologic state of the digestive tract are largely unknown. The duration of immunity has not been established, and this may be difficult to do in certain areas because of the frequent opportunities for natural booster exposures after vaccination. Until adequate supplies of vaccine are available, so that an organization equipped for mass application can move quickly into an epidemic area, it will not be known how effective oral vaccination can be in curbing an outbreak of poliomyelitis. Everyone agrees as to the desirability of strain markers and identifying characteristics, but there is considerably less agreement as to the significance and stability of these signs. These are but some of the more obvious and important problems that await solution, but they are secondary to the main problem of getting an effective tool into the hands of those who can and wish to put it to work. SUMMARY The serologic responses of 1,416 volunteers who received trivalent oral poliovirus vaccine are presented and discussed. A single vaccine dose, consisting of approximately 106 ' 1 tissue-culture doses (1,200,000 TCD 50 ) of each of the three types of attenuated poliovirus suspended in 2 ml. of fluid was administered. In the three groups which constituted the study population, the conversion rates from seronegative to seropositive status ranged from 91 to 100 per cent for Type 1 poliovirus; from 68 to 75 per cent for Type 2, and 93 to 97 per cent for Type 3. Eighty-eight per cent of total of 948 seronegatives responded to a single oral vaccination. One of the study groups included 154 persons who had received three or more injections of Salk vaccine. Collectively they represented 52 seronegatives, all but one of which responded to oral vaccination. Response rates to the trivalent oral poliovirus vaccine were comparable to response rates to the same strains fed separately. REFERENCES 1. Cox, H. R., Cabasso, V. J., Markham, F. S., Moses, M. J., Moyer, A. W., Roca-García, M., and Ruegsegger, J. M.: Immunological response to trivalent oral poliomyelitis vaccine. Brit. M. J. 2: 591-597 (October 3) 1959. 2. Embil, Jr., J., Castellanos, A., and Jiménez, R. M.: A clinical and serological study of the response of Cuban children to oral vaccination with attenuated poliovirus vaccines. In: Live Poliovirus Vaccines, First International Con- Jerence. Scient. Pub. no. 44 of the Pan American Health Organization, pp. 593-617, 1959. 3. Gelfand, H. M., LeBlanc, D. R., Fox, J. P.. and Potash, L.: Studies on the development of natural immunity to poliomyelitis in Louisiana. III. Serologic response to commercially produced "Salk Vaccine" of children totally or partially susceptible to poliovirus infection. Am. J. Hyg. 70: 303-311 (November) 1959. 4. U. S. Dept. of Health, Education and Welfare,
340 Efficacy-Laboratory Evidence CDC Poliomyelitis Surveillance Report no. 193, (January 18) p. 4, 1960. 5. Barr, R. N., Bauer, H., Kleinman, H., Johnson, E. A., Martins da Silva, M., Kimball, A. C., and Cooney, M. K.: The use of orally administered live attenuated polioviruses as a vaccine in a community setting: A controlled study. J. Am. M. Assn. 170: 893-905 (June 20) 1959. 6. Abad Gómez, H., Piedrahita, F., Solórzano, R., and Martins da Silva, M.: Community-wide vaccination program with attenuated poliovirus in Andes, Colombia. J. Am. M. Assn. 170: 906-913 (June 20) 1959.
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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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14 Safety-Laboratory Evidence of At
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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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_ _ _ _ _ _ _ _ Virologic, Serologi
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cARE NUC:4I Discussion 267 CUAw # J
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Discussion 269 in the investigation
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Virological Findings, Antibody Resp
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4. ROUTINE IMMUNIZATION WITH ATTENU
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Routine Immunization With Attenuate
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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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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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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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25. VACCINATION AND CHALLENGE-POLIO
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Vaccination and Challenge-Poliomyel
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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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