LIVE POLIO IRUS VACCINES

Large-Scale Field Trial with Oral Cox-Lederle Vaccine in Dade County 437
age groups from five through 19 and 20 through
39. On the basis of this information, it was
decided to offer oral polio vaccine to all residents
less than 40 years of age.
Season. Although paralytic poliomyelitis in
Dade County occurs during all seasons of the
year, the incidence is lowest during the months
of December through April. By restricting the
actual administration of oral vaccine to the
months of February, March, and April, it was
hoped that problems raised by coincidental
"wild" poliovirus infections would be minimized.
Certain epidemiological aspects of poliomyelitis
in Dade County are considered separately in the
companion paper by Erickson and associates.
Vaccine. The Lederle-Cox vaccine was used
in the Dade County Community Polio Program.
Detailed descriptions of the vaccine used by us,
as well as in Minnesota, Latin America, and
other areas of the world, were presented at the
First International Conference on Live Poliovirus
Vaccines and at other places by Drs. Cox,
Cabasso, Ruegsegger, Barr, Martins da Silva, and
others, and will not be reviewed at this time.
Although the published reports indicate a high
degree of stability of the liquid poliomyelitis
vaccine, adequate precautions were taken to keep
it refrigerated but not frozen insofar as possible.
Periodically, large shipments of the vaccine were
flown into Miami and placed in the appropriately
refrigerated storage. From this point it was
distributed to immunization centers through
Health Department channels. With the voluntary
cooperation of the pharmaceutical profession
the distribution to the 1,300 participating
physicians was through routine trade channels.
A central record system at the Health Department
was maintained so that inventory and
distribution control of the vaccine during and
after the actual immunization program have
been assured.
The dosage employed was a single administration
of 2 ml. dose of the liquid trivalent attenuated
poliovirus vaccine containing 1,200,000
tissue-culture doses (106.1 TCD 5 0 ) of strains Type
1-SM, Type 3-Fox, and 2,000,000 tissue-culture
doses (106.3 TCD50) of the Type 2 (MEF 1 strain).
This dosage was used regardless of age, weight
or other factors. The vaccine was usually administered
in 30 ml. wax-lined paper cups diluted
with approximately 6 ml. of distilled water, although
it was also given undiluted by dropper
or by spoon to infants.
The only contraindications specified were
vomiting, diarrhea and unexplained fever. Vaccine
was given during all trimesters of pregnancy
and to the newborn. The use of the vaccine in
relationship to oropharyngeal surgery, corticosteroid
therapy and other surgical and medical
conditions varied widely depending on the individual
convictions of the responsible physician.
Records. A prerequisite for vaccination was
submission of a completed and signed request
form. All of the data are currently being transcribed
to individual permanent business machine
cards, which will be alphabetized and maintained
as permanent records in the epidemiologist's
office in the Dade County Health Department.
In addition to the name, address, birth date,
age group, sex, race, and Salk vaccine history,
TABLE 3.
RATE OF REPORTING OF ADMINISTRA-
TION OF ORAL POLIO VACCINATION
TOTALS
WEEK WEEKLY CUMULATIVE
1 7,760 7,760
2 7,760
3 57,942 65,702
4 59,450 125,152
5 59,442 184,594
6 37,532 222,126
7 35,218 257,344
8 26,192 283,536
9 17,041 300,577
10 20,278 320,855
11 17,744 338,599
12 20,359 358,958
13 52,321 411,279
Total 411,279 411,279
the week and place of vaccination are recorded
and by means of the "batch no." the original
record on any individual can be located with
minimal inconvenience or delay. Blank Mark-
Sense columns are available for the addition
of other information at a later date.