LIVE POLIO IRUS VACCINES

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Discussion 29 Discussion 29 Now he is doing all his here of the influenza virus. You know that it is sufficient for a new antigenie variety of influenza to appear, for its spread to begin among with 100,000 TCD 50 . tests with larger doses intracerebrally and disregards the quantitative aspects. The significance of the observed changes which were first reported by myself and others-and only being mentioned again by Melnick-must be based upon the epidemiologic observations that have been made in the field, when these particular viruses were used, and the abundant epidemiologic observations now available indicate that these changes which have been shown in monkeys and in tissue culture are not associated with harmful effects in human beings. DR. ZHDANOV (through an interpreter): At this moment we are dealing with an important matter, the stability or nonstability of the strains. This is the point being discussed. When we use the vaccine of the active virus, I think we could have understood apropos that the virus progeny cannot be stable. I will repeat what Dr. Koprowski said, that the virus not only is not stable, but develops in several directions, including the partial return to the previous virulence. Of course, this is a very important fact, but it seems to me that however interesting it may be from the point of view of the genesis of viruses. and the question of the safety of live antipolio vaccine, we must take into consideration ecological considerations. I replace epidemiology by ecology, because I think epidemiology is better defined by the ecology. From this point of view it will of course be exceedingly interesting, in connection with the fact that many countries at present are conducting serious campaigns against poliomyelitis with live vaccines, to follow the fate of these viruses. But if one takes the ecological approach-which, of course, is perhaps the more difficult one, but which should be taken into consideration-it seems to me that the live virus of poliomyelitis, attenuated and taken as a vaccine, does not have any chances, not any chances whatever, to compete with wild viruses. That is why, with all the interest in the importance of this research, I do not think that this concerns the question of the safety of applying vaccine as a mass vaccination. I will bring you an example from another field, which shows how difficult it is to circulate a virus among the population I am speaking the population. And at the same time the old viruses, the very energetic wild viruses that live very well in the human organism, do not survive any competition with this new virus. They very quickly decrease and completely disappear and remain only in laboratories or in animals. It is not so easy for a new virus to take its place among the population. Therefore, it seems to me that from this point of view, taking the question from the viewpoint of the safety of live vaccine, we must take into account this ecological consideration; the 10-year experience of which Dr. Koprowski spoke here confirms the thought that, even in the most massive immunization, live attenuated viruses have no chance to compete with wild viruses. There is a condition of immunity which kills both types of viruses. These are the remarks I wish to add to what has been advanced here. Da. MELNICK: I would like to say that I am glad to see first Dr. Koprowski in his talk, and Dr. Sabin later, emphasizing the fact that the viruses in the vaccines do change after multiplication in man. Because this emphasis was not clearly expressed by them a year ago, I feel that it is all to the good to have agreement on this point. The question on which we now agree is: Just how much change in the virus can be tolerated by a child who has received the oral polio vaccines, or their progeny? Last year we argued about whether the virus changes or not in the course of multiplication in man. I am glad to see we are all agreed now. I would also like to point out that the change observed is considerable. Dr. Sabin indicated that when we inoculated rectal swabs, some of them contained 60 tissue-culture doses, but many of these contained only 10 tissue-culture doses. This is as small a dose as we can give to a monkey with virulent virus and expect a take. When 10 tissue-culture doses are able to produce paralysis in the monkey, whereas it takes 10,000 doses of the original vaccine, this fact, to me, represents a considerable change in the virus and does not represent a selection of virulent virus by the central nervous system of the monkey.
30 Discussion CHAIRMAN ANDERSON: The next paper will be presented by Dr. Cabasso of the Lederle Laboratories, Pearl River, New York, on "Assessment of Correlation between Certain in vitro Poliovirus Markers and Monkey Neurovirulence."
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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 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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Experimental Infectionwith CHATAtte
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Experimental Infection with CHATAtt
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Experimental Infection with CHATAtt
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Vaccination of Full-Term Infants wi
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Response of Newborn Infants to Vacc
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Susceptibility of Newborn Infants t
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9. IMMUNIZATION OF NEWBORN INFANTS
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Immunization of Newborn Infants wit
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Discussion 323 vaccinated siblings
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Discussion 325 Discussion 325 ance
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transplacental antibodies, or antib
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Discussion 329 Discussion 329 born
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Recent Experience with Lederle Triv
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11. FURTHER EXPERIENCES WITH ORAL P
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Further Experiences with Oral Polio
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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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DISCUSSION CHAIRMAN STUART-HARRIS:
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Further Observations on First Field
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Further Observations Qn First Field
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Further Observations on First FielJ
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Poliomyelitis Vaccination in Poland
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24. A SMALL-SCALE TRIAL WITH LIVE P
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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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26. VACCINATION WITH ATTENUATED POL
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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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