LIVE POLIO IRUS VACCINES

462
Discussion
one was sponsored by the local medical society
and one by the Junior Chamber of Commerce.
The tricounty medical society of the three rural
counties also asked to be included. Studies in
the three large cities were developed after we had
received assurances of active cooperation of the
health officer, the school authorities, and the
medical societies concerned. Subsequently, we
have had any number of requests for inclusion
in the study.
The Minneapolis Tribune, which has a poll
service for determining state-wide public opinion
on subjects of public interest, reported on 26
May 1960 that 79 per cent of the people in Minnesota
knew about the Minnesota feeding experiments,
which included a placebo. Approximately
75 per cent of the people said that they would
be willing to take part in such an experiment
if given the opportunity. I believe this gives you
some idea of the public confidence in the oral
vaccine studies in Minnesota.
The Minnesota State Board of Health is an
administrative board of health. It has had,
throughout this whole polio experience described
to you, an advisory committee on poliomyelitis,
both for the Salk vaccine programs and for the
oral vaccine studies. The Board specifically
said that it felt it had a responsibility of doing
everything it could in the evaluation of this oral
vaccine.
This is one of the reasons why Minnesota has
been involved in the study of the use of oral
vaccine for such a long period of time. We are
convinced, of course, that the vaccine is safe and
that it is effective.
May I add that this study has been headed for
the entire period by Dr. Bauer, whom you heard
earlier.
I can only say that we feel, of course, very
pleased. We have had no problems with the
vaccine. We have maintained a very close surveillance.
We approached the Surgeon General
with the request that he assign observers to these
feeding experiments, and we specifically requested
that Dr. Carl Eklund be assigned as an
observer to Minnesota. Since he spent a considerable
amount of time interviewing families
who participated in the study, 1 should like to
have him recognized at this time.
DR. EKLUND: 1 feel very strongly that studies
like this should be set up in a double-blind manner
and planned in such a way as to produce
answers.
In Minnesota there were nine areas, and no
one outside of these areas could take any oral
vaccine. We therefore had a chance to study
spread from vaccinated groups to unvaccinated
groups. Within the areas, the study was completely
double blind, so it was possible to interview
people without knowing whether they liad
taken vaccine or placebo.
My main concern has been to see whether any
ill effects come from this vaccine. I went from
family to family and interviewed people without
knowing what they had taken. I interviewed
physicians. I went to small rural schools. 1
could not tell a placebo lot from a vaccine group.
All I knew was the lot numbers.
No illness accumulated in any lot number.
Complaints would vary from one area to another,
but there was no uniformity in complaints and
no serious ones of any kind.
One saw miscellaneous diseases in the community-skin
rashes, mumps, measles, chickenpox,
broken legs, operations, tonsillectomies, etc.
But to date, there has been no evidence of any
ill effect.
I believe that future studies should be set
up in this manner so as to avoid obtaining controversial
data.
DR. BODIAN: Since Dr. Eklund has done a
most remarkable single-handed job of case finding,
I should like to inquire whether he also
asked the people who had received placebo and
vaccine, first, whether they had previously had
Salk vaccine; second, how many of those interviewed
might have been in the age group that
Sir MacFarlane Burnet mentioned; and third,
whether they were triple or double negatives.
DR. EKLUND: I think the points raised are very
pertinent. First, you have to collect fecal specimens
in every area to know what viruses are circulating
before your study starts; second, you
have to bleed part of the population; and third,
you have to know the Salk status. All three of
these steps were taken.