LIVE POLIO IRUS VACCINES

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Vaccination with Attenuated Polioviruses in Costa Rica 567 METROPOL SUBURBAN TRIVAL. NEWBORN TRIPLE MONOV. MONOV. NEGS. Fic. 3. Costa Rica oral poliovirus vaccine seronegative conversion rates. TABLE 7. SAN JOSÉ, COSTA RICA-CONVERSION RATES BY AGE FOLLOWING MONOVALENT VACCINATION IN 447 CHILDREN AGE TESTED PRE 1 POST PRE 2 POST PRE 3 POST TOTAL PRE POST CON- VERSION RATE (%)
568 Efficacy-Field Evidence Costa Rica's vaccination program was organized to protect the greatest number of children against poliomyelitis as rapidly as possible. For this reason, the more speedily applied trivalent vaccine was quickly adopted, and thereafter used for operations in new areas and for clean-up operations where monovalent vaccine had previously been used. The purpose of the clean-up operations was to reach children previously missed and to vaccinate those who had not completed the three monovalent doses. A basis for estimating the state of immunity of that part of the population primarily at risk was provided by the pre-vaccination blood samples collected in the serologic survey undertaken in the earlier stage of the vaccination program. Triple negative sera were confined almost exclusively to children under the age of three years, and double negatives after this age were uncommon. Almost 90 per cent of the children were triple positive by the time they reached the five- to 10-year age group. In conjunction with the known age-incidence of the disease, the information provided by the survey focused attention on that segment of the childhood population in which to concentrate the greatest control effort. In addition to providing a substantial basis for judging the relative efficacy of vaccine strains and of methods of administration, the sera collected pre- and post-vaccination in different areas and in different vaccination programs served to confirm the safety of the vaccines, since the data indicate the frequency of infection by the vaccine strains. The serologic studies show that conversion rates with the monovalent and trivalent vaccines are comparable, although with the trivalent, Type 2 conversions were slightly better. The significance of this difference is difficult to assess, but coupled with the other advantages of trivalent vaccine, even a slight advantage in this strain, apparently the weakest of the three, is worthwhile. Although they are based on relatively small numbers, the conversion rates among triple negatives appear to be essentially like those of homotypic-negative children in general. The true response of infants vaccinated during the first week of life is difficult to assess on the basis of titer alone, since the infants were bled from five to eight months after vaccination. However, sufficient instances of seronegatives were found at different intervals after birth to justify the assumption that without the intervention of vaccination or natural infection, all but seven of the 125 infants would have been triple negatives at the time of bleeding. It therefore seemed justifiable to compare the incidence of seronegatives of these vaccinated infants with that of unvaccinated infants under one year of age as indicated by the general prevaccination survey. On this basis, the conversion rates among newborn infants have considerable interest. Meager though the data are, it is believed that they indicate clearly that newborn infants can and do respond to vaccination. It might, therefore, be advisable to establish vaccination services in maternity hospitals. In Costa Rica, however, relatively few of the babies in the rural areas are born in hospitals, so that it obviously is impossible to rely on such a program to reach more than a small part of the population requiring protection. In our opinion, based on experience in Costa Rica, a thoroughly organized and conducted mass vaccination campaign followed by a maintenance program operating through well-baby and pre-school clinics in community health centers and through mobile health units in rural areas should provide adequate protection in keeping with population growth. SUMMARY 1. From a Public Health point of view, the attenuated poliovirus oral vaccine offers marked advantages over the injected Salk-type vaccine. 2. It was noted that by the use of separate monovalent vaccine, the number of children receiving each subsequent dose decreased and that this disadvantage alone justified t-e use of the trivalent vaccine. Conversion rates for both types of vaccines were comparable. 3. The prevaccination serologic survey shows that under the conditions prevailing in 1959, most of the child population progressively changes from triple negative at eight to 12 months of age to triple positive by five to 10 years of age.
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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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Dr. Ghislain COURTOIS Director, Pri
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Dr. Edith PETTE Institute for the R
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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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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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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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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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Use of Attenuated Live Poliovirus V
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Use of Attenuated Live Poliovirus V
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Live Poliovirus Immunization-Condit
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Use of Sabin's Live Poliovirus Vacc
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436 Efficacy-Field Evidence TABLE 1
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Vaccination with CHAT Strain Type 1
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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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