LIVE POLIO IRUS VACCINES

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Large-Scale Practical Trials, Use of Live Poliovirus Vaccine in USSR 583 TABLE 2. DATA OM THE DISTRIBUTION OF THE LIVE POLIOVIRUS VACCINE MADE FROM A. B. SABIN STRAINS THROUGHOUT THE REPUBLICS OF THE SOVIET UNION IN THE FIRST QUARTER OF 1960 NUMBER OF VACCINAIL DOSES ISSUED, IN THOUSANDS REPUBLIC MONOVACCINE OF TYPE 1 TYPE 2 TYPE 3 TRIVALENT MIXTURE OF TYPES 1, 2, AND 3 TOTAL INCLUDING NUMBER OF DosEs USED IN PRIMARY IMMUNIZATION RSFSR 36,535 2,242 13,674 2,050 54,501 36,535 Ukraine 11,753 2.123 2,076 5,117 21,059 12,023 Byelorussia 3,000 2,910 5,910 3,000 Uzbekistan 2,976 4,406 7,382 3,500 Kazakhstan 2,294 120 353 2,767 2,100 Georgia 1,500 1,500 1,500 Azerbaidzhan 1,404 30 1,434 1,400 Moldavia 600 900 1,500 1,100 Lithuania 750 750 750 Latvia 300 * 400 700 700 Kirghizia 800 - - . 800 800 Tadzhikistan 750 - - 1,101 1,851 750 Armenia - 902 900 - 1,802 900 (in December 1959-900,000 doses) Esthonia 850 850 800 Turkmenia 1,478 1,478 1,100 Total 64,990 5,297 19,680 14,327 104,284 66,958 Note: In view of the large amount of immunization with live poliovirus vaccine done in a number of republics in 1959, the whole population of those republics (Esthonian SSR, Lithuanian SSR, Georgian SSR. Azerbaidzhanian SSR, Moldavian SSR, Uzbek SSR, Tadzhik SSR, Kirghiz SSR, and Turkmenian SSR) will receive two doses in 1960, the first consisting of a monovaccine of Type 1 and the second of a trivalent mixture of Types 1, 2, and 3.
584 Efficacy-Field Evidence medical establishments on a strictly voluntary basis. The public was drawn into the work to the greatest possible extent by means of extensive health education and propaganda, use being made of the press, radio, television, newsreels, talks, leaflets, etc. In the areas covered by the campaign, consultative teams of experienced physicians were set up for a thorough investigation of all cases of disease of the central nervous system which might give rise to a suspicion of poliomyelitis. In the Esthonian and Lithuanian SSR Epidemiological Bureaux were established for detecting and investigating all cases of poliomyelitis. In addition, travelling groups of consultants were organized in Esthonia, Lithuania, the Moscow Oblast, the city of Karaganda, the Sverdlovsk and Orenburg Oblasts, etc. More than 1,500 vaccinated persons and persons in contact with them were given serological and virological examinations. The laboratory diagnosis of cases of poliomyelitis in areas covered by the campaign was considerably extended and consolidated in the Baltic republics, Tashkent, Alma- Ata, Karaganda, Moscow Oblast, etc. All this has made it possible considerably to improve the organization of mass vaccination, to provide for careful observation to be kept over the vaccinated, to intensify the diagnosis of poliomyelitis, and to ensure the fullest possible registration of all cases of illness during and after administration of the vaccine. In children's establishments in a number of places long-term observations of the temperature and state of health of the vaccinated children and children in contact with them were carried out. We laid down as our main principle in organizing oral administration of live anti-poliovirus vaccine that it should be on a mass scale and simultaneously carried out throughout the territory of a whole rayon, city or oblast in order to establish extensive immunity among the population in the shortest possible time and to reduce to a minimum the possibility of lengthy circulation among susceptible persons of any strains of poliovirus and to eliminate the possibility of an increase in their virulence through serial passage in children. The first results of the study and mass use of live poliovirus vaccine made from Sabin strains in the USSR in 1959 were summed up in Report No. 2 of the Institute for the Study of Poliomyelitis of the USSR Academy of Medical Sciences and of many Republican, Oblast, and City Sanitational and Epidemiological Centers.* On a basis of the extensive research carried out in the Soviet Union by several teams of scientists and of practical trials, the following conclusions can be drawn concerning the most important questions connected with live poliovirus vaccine: 1. Harmlessness of the Live Vaccine. We may consider as completely settled the question of whether the live vaccine made from the Albert Sabin strains and in the manufacture of which certain conditions have been fulfilled, are completely harmless and will cause no reactions. The practical trials of the vaccine on a very large scale have merely confirmed the fact. The safety tests for the vaccine during manufacture perhaps still need simplification and improvement, but even in their present form they ensure reproducibility of results. The problem of reversion of the pathogenic properties in the strains of live poliovirus vaccine was eliminated in practice by the simultaneous coverage of the whole susceptible population in an oblast by a large-scale immunization campaign, since immunity in the population developed more quickly than could changes in the poliovirus strains, which were thus not given an opportunity of continuous passage. No cases of poliomyelitis caused by the actual administration of live vaccine made from Sabin strains have been recorded in the Soviet Union. The reaction-causing properties of the live poliovirus vaccine were studied by many physicians in the vaccination areas on the basis of the material provided by records of complaints from those vaccinated. In the opinion of the specialists, under conditions of mass vaccination, cases of the coincidence of vaccination with symptoms of various kinds caused by other diseases may be observed. It proved impossible to establish beyond doubt a connection between any complaint or symptom and the vaccine itself. The total incidence of so-called vaccinal reactions was very low (not more than 3 per 100,000). The question of the reaction-causing properties of the live vaccine evidently still re- * On Mass Oral Inmmunization of Population in the Soviet Union against Poliomyelitis with Live Vaccine from A. B. Sabin's Attenuated Strains, Moscow, 1960.
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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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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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32 TABLE 1. Safety-Laboratory Evide
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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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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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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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transplacental antibodies, or antib
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Recent Experience with Lederle Triv
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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 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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TABLE 14. Use of Sabin's Live Polio
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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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436 Efficacy-Field Evidence TABLE 1
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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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Poliomyelitis Vaccination in Poland
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Page 625 and 626: 608 Index Antibodies-continued half
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Page 629 and 630: 612 Index Coxsackie--continued B-3
Page 631 and 632: 614 Index Epidemics-continued intro
Page 633 and 634: 616 Index Genetic stability-continu
Page 635 and 636: 618 Index Infants-continued source
Page 637 and 638: 620 Index Laboratory surveillance d
Page 639 and 640: 622 Index Monkey neurovirulence, 95
Page 641 and 642: 624 Index pH neutralization test, 6
Page 643 and 644: 626 Index Poliomyelitis virus-conti
Page 645 and 646: 628 Index Serological response-cont
Page 647 and 648: 630 Index T marker-continued T- str
Page 649 and 650: 632 Index Vaccine, Attenuated-conti
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634 Index Virus isolations and anti
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