PRECONCEPTIONS ABOUT VACCINATION AGAINST PARALYTIC POLIOMYELITIS

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Abstract
Preconceptions about vaccination against paralytic poliomyelitis are reviewed in the light of recently acquired evidence suggesting that a virus disease can be effectively controlled by immunization with a killed-virus vaccine. Among recently acquired revelations is the fact that a relatively small antigenic mass of non-infectious virus induces the formation of a substantial quantity of antibody which persists for a period of time, the length of which is yet to be determined. Although smaller quantities of poliovirus antigens are less effective in maintaining antibody at detectable levels without re-stimulation, immunologic hyper-reactivity seems to persist long after initiation of the original stimulus. If an adequately hyper-reactive immunologic mechanism is the minimal requirement for persistent immunity to paralysis, then it may be expected that the immunity to paralytic polio, induced by the use of a killed-virus vaccine, will be durable. The factors of importance for inducing such immunity are reviewed[long dash]i.e., antigenic mass and interval between primary and secondary stimulation. The level of antibody attained, and maintained, following the secondary stimulus, is markedly influenced by the intensity of the primary immunization effects. The question of the effect of the use of a killed-virus vaccine in virus transmission is examined. There is some indication that while vaccination with a killed-virus vaccine does not alter intestinal carriage of the virus, pharyngeal virus may be reduced. This could help explain the epi-demiologic observations suggesting that widespread vaccination has been accompanied by a reduction in the amount of disease out of proportion to the number of individuals vaccinated. This should not imply that reliance should be placed upon this apparent herd effect, but that because of the high stakes in the risk to the individual, protection of the individual should be practiced and as a by-product there could conceivably be a reduction in the spread of virus in the population to a point that may some day approximate eradication.

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