How Many Injections of Poliomyelitis Vaccine for Effective and Durable Immunity?

The author presents evidence that antibody against poliomyelitis virus may be expected in the serum for a number of years after an effective course of immunization with poliomyelitis vaccine. The level of antibody induced after the booster dose is influenced by the amount of antigen which was administered in the primary vaccination as well as by the amount of antigen contained in the booster dose. The persistence of antibody is influenced similarly. Thus the answer to the question posed by the title of the paper is in part dependent upon the potency of the vaccine used in the primary vaccination and in the booster dose. Apparently all lots of commercially-prepared vaccine have not been of optimal potency. After considering all the theoretic and practical aspects of the problem the author indicates that the answer to the question "Should a fourth dose be given?" is answered in part by the assertion that it will do no harm. Without a knowledge of the degree of protection afforded by the primary immunization and a subsequent dose, the physician will be inclined to give a fourth dose of poliomyelitis vaccine as a booster to gain further assurance of protection. It is estimated that this will be of additional benefit to no more than 10% of those who have received three injections of the vaccine. There does not appear to be sufficient epidemiologic grounds upon which to base an aggressive campaign for universal application of a fourth injection.

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