PEDIATRICS Vol. 31 No. 4 April 1963, pp. 641-650
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EFFECT OF ORAL POLIOVIRUS VACCINE IN NEWBORN CHILDREN

II. Intestinal Resistance and Antibody Response at 6 Months in Children Fed Type I Vaccine at Birth

Albert B. Sabin M.D.1, Richard H. Michaels M.D.1, Philip Ziring M.D.1, Saul Krugman M.D.1, and Joel Warren Ph.D.1

1 The Children's Hospital Research Foundation, University of Cincinnati College of Medicine, Cincinnati, Ohio (A.B.S. and R.H.M.), the Department of Pediatrics, New York University School of Medicine, New York, N.Y. (P.Z. and S.K.), and the Department of Biologic Research, Chas. Pfizer and Co., Terre Haute, Indiana (J.W.)

Twenty-one infants who received Type 1 oral vaccine at birth, and six infants from an unvaccinated control group observed since birth, were fed 105.9 TCD50 of Type 1 oral vaccine at 6 months of age. Among the 11 infants with evidence of infection at birth, 6 (55%) failed to excrete Type 1 poliovirus a second time and 5 excreted only for 7 to 10 days. This complete or partial resistance to reinfection obtained also for the eight infants in this group, who after the first dose of vaccine excreted virus without developing enough antibody to be detected at 3 months. Among the 10 vaccinated infants who exhibited no evidence of infection after the first dose because they had no demonstrable virus in the single specimen tested during the first week after birth and at 3 months did not fulfill the criteria for development of antibody, there were, nevertheless, 3 who did not excrete poliovirus after the second dose and 2 who excreted for only 7 to 10 days, while the remaining 5 excreted for 20 days or longer. The serologic data on the response of these infants to Salk vaccine prior to the second feeding also suggested that a few infants in this group may have been infected after the first dose.

The serologic tests indicated that immunologic tolerance does not develop in orally vaccinated newborn infants in whom the virus multiplies with insufficient antibody formation. On the contrary, their antibody mechanism is so sensitized that a subsequent dose of Salk vaccine calls forth a booster type of response only for the type of virus that multiplied shortly after birth. While oral poliovirus vaccine is not maximally or optimally effective when given during the first few days after birth, there may be administrative or public health indications for use of the Type 1 vaccine shortly after birth in poliomyelitis eradication programs in certain parts of the world.

Submitted on July 20, 1962
Accepted on October 15, 1962