Where Is the Vaccine?

All across the U.S., the needles were flashing, arms were stinging, and the lollipop business was booming. In and around Atlanta last week, 18,301 youngsters in the first and second grades got the Salk polio vaccine provided by the National Foundation for Infantile Paralysis. In Dallas it was 59,000 youngsters in the first four grades. In hundreds of counties along or near the U.S.'s southern border, where the 1955 polio season is starting, there was the same bustle. Los Angeles and San Francisco also got in under the wire, but the rest of the country was still waiting, in line with the policy of serving the most-threatened warm-weather zones first. The vaccine timetable was shaping up thus:

P: By week's end, about 2,000,000 kids had had the needle, and 2,500,000 more doses of vaccine (1 cc. each) had been shipped to inoculation centers. This was enough to give the first shot to half the 9,000,000 children whom the foundation will vaccinate free (TIME, April 25). By June 1, officials are confident, the foundation will have enough vaccine for both shots for all 9,000,000. Until then, there will be no more allocations of vaccine for commercial distribution and use in doctors' offices.

P: By July 1, there should be enough vaccine to inoculate an additional 17 million kids; by Aug. 1, 9,000,000 more.

P: By Labor Day, experts estimated, every child aged one to nine can be vaccinated, plus three-quarters of all under 20. Although polio is rated as a summer disease, about half of all cases each year occur after Labor Day and 40% of them after mid-September. So inoculation, even after Labor Day, would give worthwhile protection in 1955.

P: By November, anybody under 20 who wants the shots can have them, and only then will it be all right for adults (other than pregnant women) to ask for them.

Tight Control? While the foundation was busy with its needles, U.S. Health, Education and Welfare Secretary Oveta Gulp Hobby belatedly gathered 100 experts in Washington for a conference on allocation of vaccine and enforcement of any controls that might be ordered. Represented were her own department, the National Foundation, state and county health officers and medical societies, and the six firms licensed to manufacture the vaccine. Conference chairman was Dr. Chester Keefer, top medical aide in HEW. Assorted politicians, some labor unions and newspapers were clamoring for rigid federal centre's. But the conferees had been warned in advance that the Administration would not accept any such proposal.

First on the agenda were reports of who was making how much vaccine and where it was going. The foundation was still getting slow delivery. Despite this, certain companies had unwisely started to ship out some vaccine--200,000 shots in all--for commercial distribution as soon as it was approved as safe. Now, finding that the foundation was going to be short, the companies decided to ship no more on their own account until their quotas for the foundation are filled.

Then the conference proposed (and Secretary Hobby and the President promptly approved) a national advisory committee on the vaccine, headed by Dr. Keefer. The committee will gather data from the states on their needs, then recommend allocations. Within each state there will have to be a similar committee to divide up the assigned quota, notably between charity and private use. There will be no rigid compulsory controls; compliance was hopefully left on a voluntary basis.

The immediate shortage of vaccine may actually prove a blessing in the long run. It means that with tighter controls until June there is small danger of a major black market.

Doctors' Dilemma. Most of the confusion about vaccine distribution could have been avoided if the Government, the National Foundation, the A.M.A. and local medical societies had begun to cooperate months ago. They might easily have made plans for joint action on allocations, but simply failed to get together. The situation was further complicated when, weeks ago, "detail men" for the drug companies called on doctors and asked how much vaccine they wanted. How much they actually got depended less on how far ahead the company was with its production program than on how the salesmen liked individual doctors. Now the unhappiest doctors are those few with a little vaccine. Pressure from parents on these doctors is heavy.

Perhaps the calmest doctor in the U.S. last week was Dr. Jonas E. Salk, who was in Washington during Secretary Hobby's conference, but was bent on other business. With his wife and three sons (Peter, 11, Darrell, 8, and Jonathan, 5) he went to the White House rose garden, where Dwight Eisenhower read and presented him with a special citation for a "historic contribution to human welfare ... in the highest tradition of selfless and dedicated medical research."

Other Eisenhower awards: a citation to the National Foundation, given to its president, Basil O'Connor, and pens and pocket knives for each of the Salk boys. Ike's advice to Jonathan: don't use that knife until you're six.

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