Vaccine Snafu (Contd.)

The polio vaccine program was hopelessly bogged down. Supplies of double-checked vaccine were running out even faster than the sands of time remaining before schoolterm's end and the height of the epidemic season. The Public Health Service was not releasing any newly made vaccine. Last week it was not even releasing rechecked vaccine on hand, made by two manufacturers (Pitman-Moore Co. and Wyeth Inc.). The shortage was bound to get worse. At week's end, PHS was reported considering new, stricter testing procedures that would in effect call off the whole program this season.

Nobody at the top seemed sure just how much vaccine was available, or would soon be. There were at least four reasons why the pinch had not been accurately foreseen:

P:Berkeley's Cutter Laboratories had been expected to supply one-sixth of the total, were out of the running and would stay out as long as their vaccine remained under suspicion.

P: Sharp & Dohme, also scheduled to make one-sixth, could have none ready until August.

P: Official figures on the amount of vaccine released had always been misleading by 10%, because the makers put almost 10 cc. in each vial labeled 9 cc., to make up for the few drops lost every time a doctor changes needles.

P: Some batches of vaccine "went sour" (showed either presence of active virus or absence of potency) after they had been counted in the available supply.

Health Secretary Oveta Hobby added another reason, in the most foolish statement yet made about the situation: "No one could have foreseen the public demand for the vaccine."

Pat Answer. Many states were getting ready to hold clinics in the schools during vacations, though officials fully recognized that there would be wholesale absenteeism. Parents were relaxing their pressure to get vaccine. The pressure now took on a new form: the big question across the U.S. last week was whether even the rechecked vaccine is safe.

Many parents withdrew or failed to renew consent slips. In New York City, the fallout rate when shots were given last week ran around 30%, in San Francisco about 40%. Most family doctors advised parents to go ahead with vaccination, but in many cases without enthusiasm. Physicians still resented the lack of scientific information on the Salk vaccine in any medical publication, were just as confused as everybody else by the Public Health Service's repeated change of signals.

Nobody yet knew how much danger there might be. Of five manufacturers that have shipped vaccine, two (Parke, Davis & Co. and Pitman-Moore) had spotless records: no reported cases of polio after use of their vaccine. But the U.S. (mostly western) total of such cases reached 78: after Cutter vaccine, 59 (five fatal); after Eli Lilly & Co.'s, 14; and after Wyeth's, five.

Getting Under the Skin? More startling and possibly just as significant, though no epidemiologist wanted to commit himself, was the fact that 23 cases had developed in the families of children who had come down with polio after getting Cutter vaccine. Eleven were adults, and one had died. This was a notably higher rate for family contact cases than would be expected, or than had been seen in last year's trials.

PHS officials, headed by Surgeon General Leonard Scheele, were in huddles all week long, much of the time with an advisory committee of top virologists, trying to figure out what to do. One bright suggestion, from state health officials: try giving only 1 1/2 drops (Vw cc.) of vaccine, instead of a whole cubic centimeter, to stretch the supply. Furthermore, inject it not into the muscle, as now, but under the skin or between the skin's layers (in hopes that this is less likely to provoke paralysis). At week's end the advisers and PHS decided against this course because it is untested.

Also on its outside experts' advice, the PHS advised local authorities to go ahead giving second shots all through the polio season, because the "slight immunity resulting from the first dose of vaccine will most likely provide protection against any [harmful] effect." Yet even while the PHS talked of ways and means to continue the shots, and while parents were still being urged to let children be vaccinated, experts kept showing serious doubts as to the vaccine's safety under present testing procedures.

All week the air was full of brickbats for Secretary Hobby and her department, although President Eisenhower defended her (see NATIONAL AFFAIRS). In retrospect, a good deal of the blame for the vaccine snafu also went to the National foundation, which, with years of publicity, had built up the danger of polio out of all proportion to its actual incidence, and had rushed into vaccinations this year with patently insufficient preparation.

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