Renewed Attack on Polio

As a blizzard swept over the peak of Vermont's Mount Mansfield one day last week, a woman in a wheelchair pulled the veil from a two-ton marble sculpture fashioned like a huge dime. With the dedication of the mountaintop sculpture, a monument to the victims of the U.S.'s first polio epidemic,* the 1956 March of Dimes opened. There was the usual fanfare--the sort that has made Americans contribute more than three billion dimes since the drive began in 1938. But the 1956 kickoff was different: for the first time, the year was beginning with the certain knowledge that polio is on the run.

Although polio suffered one of its periodic (and unexplainable) natural declines in the U.S. during 1955, doctors credited the Salk vaccine with causing a 25% drop in the number of polio cases among the 7,000,000 children who were vaccinated. It had this success despite distribution snafus and faulty vaccine batches. In 1956 the vaccine will be safer and, doctors hope, at least 80% effective in preventing paralytic polio. How will it reach the children?

Given & Bought. The U.S. Public Health Service allocates all available polio vaccine to states that request it (usually on the basis of the number of unvaccinated children and pregnant women). Each state decides how much of its total will be distributed free--from supplies bought with either federal or state lunds--and how much can be sold through regular commercial channels. Distribution of free vaccine is generally left to local communities, which may give it in mass inoculations or through private physicians.

Most available vaccine will probably continue to be distributed free during 1956 (doctors usually charge a fee for administering the injections privately). Some states, e.g., Illinois and Colorado, have decided to freeze out commercial vac cine for the present, distribute their entire allotment free. Others are increasing their allotment of commercial vaccine. The National Foundation for Infantile Paralysis, which provided the free vaccine for first-and second-grade school children in 1955, has stopped distributing vaccine, although some of its vaccine is still being used. The Government's $30 million vaccine grant to the states is available only until Feb. 15, but Secretary of Health, Education and Welfare Marion Folsom says he will ask Congress to extend the deadline and appropriate additional funds (only $8,000,000 of the grant has been used so far).

School & Office. The distribution of vaccine is progressively moving out of the schools into public-health clinics and the offices of general practitioners and pediatricians. Polio shots are being tied in with general immunization programs. Yet many parents are showing little initiative about having their children inoculated, despite doctors' pleas that now is the best time to do it. In Colorado, where 300,000 children still need shots, only about 35% of the free vaccine allotted to private physicians has been reported used. Demand is well below expectations in Georgia, where 700,000 children have yet to get their first shots. Parents have failed to take advantage of available vaccine in North Carolina to such an extent that the state may have to launch a campaign to move its vaccine. (Vaccine tends to lose its effectiveness after being stored for six months.)

Last week the Public Health Service announced that 45% of the vaccine that states have received under the Government's voluntary control plan has not been used. Public apathy is not the only reason: some states are stockpiling vaccine in order to have enough for mass inoculations later. The fact remains that, all over the U.S., parents are hesitating about the vaccine because they feel that the polio season is too far away or because they are still confused as a result of last year's vaccine fiascoes.

Massachusetts, which had the worst polio year in its history in 1955 (3,900 cases), called a stop to public vaccination programs. But this week the Massachusetts State Poliomyelitis Advisory Committee is due to issue a report that, doctors believe, may clear the Salk vaccine of any blame in the epidemic and revive the state's vaccine program. With that report, and the stepping up of all vaccine programs in the months ahead, officials hope that public response will be better before the polio season approaches.

* In Rutland County, Vt. in 1894, when more than 100 children were stricken. The woman in the wheelchair was 64-year-old Miss Sarah Jones, the only victim of the epidemic now alive.

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