Halt!

The nationwide program of vaccination against polio, so eagerly awaited for so many years, so recently greeted with clarion calls of hope, ground this week to a sickening halt. The U.S. Public Health Service recommended (and all states were virtually certain to comply) that use of the Salk vaccine be postponed until it can "reappraise" the vaccine now on hand. This includes 1) vaccine shipped to public authorities and now in their refrigerators (enough for 4,000,000 or more shots), plus 2) a similar amount still in the manufacturers' vats.

Main reason for the drastic decision, which caused bitter disappointment to countless parents and utter chaos in many health departments and school systems, was that experts had found a "definite association" between inoculations with Cutter Laboratories' vaccine and polio.

Surgeon General Leonard A. Scheele of the U.S. PHS would not go so far as to say that the polio cases in Cutter-vaccinated children were a direct result of the vaccine, but if the statement made any sense at all, the inoculations must have been at least a contributing factor in the onset of the disease. His announced toll: 52 cases of clinical polio among vaccinated children, 50 of them paralytic and 44 after use of Cutter vac cine. (Among all unvaccinated Americans, the week would be expected to bring reports of no more than 150 cases.)

No Cause for Alarm? The stop order did not mean that every batch of vaccine will be fully retested. Instead, said Dr. Scheele, teams of experts from his service will fan out to the five laboratories still making the vaccine (California's Cutter Laboratories remained under ban and under separate investigation), go through them, examine their records, inspect their equipment and methods, and try to decide on this basis whether the vaccine they have shipped or are ready to ship is safe.

This seemingly haphazard procedure outraged purists among infectious-disease experts, who insisted that every batch of vaccine should be rigorously retested, even if this meant delaying the entire inoculation program a month, with the consequence that in many states it could not be completed before the polio season's peak. But Dr. Scheele was more anxious to reassure than to alarm. Although there is no apparent difference between the vaccine ordered held up and the 5,000,000 or more shots already used. Surgeon General Scheele insisted that "the parents of children who have received [the] vaccine this spring ... in the very best judgment of the Public Health Service . . . have no cause for alarm." What was involved, said Scheele, was only "a double check."

Surgeon General Scheele held out the hope that inoculations might be resumed toward the end of this week, as the several manufacturers' vaccine is okayed lot by lot.

The week leading up to the stop order showed the U.S. Government at its confused worst.

Monday. The week began with widespread confidence that the Salk vaccine, excepting possibly some of the Cutter product, was safe and that the real problem was to get enough of it to the right places at the right time. Thus the question of controls loomed larger than that of the vaccine's overall safety. Members of Congress drafted bills providing for compulsory federal controls. But Secretary Oveta Gulp Hobby's advisory committee on vaccine distribution adopted a report urging only voluntary controls, relying on "health patriotism." It became increasingly clear that no one in Washington, even in Mrs. Hobby's department, had given any serious thought to the situation before April 12, when the results of last year's tests were announced.

Tuesday. In the Senate, nine Republican's and three Democrats joined New York Republican Irving Ives in sponsoring a bill calling for federal control; three similar bills dropped in the House hopper. State after state and city after city had to announce postponement of mass vaccinations in schools because vaccine supplies were falling behind.

Wednesday. President Eisenhower gave the vaccine top billing at his press conference, calling it "a very emotional subject." First, the President pointed out, more exacting tests than those currently used could be devised, but they might delay vaccination programs. Second (and here Ike showed that he had been briefed in a highly technical field), scientists have suspected "a reaction or a development that you might call the provocative effect of this vaccine. You or I, or a little child . . . might have latent polio germs in his system . . . Now the actual puncture of the skin . . . might cause some trouble." This was true, but it had been no less true during last year's field trials, when no such ill effects had been noted. This year's paralytic polio cases following vaccination evidently required another explanation--most likely, defective vaccine.

Thursday. The Washington Post wasp-ishly called Ike's press conference "a miracle of confusion" (but far more confusion was to come). The first child in the Southeast to die of polio after receiving Salk vaccine was Eugene Allen Davis Jr., 2 1/2, of New Orleans, grandson of famed Cancer Surgeon Alton Ochsner. But New York City parents showed their continuing confidence in the vaccine: fewer than 1% withdrew permission for their children to be inoculated.

A pared-down technical committee on immunology began meeting with Surgeon General Scheele and Dr. Salk at the National Institutes of Health at Bethesda, Md., ten miles from downtown Washington. The session lasted until 2 a.m.

Friday. Surgeon General Scheele--whose own eight-year-old son Leonard ("Bobo") had been vaccinated--testified before the House Banking and Currency Committee (which was considering the vaccine-control bills). Scheele said that all vaccine not yet shipped from the manufacturers' plants was embargoed. At Bethesda, meanwhile, the experts' meeting went on until 4 a.m.

Saturday. The Public Health Service recommended that further vaccinations, with vaccine from any source, be postponed until another statement next day.

Sunday. Surgeon General Scheele announced postponement of vaccinations. Whatever the field teams of investigators might find, two things were clear:

P: There was a hard-to-down suspicion that more live virus particles than a child can tolerate had slipped through in some of this year's vaccine.

P: The simplified 1955 testing procedure (with U.S. laboratories only reading reports on tests made by manufacturers and spot-checking occasional batches of vaccine) was not good enough to detect such possible slipups. It remained to be seen whether the meticulous triple-testing of every batch used in last year's field trials would be enough for the future, or whether new procedures would have to be found.

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