Medicine: 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.