Poliomyelitus: Vaccine

P.M.
Outlined dilemma - as in brief. If we test, we are bound to have more cases : if we don't, we might get v. many more. Middle course wd. be to abridge the tests.

D.W.S.

If we do present tests, there will be waiting - and protests - when U.S. vaccinn. is known to be available. This seems to be unacceptable. I therefore favour some adjustment. Later informn. suggests greater delay because large batch of U.S. vaccine is now held up in U.S. for further tests. Plan for accelerated tests wd mean doing what M.R.C. regard as 2 more important tests and omitting 3rd. and least important. This wd. be practicable & wd. give substantial time saving. It wd. be diff. if M.R.C. were unwilling : if they were, we mght face need to omit all M.R.C. testing. Risk of Cutter incident is v. small.

Hail.

Value of 3rd. test: vid para. 5 of my memo. M.R.C. (para. 9(a)) view is tht. cases are being caused in U.S. by use of vaccine which hasn't bn. thro' last test of M.R.C. If we bght. 5.000 litres vice 4.000, we cd. save time. As a matter of policy, we cd. dispense with all M.R.C. tests. Cd. then cover whole short-fall. M.R.C. have advised tht. this risk be not taken. Can we disregard that advice. Last summer, when we decided to use Salk at all, we made great point of addl. tests. Diff. to go back on that. In a sense compromise is worse. Half-tested gives undue confidence to public : delays p'mme : and disregards.

H.B.

}Agree with L.P.

D.E. K.

So do I. M.R.C. view on original import of Salk. Also II(iv) of M.R.C. rpt. Prefer solution in L.P. memo. para. 6.

P.M.

Matter of judgement. If we do full tests, 300 (prs. 600) wh. need not have occurred. If no tests, prs. 100. (or 500 if Cutter). K. Don't disregard risk of wrecking confidence in whole vaccn. policy.

D.W.S.

Remember tht. no test can wholly exclude risk. Hard choice for parent if we don't test. But if we do full test many parents won't even have chance of taking the risk.

H.W.

}What of suggn. in para. 16?

H.B.

}This seems promising.

D.W-S.

2 injns. give only 70% immunity. In U.S. they insist on 3. Degree of immunity from 1 wd. be so low tht. this wd. be waste of available vaccine.

Ch.H

Cutter incident cd. result in far more than 400 cases. What wd. be our posn. then - on revelation of M.R.C. advice? We cdn't survive it. We really have no choice but to follow advice of M.R.C.

D.W-S.

We must scrutinise advice of experts. And this advice doesn't stand scrutiny. Para. 6 of H.'s memo. wdn't enable us to finish before end/August.

J.M.

Given extent to which Salk is used in U.S., can we not leave choice to parent - giving them full informn.

M.

If you did that, you wd. have also to tell them M.R.C. view.

P.M.

What is greater risk : not to be vaccinated at all or to be vaccinated with Salk not tested in M.R.C.

I.M.

Believe M/H. is wrong, tho' courageous. When we have sought M.R.C. view & know they wdn't support this action, we cdn't risk over-riding it.

D.W.S.

If M.R.C. tests were dispensed with, my M.O.'s wd. be ready to advise G.P.'s on the risk of use. Agreed : Order 5.000 litres instead of 4.000.

P.M.

Do we i) act on M.R.C. advice ; and publish their report in present or amended form. ii) dispense with middle course - of abridged tests. After discn. : Rely on M.R.C. view. Ask them to consider again wtr they cd. accept any kind of abridgement of tests. After further discn. v. much worried at this rejection of U.S. remedy in face of our failure to produce our own.

G.Ll.

Can't we put this back to M.R.C. in some way. So as to reconcile practical need to use U.S. vaccine and pol. diffy. of acting contrary to M.R.C. advice.

Ch.H.

Press M.R.C. on ques why they attach importance to third test wh. failed to disclose virus.P.M.
To act contrary to view of M.R.C. is not possible. But we have clear right to X-examine M.R.C. Ask some of them to meet & discuss with a few Ministers.
[M/H., Ch.H., Hail., M/Edn. to formulate ques.] Meet on Monday am. Cab. Tuesday.

Taken from C.C. 34(58) - Meeting held on 24 April 1958