Salk D
Rev Infect Dis. 1980 Mar-Apr;2(2):243-57. doi: 10.1093/clinids/2.2.243.
Killed poliovirus vaccine was the only poliomyelitis vaccine available in the United States from 1954 to 1962. During that time, the incidence of poliomyelitis among non-vaccinated individuals decreased by 90%, an indication that the circulation of wild poliovirus had been reduced ("herd effect"). The rate of decline of wild poliovirus disease, which resulted from use of killed vaccine, did not change after oral, live poliovirus vaccine was introduced in 1962. Neither mass immunization campaigns nor use of an orally administered vaccine has increased rates of poliomyelitis immunization. Outbreaks of poliomyelitis can occur in susceptible subgroups in otherwise well vaccinated populations; therefore, the degree of population protection is best evaluated in terms of the number of susceptible individuals and their opportunities for contact with each other rather than in terms of the percentage of the total population vaccinated. Eradication of poliomyelitis and elimination of poliovirus from large populations are possible with use of killed poliovirus vaccine.
1954年至1962年期间，灭活脊髓灰质炎疫苗是美国唯一可用的脊髓灰质炎疫苗。在此期间，未接种疫苗个体中的脊髓灰质炎发病率下降了90%，这表明野生脊髓灰质炎病毒的传播已减少（“群体效应”）。1962年引入口服活脊髓灰质炎疫苗后，因使用灭活疫苗导致的野生脊髓灰质炎病毒疾病下降速度并未改变。大规模免疫运动和口服疫苗的使用均未提高脊髓灰质炎免疫接种率。在疫苗接种情况良好的人群中，易感亚组可能会发生脊髓灰质炎疫情；因此，评估人群保护程度的最佳方式是根据易感个体的数量及其相互接触的机会，而非接种疫苗的总人口百分比。使用灭活脊髓灰质炎疫苗有可能根除脊髓灰质炎并从大量人群中消除脊髓灰质炎病毒。
