Bull World Health Organ. 1982;60(2):231-42.
Most of the 13 countries that participated in this ten-year study of the incidence of acute persisting spinal paralysis (APSP) used trivalent live poliomyelitis vaccine (Sabin strains), but monovalent vaccines were used for all or part of the time in 3 countries and inactivated vaccines were used wholly by 2 countries and in part by 2 other countries. Altogether 698 cases of APSP were recorded in a total population of about 509 million over the 10-year study period - an incidence of 0.14 per million per annum. The incidence varied widely between countries and not all the cases were related to immunization. In six countries where live vaccines were used three methods of assessment of risk were employed. The risk in relation to the child population under 3 years of age was less than 1 per million children in all six countries.In both vaccinees and contacts most cases were due to poliovirus type 3; of those due to type 2, the proportion was greater among contacts than among recipients. Since the results make it clear that neurovirulence tests for safety do not prove the innocuity of a vaccine with absolute certainty, it is essential that every programme of poliomyelitis immunization should include a continuous and effective system of surveillance. The study showed the need for the immunization of presumed susceptible adults at the same time as their children are vaccinated.Though in most countries the incidence of vaccine-associated cases was low, two countries had much higher rates. In one the rate has now fallen but in the other it persists at the same level as before. No clear explanation of the differences between these and the other countries was obtained.
参与这项为期十年的急性持续性脊髓麻痹（APSP）发病率研究的13个国家中，大多数国家使用三价口服脊髓灰质炎活疫苗（萨宾株），但有3个国家全部或部分时间使用单价疫苗，2个国家完全使用灭活疫苗，另有2个国家部分使用灭活疫苗。在为期10年的研究期间，在约5.09亿总人口中总共记录了698例APSP病例——每年每百万人口的发病率为0.14。各国之间的发病率差异很大，而且并非所有病例都与免疫接种有关。在使用活疫苗的6个国家中，采用了三种风险评估方法。在所有6个国家中，3岁以下儿童群体的风险低于每百万儿童1例。在接种疫苗者和接触者中，大多数病例是由3型脊髓灰质炎病毒引起的；在由2型病毒引起的病例中，接触者中的比例高于接种者。由于结果清楚地表明，用于安全性的神经毒力测试并不能绝对确定地证明疫苗无害，因此脊髓灰质炎免疫接种的每个计划都必须包括一个持续有效的监测系统。该研究表明，在为儿童接种疫苗的同时，有必要为假定易感的成年人进行免疫接种。尽管在大多数国家，与疫苗相关的病例发病率较低，但有两个国家的发病率要高得多。其中一个国家的发病率现已下降，但另一个国家的发病率仍维持在以前的水平。对于这些国家与其他国家之间的差异，尚未找到明确的解释。
