“It was the day of my ninth birthday party, and they were putting me in the ambulance, when I remember hearing one of my friends saying, “Where is Sandy going? Isn't that Sandy? Today's her birthday party.” My mother never even had a chance to call off my birthday party. . . . I remember hearing somebody say, “If this doesn't stop, if her fever doesn't break, we're going to have to put her in an iron lung.” And I woke up the next day, my temperature had broken, and I was completely paralyzed from my neck down. I couldn't even move my neck. . . . And they sent me down to Warm Springs, Georgia, where I went for three summers in a row, where they rehabilitated me, they did corrective surgery on me, and they got me walking at least to where I could get around with braces and crutches. . . . I was so happy that there would never be any more paralysis from polio around the world again, if people used this vaccine. I was so grateful that nobody in my family would ever have to experience the things that I was going through and probably would have to go through the rest of my life.”

* From a March of Dimes video commemorating the 40th anniversary of the release of the Salk polio vaccine.

One case of paralytic poliomyelitis theoretically can represent hundreds of individuals infected with the virus. Estimates vary from 50 to 1,000 subclinical infections for each case of paralytic disease diagnosed. It is particularly difficult to ascertain the risk of spread following importation when the level of immunity in the population is high.

Vaccine-Associated Paralytic Poliomyelitis

Between 1980 and 1992, a total of 109 cases of vaccine-associated polio were reported in the United States, an average of 8.4 cases per year.2 During


Of these, 41 were immunologically normal vaccine recipients, 38 were normal contacts of immunologically normal vaccine recipients, 7 had community-acquired cases of polio, and 23 were vaccine recipients or contacts who were immunologically abnormal (17 vaccine recipients and 6 contacts).

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