David Salamone received the oral polio vaccine as an infant. Within days, he had a high fever and within weeks he could no longer crawl or use his legs. He had contracted poliomyelitis from his vaccine. David was eventually found to have Bruton's agammaglobulinemia, a rare immunodeficiency that renders him vulnerable to infections and makes it hazardous for him to receive any live vaccine. Today, at age 5, David can walk with the help of a brace, but he tires easily and falls frequently. He makes weekly visits to a physical therapist, whom he calls his “toy doctor” because of the playthings used in his therapy. He also regularly sees a neurologist, a physiatrist, a rheumatologist, and an orthopedist. David's parents try to allow him to be as much like other children as possible. He loves to play in the park, although much of the time he is watching other children at play. As he interacts with more children in school, he asks his parents why he is not chosen for teams and is always last in races. His parents try to maintain a positive approach for him, but they know that he faces years of therapy and surgery. The family believes that polio vaccination policy should be changed to rely primarily on the inactivated polio vaccine to prevent other children and families from suffering as they have.
In September 1985, when polio remained endemic in 15 of 37 member countries, the Pan American Health Organization determined that poliomyelitis must be eradicated. The strategy consisted of (1) achieving and maintaining very high levels of immunity in the population at risk (children less than 5 years of age), (2) surveillance for suspected cases, and (3) response to these cases. This strategy was implemented in all countries of the region in the
The material in this section is adapted from presentations by Ciro de Quadros and Ronald Gold and comments by other workshop speakers or participants.