The Cox live attenuated vaccine was given in healthy infants and in poliomyelitis patients. The immunological effect, safety, infection in contacts and replacement of the virulent strain of virus were studied. The following result were obtained.
Administration of all three monovalent vaccine in 6 healthy children ranging in age from 1 month to 14 months resulted in a rise in Type I antibody in 5, Type II in 1 and Type III in all 6. Type I virus was isolated from the stool in 5, Type II in 1 and Type III in 6 children.
In two cases examined, blood picture showed no marked alteration and virus could not be isolated from the blood or spinal fluid.
Autopsy was performed in 2 cases dying of other causes and there were no changes attributable to polio in the spinal cord and virus was not isolated from the organs.
Infection in contacts was investigated. A slowly spreading infection was found in 5 infants, while a fast spreading infection was forund in 6 of 7 children and infection within the family occurred in 8 of 13 subjects.
Vaccine of a viral strain differing from the infective strain was administered in fresh cases of poliomyelitis and the stool examined for the strain excreted. Excretion of the attenuated strain was observed in 7 cases. The finding suggests that the virulent strain is replaced by the attenuated strain and this is significant immunologically as it would be possible to prevent further spread of the virulent strain by giving attenuated virus and also that the live virus vaccine would be a valuable measure at times of poliomyelitis epidemics. Virus excreted in the stool was tested by intraspinal injection in the mouse and it was found that there was some increase in neurotropism following passage in man.
Untoward effects were not found in any of the cases given the live attenuated poliovirus vaccine.

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The live attenuated poliovirus vaccine of Cox was administered in monkeys and clinical, virological and histological studies conducted. The trivalent vaccine and a mixture of the 3 monovalent vaccines were used. Clinical symptoms suggestive of poliomyelitis were not observed in any of the animals. The stcol, blood and spinal fluid were examined for virus following administration of vaccine. A mixture, Type I or Type II virus was isolated from the stool of all except one animal. Virus could not be isolated from the blood, or spinal fluid or from tissues obtained on dissection of the animals. Histological examination of the tissues revealed no significant changes in the cerebrum or cerebellum but in the spinal cord, there was a decrease in number, degeneration and phagocytosis of neurons in the anterior horn, especially the cervical and lumbar cord. Compared to the changes in typical poliomyelitis, the findings were slight but in contrast to the control the changes were definite. Infiltration by inflammatory cells was observed in the mucous tissue of the small and large intestines and sinuitis was found in the mesenterial lymphnodes. The findings suggest that proliferation of virus takes place at this site. The results suggest that administration of the Cox vaccine in the form of a mixture of the 3 types may be accompanied by some danger. The reason for this is that the attenuated virue still possesses some neurotropicity and also due to the administration of the 3 types of virus at the same time.

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During an influenza outbreak, mass nasal vaccination was carried out using a living influenza A2 vaccine at the Osaka University Hospital in March, 1960. 224 persons were involved.
Vaccine used was infected chorioallantoic fluid two days after inoculation with Okuda strain of 91st, 97th and 142nd egg passage and Kinugasa strain of 118th egg passage. The vaccine contained 10⁹-10^9⋅5 EID₅₀ and 4096 HAU per milliliter. Vaccination was carried out by inhalation method using a nebulizer and an air compressor. An outlet of the nebulizer was kept 1-2cm apart from the nostrils and vaccine was inhaled for 10 seconds. The vaccine used for one person was 0.01-0.06ml.
78 paired sera were tested and 4 fold or more HI (hemagglutination inhibitting) antibody rise was observed in 83% of them and geometrical mean of antibody rise was 9.4 fold. The result obtained were rather uniform with the various vaccine materials employed.
CE (complement fixing) antibody response was also examined and two fold or more rise in anti-V titer was observed in 71.4% of 77 persons and in anti-S titer in 44.2% of them. Rise in anti-V and anti-S titer was roughly proportionate and in the majority of cases rise in anti-V titer exceeded anti-S. Only a few showed 4 fold or more rise in anti-V titer without rise in anti-S titer. This situation is the reverse to that encountered after subcutaneous injection of inactivated vaccine. Some showed HI antibody response without CF antibody rise.
Clinical reactions were mainly general signs such as headache, malaise, lassitude and fever and were observed in 23.4% of 214 persons. Fever higher than 38°C was observed in 2.8% of them and lasted for 24 hours or less except one who might have already been infected with epidemic influenza. Other symptoms were extremely mild and lasted for less than 12 hours in most cases. These reactions were observed dominantly in those with low initial HI antibody titer. CF antibody titer before vaccination also seems to be related to clinical reactions. HI antibody response was observed in lower percentage in the group with clinical reactions than in the group without.
The vaccination with living virus seems to have prophylactic effect against influenza.

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