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As each child entered the room, Dr. Salk's secretary handed him a test tube bearing the youngster's name and control numbers. Time and again, in answer to an anxious "Wotta they gonna do?" she explained the procedure softly and reassuringly. Working in twos, nurses slipped a needle into a vein in the hollow of the child's elbow (what doctors call the antecubital fossa) and snapped a vacuum seal. Immediately the tube began to fill with blood. Most of the youngsters watched with impersonal detachment, and girls were no more upset by the sight of blood than boys. (These blood samples will be tested to see how many children already had antibodies to one or another type of polio virus. In the forthcoming national trials, no more than 10% of the children will be asked to give blood for a cross-section sampling.)
The child's other arm was promptly swabbed with alcohol and Dr. Salk hustled over with a hypodermic. Though the syringe might hold up to 5 cc. of vaccine, the needle was changed for each child to cut down the danger of serum hepatitis. With a quick, deft motion perfected by much practice, Dr. Salk jabbed the needle in and pushed the plunger until 1 cc. had been injected. Most children let out an "Oh!" or "Ow!" and marched off, self-consciously proud, to another room where a nurse watched their reactions. One of the commonest: "Why. I didn't even cry!"
Nearly every child got a warm smile and a word of encouragement from Dr. Salk, who obviously enjoys working with them. Some who were yelling with fright he calmed easily. He waved along the few who could not be pacified—he would rather miss an injection than give one to a hysterical child.
Consenting Parents. By 1953's end, Dr. Salk had given his vaccine to about 1,000 children and adults in communities around Pittsburgh, with good evidence of an increase in antibodies and no bad reactions. Many doctors, especially state and county health officers who must take responsibility for the trials in their areas, argued that 1,000 cases were not enough to prove the safety of the vaccine or give a valid indication of its effectiveness. They suggested advance trials of 10,000 and 50,000 subjects. This would have meant a full year's delay of the large-scale national trials.
To meet these objections, Dr. Salk has had a busy season of needlework. In little more than five weeks he has inoculated almost 5,000 children in. the Pittsburgh area. Some have had three shots, some two, some one, all with vaccine made in his own laboratory. Now Dr. Salk has begun a marathon vaccinating program. Switching to commercial vaccine, he will try to inoculate 2,500 children this week and finish their quota of shots in time for the foundation to begin mass trials in the South about April 12. By then, enough commercial vaccine will be ready for 370,000 children, foundation officials have computed, and there is plenty more coming along in the pipeline.