316 



recommendations, Mrs. Hobby emphasized the Department's concern 

 for safety of the vaccine : 



* * * The safety of the vaccine must always be the first consideration. Dis- 

 tribution must be secondary to safety. The safety of the vaccine released for 

 use will continue to be the responsibility of the Public Health Service Act, and 

 the biologies-control provisions of the Public Health Service Act, and is re- 

 ceiving the constant and diligent attention of the Public Health Service." 



Her recommendations detailed the testing responsibilities of PHS 

 and other departmental responsibilities of DHEW; provided guide- 

 lines in the determination of priorities for vaccination and distribu- 

 tion of vaccine by NFIP to fulfill its contract to immunize the Na- 

 tion's first and second graders ; and proposed establislnnent of a com- 

 mittee to oversee international distribution of the vaccine. Mrs. Hobby 

 emphasized that the distribution program could be efi^ectively carried 

 out under existing law, that it should be voluntary, and that Federal 

 funds should be used to buy vaccine only for indigent children : 



That the Secretary of Health, Education, and Welfare direct on a national 

 level the division among the States of the entire output of the * * * vaccine * * *. 



* 4! * * * * * 



That the supplies of vaccine be allocated to each State on the basis of its 

 population of children within the 5-through-9 age group until all children of 

 that group have been vaccinated. [That HEW receive reports from manufac- 

 turers and physicians regarding shipping, vaccination, and lot number, for 

 epidemiological study purposes.] 



That each State, through an appropriate single agency to be designated by 

 the Governor of the State, direct the distribution of the vaccine within the 

 State. [That the State advise HEW on its ratio between dissemination to 

 public and private agencies.] 



[That, commensurate with the bill sent to the Senate] * * * Federal funds 

 [be made] available to the States for the purchase of vaccine * * * sufiieient to 

 pay the cost of vaccine for children through age 19 in low-income families.^ 



In justifying the distribution plan preferred by the administration 

 Mrs. Hobby stated : 



In our opinion it is both practicable and desirable to permit States and lo- 

 calities to apply these established policies and procedures to their programs 

 for poliomyelitis vaccination. 



* * 4c m * i» 4e 



The.se services are well established and accepted in nearly all communities, 

 and they are provided in a manner which is not discriminatory or offensive. 

 Seldom, if ever, is any formal "means test" applied. Rather, free injections are 

 available at clinics or other centers to all who request them, but the great majority 

 of those who are able to pay prefer to go to their family physicians for preventive 

 services as well as for treatment. The arrangement is analogous to the availabil- 

 ity of pediatric services from a "well baby clinic" operated by the local health 

 department. Many mother.s— particularly in communities where the income is 

 at least average — prefer to take their children to a private pediatrician or 

 family doctor, but there is certainly no stigma attached to the use of the public 

 clinic. 



If [States] wish to adopt special programs for this purpose they should have 

 that privilege, but we see no reason for the Federal Government to require or 

 promote a separate and different local policy for immunization against one 

 particular disease. That many States and communities are willing and able to 

 provide funds for polio vaccination programs is clearly evident. Steps have 

 already been taken by State legislatures, local governments, voluntary organiza- 



^■^ Senate. Committee on Labor and Publio Welfare. Poliomvelitis vaccine hearings, 

 pt. 2 (May 16, 1955), op. cit., p. 131, citing U.S. Department of Healtli, Education, and 

 Welfare. Report to the President by the Secretary of * * * on distribution of Salk vaccine. 

 May 16. 1955. (Washington, D.C., mimeo, 1955), 34 p. plus appendixes. 



"Ibid., pp. 129-132. 



