336 



began, and later issued recommendations that the Salk vaccine be given 

 primarily to adults, and the Sabin to children. 



Undeniably, the introduction of the Sabin vaccine followed a more 

 orderly and deliberate course than had the Salk vaccine. To some ex- 

 tent, this was attributable to the fact that the edge had been taken off 

 the public fears of polio by the earlier treatment. The reduced pressure 

 for an instant preventive allowed the systematic processes of scientific 

 evaluation and validation to operate. 



The question is unresolved as to whether the experience with the 

 Salk vaccme has conferred any lasting lessons applicable to some new 

 solution for a hitherto intractable disease such as cancer or lukemia. 

 The complex jurisdictions prevailing in medicine, the deepseated 

 policy positions concerning its organization and control, and the urg- 

 ency of making generally available some promising remedy for a 

 widely feared disease, might precipitate a future repetition of the 

 confusions generated by the Salk vaccine. Possibly the enlarged re- 

 search effort and capability of the NIH gives some assurance of im- 

 proved coordination of large-scale medical programs in the future. 



