Risks from polio vaccination

To the Editor.— In their response to my letter on polio vaccination during pregnancy, Goodman et al 1 state, "Use of the number of doses distributed gives a measure of the overall risk of vaccine-associated poliomyelitis and gives a prospective OPV [oral polio vaccine] recipient or contact of a recipient the overall odds of becoming a vaccine-associated case." The courts of the state of Washington have held that this statement was inadequate and misleading and, therefore, awarded judgment to the vaccine-associated polio victim against the vaccine manufacturer. Other parties to the litigation settled out of court, in part because that statement on the signed informed consent was regarded as indefensible. The vast majority of OPV recipients are newborns who are slated to receive four doses of OPV (five in past years) by the time they enter school. Consequently, estimation of "one case of paralytic poliomyelitis in recipients or contacts for