Author Contributions: Ms Alexander had full
access to all polio case data in the study and Dr Santibanez to National Immunization
Survey data and each takes responsibility for the integrity of these data,
respectively, and the accuracy of the data analysis.
Study concept and design: Alexander, Seward, Wharton,
Acquisition of data: Alexander, Pallansch,
Kew, Prevots, Strebel, Cono, Sutter.
Analysis and interpretation of data: Alexander,
Seward, Santibanez, Pallansch, Prevots, Orenstein, Sutter.
Drafting of the manuscript: Alexander, Seward,
Santibanez, Prevots, Sutter.
Critical revision of the manuscript for important
intellectual content: Alexander, Seward, Santibanez,
Pallansch, Kew, Prevots, Strebel, Cono, Wharton, Orenstein, Sutter.
Statistical analysis: Alexander, Santibanez.
Administrative, technical, or material support:
Pallansch, Prevots, Strebel, Cono, Wharton, Orenstein.
Study supervision: Seward, Sutter.
Acknowledgment: We thank the following individuals
from the National Immunization Program at the CDC: Rex Ellington, for providing
Biologics Surveillance data, Barry Sirotkin, MSC, for maintaining historical
data, Mary McCauley, MTSc, for editorial comments, and Patti Smith, for assistance
with graphics. We greatly appreciate the expert review panel physicians Catherine
Wilfert, MD, Robert Eiben, MD, and Howard Lipton, MD, who have dedicated many
hours over the decades in reviewing clinical poliomyelitis cases. We also
acknowledge the members of the Advisory Committee on Immunization Practices
involved with the polio policy changes discussed in this article for their
involvment in making a difficult public health policy decision.