Poliomyelitis (Polio) Vaccine Recommendations and Safety

Poliomyelitis (Polio) Vaccination Recommendations

The Polio Vaccine is recommended in a 4-dose series in children at ages 2, 4, 6 through 18 months, and 4 through 6 years. The final dose in the series should be administered on or after the fourth birthday and at least 6 months after the previous dose.

Most U.S. adults are at low risk for polio exposure and are likely to have received polio immunizations. Therefore, routine immunization for adults 18 years or older is not recommended.  However, some U.S. adults are at increased risk for polio exposure.  Adults in any of the four groups listed below should be assessed for immunity and offered any additional doses:

  • Individuals traveling to countries where polio is endemic (Afghanistan, India, Pakistan and Nigeria) need to be immunized, or if previously immunized will generally need a one-time booster immunization. 
  • Health care personnel in close contact with patients shedding polio virus (unlikely in the United States).
  • Groups that do not vaccinate, and have had an outbreak of even a single case of polio, especially after traveling to endemic areas.
  • Lab workers handling specimens that may contain polioviruses (unlikely in the United States).

The polio vaccine should be given to pregnant/breastfeeding women who are at risk; the attack rate of polio is greater in pregnant versus non-pregnant women.

All current polio vaccines are trivalent, designed to protect against all three serotypes of poliovirus.  Two inactivated polio vaccines (IPV) are licensed in the United States, but only the IPOL (Sanofi Pasteur) is actually distributed.  IPV is given to adults in three doses on the following schedule:

    • Initial dose at anytime
    • Second dose 1-2 months later
    • Third dose 6-12 months following the second dose.

Current ACIP Vaccine Recommendations: Polio

Poliomyelitis (Polio) Vaccine Safety

There are two types of vaccine that protect against polio: inactivated poliovirus vaccine (IPV) and oral poliovirus vaccine (OPV). IPV is given as an injection in the leg or arm, depending on the patient's age. Polio vaccine may be given at the same time as other vaccines. Most people should get polio vaccine when they are children. Children get 4 doses of IPV at these ages: 2 months, 4 months, 6-18 months, and a booster dose at 4-6 years. OPV has not been used in the United States since 2000 but is still used in many parts of the world.

A person is considered to be fully immunized if he or she has received a primary series of at least three doses of inactivated poliovirus vaccine (IPV), live oral poliovirus vaccine (OPV), or four doses of any combination of IPV and OPV. Until recently, the benefits of OPV use (i.e. intestinal immunity, secondary spread) outweighed the risk for vaccine-associated paralytic poliomyelitis (VAPP) which occurred in one child out of every 2.4 million OPV doses distributed. To eliminate the risk of vaccine-associated paralytic poliomyelitis (VAPP), as of January 1, 2000, OPV was no longer recommended for routine immunization in the United States. However, OPV continues to be used in the countries where polio is endemic or the risk of importation and transmission is high. OPV is recommended for global polio eradication activities in polio-endemic countries due to its advantages over IPV in providing intestinal immunity and providing secondary spread of the vaccine to unprotected contacts. (http://www.cdc.gov/vaccines/vpd-vac/polio/default.htm)

As with all vaccines, there can be minor reactions, including pain and redness at the injection site, headache, fatigue or a vague feeling of discomfort.

Some people should not get IPV or should wait.

These people should not get IPV:

  • Anyone with a life-threatening allergy to any component of IPV, including the antibiotics neomycin, streptomycin or polymyxin B, should not get polio vaccine. Tell your doctor if you have any severe allergies.
  • Anyone who has a severe allergic reaction to a polio shot should not get another one.

These people should wait:

 

 

Updated 9/14/15

 

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