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| Definition | |
| Alternative Names | Inactivated polio vaccine (IPV); Salk vaccine; Trivalent oral polio vaccine (TOPV); Oral polio vaccine (OPV); Sabin vaccine; Immunization - polio; Vaccine - polio immunization |
| Information | No wild polio has been found in the United States for over 20 years, but polio is still common in some parts of the world, only one plane flight away. It would only take one case of polio entering from another country to bring the disease back, unless we are protected by vaccine. Experts hope that polio will be eliminated worldwide in a few years, and that soon these vaccines will no longer be necessary. In the meantime, this vaccine is important. There are two types of polio vaccine. The Salk vaccine (inactivated polio vaccine, IPV) was developed by Dr. Jonas Salk in 1955. It consists of injections of dead (inactivated) polio virus. The Sabin vaccine (oral polio vaccine, OPV) was developed more recently. This vaccine contains weakened, live virus. It is a liquid that is given by mouth. The trivalent form (TOPV) is effective against all known forms of polio; the monovalent form (MOPV) is effective against one type of polio. Oral polio vaccine is no longer used routinely in the Unites States. The Advisory Committee on Immunization Practices (ACIP) for poliomyelitis prevention replaced the previous recommendations issued in 1997 with new recommendations as of January 1, 2000. ACIP recommends that the inactivated poliovirus vaccine (IPV) be used exclusively for routine childhood polio vaccination in the United States. The reason for this is that the only cases of polio reported in the U.S. since 1979 have been associated with the OPV (oral polio vaccine) vaccine. OPV is very effective. It was largely responsible for ridding the United States of polio, but caused vaccine-associated paralytic poliomyelitis (VAPP) in about one in 2.4 million people receiving it. In the United States and other countries where the risk of polio is extremely low, using OPV is no longer worth this small risk. IPV cannot cause polio. An all-IPV schedule for routine childhood polio vaccination has now eliminated the risk of VAPP in the U.S. The ACIP continues to support the use of OVP for global polio eradication in other countries where polio is still a problem. IMMUNIZATION SCHEDULE : Polio vaccination is one of the recommended childhood immunizations and should begin during infancy. In most parts of the United States, polio immunization is required before starting school. Children should receive four doses of IPV at ages 2 months, 4 months, 6-18 months, and 4-6 years. Children who have received three doses of IPV before age 4 should receive a fourth dose before or at school entry. The fourth dose is not needed if the third dose is given on or after the fourth birthday. The first and second dose of the IPV are necessary to provide a primary immune response, and the third and fourth doses are for raising the strength of the antibody to high levels. Children who have started the poliovirus vaccination series with one or more doses of OPV should receive IPV to complete the series. A minimum interval of 4 weeks should pass after OPV has already been administered before giving IPV. Once the initial series of vaccinations is complete, adults are NOT routinely given booster vaccinations unless they are likely to be exposed to the disease (for example, if they plan to travel to an area where polio is currently occurring). If adults who have never received any polio vaccine need to be immunized, they should be given only the IPV form. Adults who had the primary series of OPV or IPV and who are at increased risk can receive another dose of IPV. The ACIP indicates that one lifetime booster dose with IPV is all that is needed for adults. For almost all people, the benefits of vaccination far outweigh the risks. PRECAUTIONS AND CONTRAINDICATIONS : People who have had severe allergic (anaphylactic) reactions after a previous dose of IPV, or to streptomycin, polymyxin B, or neomycin should not be administered IPV. They should receive OVP. There have been no adverse effects in women who have received IPV during pregnancy; however, in theory it should be avoided. If a pregnant woman is at an increased risk for infection and requires immediate protection, IPV should be administered in accordance with the recommended schedules for adults. For persons with a disorder or condition that make it hard for the body to fight infection or are immunodeficient, the IPV is the only type of vaccine recommended. This includes persons with AIDS , HIV infection , and other immunodeficiency diseases ( cancer , leukemia , lymphoma , and so on). It also includes people who are receiving radiation treatments, medications to treat cancer, corticosteroids (such as prednisone), or other immunosuppressive medications. IPV can be given during breastfeeding and to a child who has diarrhea. Persons who have minor upper respiratory illnesses with or without fever, mild to moderate local reactions to a previous dose of vaccine, current antimicrobial therapy or are in the improvement stage of an acute illness may all still receive the vaccine. Those who are moderately or severely ill should usually wait until they have recovered before receiving the vaccine. POSTIMMUNIZATION SYMPTOMS AND CARE : The IPV may cause mild soreness and redness at the site of the injection. This is usually not severe, and lasts only a few days. There are usually no other symptoms or other care needed after immunization. CALL THE PRIMARY HEALTH CARE PROVIDER IF : You are uncertain whether polio immunization should be given, particularly if there are conditions where immunization may need to be delayed or not given. An allergic reaction or other symptoms develop after polio immunization. There are other questions or concerns about polio immunization. |
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