Polio

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Polio Immunization (Vaccine)

Alternative names:

immunization - polio; inactivated polio vaccine (IPV); monovalent oral polio vaccine (MOPV); oral polio vaccine (OPV); Sabin vaccine; Salk vaccine; trivalent oral polio vaccine (TOPV) 

Information:

Definition

An immunization (vaccination) against poliomyelitis (a viral disease that can cause permanent crippling, paralysis, and sometimes even death). 

Vaccine Information

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 injection of dead (inactivated) polio virus. 

The Sabin vaccine (oral polio vaccine, OPV) was developed more recently. It is the most commonly used polio vaccine today. 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 and is no longer used in the Unites States. 

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. At least 3 doses should be given, and 4 doses are preferred (more doses may be recommended in areas where polio is prevalent). 

The usual series consists of vaccinations (preferably with the oral polio vaccine) at 2 months, 4 months, 6 months, and 15 to 18 months (the latter is optional, given if polio is prevalent in the area). A final dose should be given just before the child begins school (4 to 6 years old). 

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 received prior polio vaccines but did not complete the series may be given either the IPV or the OPV form. 

Benefits

Over 90% of persons who are completely vaccinated with either form of polio vaccine will be protected against polio. 

The Sabin vaccine can be safely given to infants. As a general rule, medications, including immunizations, are not recommended for pregnant women. However, a pregnant woman who needs immediate protection against polio can receive the Sabin (oral) vaccine (there have been no documented problems for the woman or the fetus). 

Risks

Polio can develop in the person being immunized. This is very rare (about 1 out of 7.8 million polio immunizations). 

Polio can also develop in people who are in close contact with the immunized person. This can occur if a person is not already protected (immunized) against polio. The risk is highest after the first dose of vaccine. If a child is to be given the polio vaccine, and an adult household contact of the child has not been vaccinated, the adult should consider being vaccinated at the same time as the child. (Note contraindications for immunosuppressed persons). 

As with any medicine or any vaccine, other serious problems or even death can occur; this is very rare after polio vaccine. For almost all people, the benefits of vaccination far outweigh the risks. 

Delay or do not give (CONTRAINDICATIONS)

The injected (Salk) vaccine is recommended instead of the Sabin (oral) vaccine in immunosuppressed persons (persons with a disorder or condition that makes it hard for the body to fight infection). This includes persons with AIDS, HIV infection, other immunodeficiency diseases, cancer, leukemia, lymphoma (lymph node cancer), and so on. It also includes people who are receiving radiation treatments, medications to treat cancer, corticosteroids (such as prednisone), or other immunosuppressive medications. 

Immunosuppressed persons should avoid contact with persons who have received the Sabin vaccine for 2 weeks after vaccination (because the live virus in the oral vaccine can be transmitted from the vaccinated person). The injected (Salk) vaccine is usually recommended if any close member of the household has any of the medical conditions listed above. 

The Salk (injected) vaccine should not be given to persons with severe allergy to neomycin or streptomycin. 

Post Immunization Symptoms and Care

The oral polio vaccine usually causes no postimmunization symptoms. The Salk vaccine (injection) can 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

  • uncertain whether polio immunization should be given, particularly if there are conditions where immunization may need to be delayed or not given.
  • symptoms of poliomyelitis develop after polio immunization, including fever, sore throat, muscle or joint pain and stiffness (particularly the neck, back, or legs), and weakness or paralysis.
  • other symptoms develop after polio immunization.
  • there are other questions or concerns about polio immunization.

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