POLIO VACCINE

Poliomyelitis is an acute viral infection that involves the gastrointestinal tract and occasionally the central nervous system. The polio vaccine, available in 2 forms, immunises you against the polio virus.

A person is considered to be fully immunised if he or she has received a primary series of at least three doses of inactivated poliovirus vaccine (IPV), live oral poliovirus (OPV), or four doses of any combination of IPV and OPV.

To eliminate the risk of vaccine-associated paralytic poliomyelitis, OPV is no longer recommended for routine immunisation.

Infants and Children

Because OPV is no longer recommended for routine immunisation in the United States, all infants and children should receive four doses of IPV at 2, 4, and 6-18 months of age, and 4-6 years of age. If accelerated protection is needed, the minimum interval between doses is 4 weeks, although the preferred interval between the second and third doses is 2 months. The minimum age for IPV administration is 6 weeks. Infants and children who have initiated the poliovirus vaccination series with one or more doses of OPV should receive IPV to complete the series.

Adults

Adults who are travelling to areas where poliomyelitis cases are still occurring and who are unvaccinated, incompletely vaccinated, or whose vaccination status is unknown, should receive IPV. Two doses of IPV should be administered at intervals of 4-8 weeks; a third dose should be administered 6-12 months after the second. If three doses of IPV cannot be administered within the recommended intervals before protection is needed, the following alternatives are recommended:

• If >8 weeks is available before protection is needed, three doses of IPV should be administered at least 4 weeks apart.
• If <8>4 weeks is available before protection is needed, two doses of IPV should be administered at least 4 weeks apart.
• If <4>

The remaining doses of vaccine should be administered later, at the intervals recommended above, if the person remains at increased risk for poliovirus exposure. Adults who are travelling to areas where poliomyelitis cases are occurring and who have received a primary series with either IPV or OPV should receive another dose of IPV before departure. For adults, available data do not indicate the need for more than a single lifetime booster dose with IPV.

Allergy to Vaccine

Minor local reactions (pain and redness) can occur following IPV. No serious adverse reactions to IPV have been documented. IPV should not be administered to persons who have experienced a severe allergic (anaphylactic) reaction after a previous dose of IPV or to streptomycin, polymyxin B, or neomycin. Because IPV contains trace amounts of these three antibiotics, hypersensitivity reactions can occur among persons sensitive to them.

Pregnancy

Although no adverse events of IPV have been documented among pregnant women or their foetuses, vaccination of pregnant women should be avoided on theoretical grounds. However, if a pregnant woman is unvaccinated or incompletely vaccinated and requires immediate protection against polio because of planned travel to a country or area where polio cases are occurring, IPV can be administered as recommended in the adult schedule. Breastfeeding is not a contraindication to immunisation against polio.

Precautions and Contraindications

IPV may be administered to persons with diarrhoea. Minor upper respiratory illnesses with or without fever, mild to moderate local reactions to a previous dose of IPV, current antimicrobial therapy, and the convalescent phase of acute illness are not contraindications for vaccination.