Introduction to Polio & Polio Vaccines

What is Polio?


 Polio is a disease caused by a virus. It enters the body through the mouth. The virus usually spreads through feces. It also spreads orally due to bad hygienic habits.  Contaminated water, food or unhealthy environmental conditions add to the spread of the disease. Usually, it does not cause serious illness. But, it sometimes causes paralysis (inability to move arm or leg), and it can cause meningitis (irritation of the lining of the brain). It can kill people who get it, usually by paralyzing the muscles that help them breathe.

 

Questions: 

 

Causative Agent: Polio Virus

Symptoms:

      • Acute onset of fever
      • Headache
      • Malaise
      • Flaccid Paralysis
      • Skeletal Deformity

Climate/ Environment: More common in peak summer or early autumn.

Treatment:

Polio is not a curable disease. The only prevention from the disease is Polio vaccine.

Recommendations for IPV Vaccination of Children

(Inactivated Polio Virus Vaccine)

Administration

IPV is a shot, given in the leg or arm, depending on age. It may be given at the same time as other vaccines.

Routine Vaccination

All children should receive four doses of IPV at ages 2, 4, and 6–18 months and 4–6 years. The first and second doses of IPV are necessary to induce a primary immune response, and the third and fourth doses ensure “boosting” of antibody titers to high levels. 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. All children who have received three doses of IPV before age 4 years should receive a fourth dose before or at school entry. The fourth dose is not needed if the third dose is administered on or after the fourth birthday.

Incompletely Vaccinated Children

Those who are inadequately protected should complete the recommended vaccination series. No additional doses are needed if more time than recommended elapses between doses (e.g., more than 4–8 weeks between the first two doses or more than 2–14 months between the second and third doses).

Scheduling IPV Administration

Until appropriate combination vaccines are available, the administration of IPV will require additional injections at ages 2 and 4 months. When scheduling IPV administration, the following options should be considered to decrease the number of injections at the 2- and 4-month patient visits:

Administer HepB at birth and ages 1 and 6 months.

Schedule additional visits if there is reasonable certainty that the child will be brought back for subsequent vaccination at the recommended ages.

Interchangeability of Vaccines

Children who have initiated the poliovirus vaccination series with one or more doses of OPV should receive IPV to complete the series. If the vaccines are administered according to their licensed indications for minimum ages and intervals between doses, four doses of OPV or IPV in any combination by age 4–6 years is considered a complete series, regardless of age at the time of the third dose. A minimum interval of 4 weeks should elapse if IPV is administered after OPV. Available evidence indicates that persons primed with OPV exhibit a strong mucosal immunoglobulin ‘A’ response after boosting with IPV

Administration with Other Vaccines

IPV can be administered simultaneously with other routinely recommended childhood vaccines. These include DTP, DTaP, Hib, HepB, varicella (chickenpox) vaccine, and measles-mumps-rubella vaccine.

Doses:

Primary immunization: Administer three 0.5 mL doses, at 2, 4, and 6-18 months of age; do not administer more frequently than 4 weeks apart (preferably given more than 8 weeks apart).

Booster dose: 0.5 mL at 4-6 years of age; Minimum interval between booster and previous dose is 6 months. The final (booster) dose should be given at ≥4 years of age, regardless of the number of previous doses. If the final dose is not given at 4-6 years of age, it should be given as soon as feasible.

Note: Use of the minimum age and minimum intervals during the first 6 months of life should only be done when the vaccine recipient is at risk for imminent exposure to circulating poliovirus.

Recommendations for IPV Vaccination of Adults

Routine poliovirus vaccination of adults (i.e., persons aged >18 years) is not necessary. Most adults have a minimal risk for exposure to polioviruses. Vaccination is recommended for certain adults who are at greater risk for exposure to polioviruses than the general population, including the following persons:

      • Travelers to areas or countries where polio is epidemic or endemic.
      • Members of communities or specific population groups with disease caused by wild polioviruses.
      • Laboratory workers who handle specimens that might contain polioviruses.
      • Health-care workers who have close contact with patients who might be excreting wild polioviruses.
      • Unvaccinated adults whose children will be receiving oral poliovirus vaccine.
      • Unvaccinated adults who are at increased risk should receive a primary vaccination series with IPV. Adults without documentation of vaccination status should be considered unvaccinated.

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 more than 8 weeks are available before protection is needed, three doses of IPV should be administered at least 4 weeks apart.

If fewer than 8 weeks but more than 4 weeks are available before protection is needed, two doses of IPV should be administered at least 4 weeks apart.

If fewer than 4 weeks are available before protection is needed, a single dose of IPV is recommended.

The remaining doses of vaccine should be administered later, at the recommended intervals, if the person remains at increased risk for exposure to poliovirus. Adults who have had a primary series of OPV or IPV and who are at increased risk can receive another dose of IPV. Available data do not indicate the need for more than a single lifetime booster dose with IPV for adults.

Doses:

Previously unvaccinated: Two 0.5 mL doses administered at 1- to 2-month intervals, followed by a third dose 6-12 months later. If less than 3 months, but at least 2 months are available before protection is needed, 3 doses may be administered at least 1 month apart. If administration must be completed within 1-2 months, give 2 doses at least 1 month apart. If less than 1 month is available, give 1 dose.

Incompletely vaccinated: Adults with at least 1 previous dose of OPV, less than 3 doses of IPV, or a combination of OPV and IPV equaling less than 3 doses, administer at least one 0.5 mL dose of IPV. Additional doses to complete the series may be given if time permits.

Completely vaccinated and at increased risk of exposure: One 0.5 mL dose

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 had a severe allergic reaction to a previous polio shot should not get another one.

These people should wait:

Anyone who is moderately or severely ill at the time the shot is scheduled should usually wait until they recover before getting polio vaccine. People with minor illnesses, such as a cold, may be vaccinated.

What are the risks from IPV?

Some people who get IPV get a sore spot where the shot was given. IPV has not been known to cause serious problems, and most people don’t have any problems at all with it.

However, any medicine could cause a serious side effect, such as a severe allergic reaction or even death. The risk of polio vaccine causing serious harm is extremely small.

RECOMMENDATIONS FOR OPV VACCINATION

(Oral Polio Virus Vaccine)

Administration: It is given orally

Recommendations for OPV Vaccination for Outbreak Control

As affirmed by ACIP, OPV remains the vaccine of choice for mass vaccination to control polio outbreaks. The preference for OPV in an outbreak setting is supported by

a) Higher seroconversion rates after a single dose of OPV compared with a single dose of IPV;

b) A greater degree of intestinal immunity, which limits community spread of wild poliovirus; and

c) Beneficial secondary spread (intestinal shedding) of vaccine virus, which improves overall protection in the community.

OPV can protect more persons who are susceptible in a population, making it the preferred vaccine for rapid intervention during an outbreak.

Recommendations for Other Uses of OPV

For the remaining nonemergency supplies of OPV, only the following indications are acceptable for OPV administration:

Unvaccinated children who will be traveling in fewer than 4 weeks to areas where polio is endemic. If OPV is not available, IPV should be administered.

Children of parents who do not accept the recommended number of vaccine injections. These children can receive OPV only for the third or fourth dose or both. In this situation, health-care providers should administer OPV only after discussing the risk for VAPP (Vaccine Associated Paralytic Poliomyelitis) with parents or caregivers.

What if there is a serious reaction after Vaccine administration?

What should you look for?

Look for anything that concerns you, such as signs of a severe allergic reaction, very high fever, or behavior changes. Signs of a severe allergic reaction can include hives, swelling of the face and throat, difficulty breathing, a fast heartbeat, dizziness, and weakness. These would start a few minutes to a few hours after the vaccination.

What should you do?

If you think it is a severe allergic reaction or other emergency that can’t wait, call 1122 or get the person to the nearest hospital. Otherwise, call your doctor.

If you need any further information about Polio Vaccine, please call our 24/7 help line

Help Line: 0800-73428

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    Comments

    1. I found this information to be very helpful and appreciate your effort in providing public awareness…. may it be eradicated soon