Abstract
Recent review of the polio vaccines (live attenuated oral poliovirus vaccine [OPV] and enhanced inactivated poliovirus vaccine [eIPV]) for children has generated much debate between infectious disease experts and public health officials. Poliomyelitis was a common medical condition in the 1940s and 1950s, and the success of OPV in eradicating poliomyelitis from the United States and even the Western hemisphere cannot be disputed. However, the adverse condition of vaccine-associated paralytic poliomyelitis (VAPP) has been reported in eight to nine cases per year as a result of exclusively using OPV in the United States. The dilemma has been how to continue the elimination of wild-type poliovirus paralytic poliomyelitis in the United States and worldwide while minimizing the occurrence of VAPP. Clinical trials have supported that eIPV and OPV provide similar protection for humoral immunity. However, OPV provides superior gastrointestinal immunity, which is a public health benefit for vulnerable populations. Recommendations among experts have concluded that the sequential eIPV/OPV is the preferred schedule, with eIPV only or OPV only as alternative equally acceptable schedules. Therefore, factors such as cost, compliance, and access to health care must be considered by parents and providers when selecting a polio vaccine regimen, especially among underserved populations.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Chen R. T., Hausinger S., Dajani A. S., Hanfling M., Baughman A. L., Pallansch M. A., Patriarca P. A. Seroprevalence of antibody against poliovirus in inner-city preschool children. Implications for vaccination policy in the United States. JAMA. 1996 Jun 5;275(21):1639–1645. [PubMed] [Google Scholar]
- Dagan R., Fraser D., Handsher R. Acquisition of immunity in mothers of infants administered trivalent oral poliovirus vaccine. Eur J Clin Microbiol Infect Dis. 1994 Dec;13(12):1029–1032. doi: 10.1007/BF02111822. [DOI] [PubMed] [Google Scholar]
- Evans G. Vaccine liability and safety: a progress report. Pediatr Infect Dis J. 1996 Jun;15(6):477–478. doi: 10.1097/00006454-199606000-00002. [DOI] [PubMed] [Google Scholar]
- Marwick C. Not everyone wants IPV; opposition gears up. JAMA. 1995 Nov 22;274(20):1574–1575. [PubMed] [Google Scholar]
- Strebel P. M., Sutter R. W., Cochi S. L., Biellik R. J., Brink E. W., Kew O. M., Pallansch M. A., Orenstein W. A., Hinman A. R. Epidemiology of poliomyelitis in the United States one decade after the last reported case of indigenous wild virus-associated disease. Clin Infect Dis. 1992 Feb;14(2):568–579. doi: 10.1093/clinids/14.2.568. [DOI] [PubMed] [Google Scholar]
- Sutter R. W., Onorato I. M., Patriarca P. A. Current poliomyelitis immunization policy in the United States. Pediatr Ann. 1990 Dec;19(12):702–706. doi: 10.3928/0090-4481-19901201-08. [DOI] [PubMed] [Google Scholar]