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Immunization Action Coalition

Ask the Experts

Polio

General information - polio
Questions and answers regarding use of combination vaccines containing IPV may be found here.
What is the routine schedule for giving IPV to children?
Four doses of polio vaccine (IPV) are routinely recommended for U.S. children at ages 2 months, 4 months, 6-18 months, and 4-6 years. The first dose may be given as early as age 6 weeks.
What is the schedule for older children who have not completed their IPV series?
The schedule for polio vaccination for unvaccinated or under-vaccinated older children through age 17 years is 2 doses of IPV separated by 4–8 weeks, and a third dose 6–12 months after the second dose. If an accelerated schedule is needed, the child should receive two doses separated by at least 4 weeks and a third (final) dose given at least 6 months after the second dose. Polio vaccine is not routinely administered to persons 18 years of age and older.
Should adults get vaccinated against polio?
Routine vaccination of persons 18 years of age and older against polio is not necessary because most adults are already immune and also have little risk of being exposed to wild polio virus. Certain adults at increased risk of exposure to poliovirus and should be vaccinated. This includes travelers to areas were polio is common (currently limited to Afghanistan, Pakistan, Nigeria, and certain other countries in sub-Saharan Africa), and laboratory workers who handle specimens that might contain polioviruses.
If an adult is at increased risk of exposure and has never been vaccinated against polio, he or she should receive three doses of IPV, the first two doses given 1-2 months apart, and the third 6-12 months after the second.
If an adult at risk previously received only one or two doses of polio vaccine (either OPV or IPV), he or she should receive the remaining dose(s) of IPV, regardless of the interval since the last dose.
If an adult at increased risk previously completed a primary course of polio vaccine (three or more doses of either OPV or IPV), he or she may be given another dose of IPV to ensure protection. Only one "booster" dose of polio vaccine in a person's lifetime is recommended. It is not necessary to receive a booster dose each time a person travels to an area where polio may still occur.
A 4-year-old's vaccine records show that she had 4 IPVs, given at 2m, 4m, 6m, and age 2. Should she have a booster dose?
Yes. In June, 2009, ACIP updated its recommendations to clarify that an additional dose must be given at age 4-6 years, even if the child previously received 4 doses (either as IPV or as part of a combination vaccine containing IPV).
Immigrant children often have a written vaccination record that indicates 4 or more doses of oral polio vaccine (OPV) given before the fourth birthday. Should these children receive a dose of IPV at 4 through 6 years of age?
A valid OPV schedule is 4 doses, with all doses after 6 weeks of age and each separated by at least 4 weeks from the previous dose. The 4-year minimum age rule for the last dose applies only to all-IPV schedules. However, state immunization information systems may not differentiate OPV from IPV, and may forecast a dose of IPV on or after age 4 years in this situation. So it would be prudent to contact the state program to find out about their rule.
We occasionally encounter teen-agers who received 4 doses of IPV before their fourth birthday. Should we recommend a 5th dose of IPV for these children?
Generally, no. ACIP revised its recommendation for IPV in June 2009 to include a dose at 4 through 6 years regardless of the number of doses prior to age 4 years. However, ACIP did not recommend retroactive application of the new minimum age rule for the fourth dose. For children receiving their fourth dose prior to August 7, 2010, four doses separated by at least 4 weeks is sufficient, unless the teenager is traveling to a polio-endemic area. But you might want to check with your state immunization registry manager to see what they accept/expect. Contact information for state immunization managers can be found at www.immunize.org/coordinators.
If an immigrant infant has a record of 1 or 2 doses of OPV in their country of origin how many more doses of IPV should be given?
OPV is not available in the United States. Children who initiated the polio vaccination series with one or more doses of OPV should receive IPV to complete the series. ACIP recommends that when both OPV and IPV are used four doses of OPV or IPV in any combination is considered a complete series. As with an all-IPV series the final dose should be given at 4 through 6 years of age.
Is it true that IPV can be given either SC or IM?
Yes.
What is the risk of serious reactions following IPV?
There are no severe reactions known to occur following IPV.
Reviewed on 1/13
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