Sarah Bennett
Poliovirus can cause poliomyelitis and lifelong paralysis. The first successful polio vaccine demonstration was in 1950, and it has been part of routine childhood immunization in the United States since the late 1950s. Inactivated polio vaccine (IPV) has been the only polio vaccine used in the United States since 2000, and it is recommended that all children receive four doses of it. Poliovirus is still circulating in multiple countries worldwide, and it only takes one infected person to bring polio into the United States. Therefore, it is critical to get vaccinated and complete all recommended doses for the best protection.
| Characteristics | Values |
|---|---|
| Is polio vaccination still part of the routine childhood immunization schedule in the US? | Yes |
| Is polio vaccination required by federal law in the US? | No |
| How many doses of polio vaccine are recommended for children in the US? | 4 doses |
| What type of polio vaccine is used in the US? | Inactivated polio vaccine (IPV) |
| When was IPV introduced in the US? | 2000 |
| What is the effectiveness of IPV? | 99-100% effective for those who receive all recommended doses |
| Is polio vaccination recommended for adults in the US? | Recommended for adults who are unvaccinated, incompletely vaccinated, or at increased risk of exposure |
| Are there any areas in the US where polio vaccination is of particular importance? | Yes, areas where poliovirus has been repeatedly detected, such as Rockland, Orange, and Sullivan Counties, and Brooklyn and Queens within New York City |
| What are the risks of not being vaccinated against polio? | Polio can cause poliomyelitis and lifelong paralysis |
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What You'll Learn
The inactivated polio vaccine (IPV) is the only polio vaccine given in the US since 2000
Poliovirus can cause poliomyelitis and lifelong paralysis. Although wild poliovirus types 2 and 3 have been eradicated, wild poliovirus type 1 and vaccine-derived polioviruses are still circulating in multiple countries worldwide. In 2022, a case of paralytic polio caused by a vaccine-derived poliovirus was identified in an unvaccinated young adult in New York. This case highlighted the ongoing risk of poliovirus importation into the United States and the risk of poliomyelitis among unvaccinated individuals.
The inactivated polio vaccine (IPV) is the only polio vaccine that has been administered in the United States since 2000. IPV is highly effective, protecting 99-100% of individuals who receive the full course of recommended doses. It is safe for both children and adults and does not contain any live virus, eliminating the risk of vaccine-derived poliovirus. IPV is typically administered via injection in the arm or leg, depending on the recipient's age.
Polio vaccination has been a routine part of childhood immunisation in the United States for decades. The CDC recommends that all children receive four doses of IPV as part of their routine vaccinations. Children who have not started or completed their polio vaccine series are advised to follow the recommended catch-up schedule. IPV may also be administered in combination with other vaccines, such as tetanus, diphtheria, and acellular pertussis vaccines.
Most adults in the United States who received routine childhood immunisations are presumed to be protected against polio. However, adults with an increased risk of exposure to poliovirus may receive a lifetime IPV booster. Unvaccinated or incompletely vaccinated adults are encouraged to receive the recommended doses of IPV to ensure protection against polio.
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The polio vaccine is part of routine childhood immunization in the US
The polio vaccine has been part of routine childhood immunization in the US since the late 1950s. The first successful demonstration of a polio vaccine was in 1950, with a live attenuated virus that people drank. The success of an inactivated (killed) polio vaccine, developed by Jonas Salk, was announced in 1955. Following a mass immunization campaign, the annual number of polio cases in the US fell from 35,000 in 1953 to 5,600 by 1957. By 1961, only 161 cases were recorded in the US.
In 1999, the US adopted an inactivated polio vaccine (IPV)-only schedule, removing the oral polio vaccine (OPV). Since 2000, IPV has been the only polio vaccine given in the US. It is administered by shot in the arm or leg, depending on the patient's age. IPV is based on three wild, virulent reference strains, Mahoney (type 1 poliovirus), MEF-1 (type 2 poliovirus), and Saukett (type 3 poliovirus), grown in a type of monkey kidney tissue culture (Vero cell line), which are then inactivated with formalin. The injected Salk vaccine confers IgG-mediated immunity in the bloodstream, which prevents polio infection from progressing to viremia and protects the motor neurons, thus eliminating the risk of bulbar polio and post-polio syndrome.
The CDC recommends that all children get four doses of polio vaccine as part of their routine childhood vaccination schedule. Children should get one dose at each of the following ages:
- The first dose is given at 2 months old.
- The second dose is given at 4 months old.
- The third dose is given between 6 and 18 months old.
- The fourth dose is given at 4-6 years old.
Most adults born and raised in the US can assume they were vaccinated for polio as children. However, adults with an increased risk of exposure to poliovirus may receive one lifetime IPV booster.
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Most US adults are assumed to be vaccinated against polio
Polio vaccination has been a part of the routine childhood immunization schedule in the United States for decades. The inactivated polio vaccine (IPV), which is administered by shot in the arm or leg, has been the only polio vaccine used in the country since 2000. It is safe and effective, protecting 99–100% of people who receive all recommended doses.
As a result of this long-standing immunization program, most US adults are assumed to be vaccinated against polio. This is because they received routine childhood immunization and have only a small risk of exposure to poliovirus in the United States. In general, unless there are specific reasons to believe they were not vaccinated, most adults born and raised in the United States can assume they were vaccinated for polio as children. This is true even if they do not have written documentation of vaccination.
However, there are some adults who are unvaccinated or incompletely vaccinated. In 2022, a case of paralytic polio caused by vaccine-derived poliovirus type 2 was identified in an unvaccinated young adult in New York. This case highlighted the ongoing risk of poliovirus importation into the United States and the risk of poliomyelitis among unvaccinated persons. It also served as a reminder that adults can be at risk of exposure to poliovirus, particularly in communities with low childhood vaccination rates.
The Advisory Committee on Immunization Practices (ACIP) has updated its recommendations to include all adults who are known or suspected to be unvaccinated or incompletely vaccinated. These adults should receive additional doses of IPV to complete their primary series and be protected from paralytic polio.
It is important to note that the risk of poliovirus exposure in the United States is generally low, and polio has been eliminated in the country due to the success of the polio vaccine. However, the disease still occurs in other parts of the world, and it only takes one person traveling from an affected country to bring polio into the United States. Therefore, staying up to date with vaccinations is crucial for maintaining protection against polio.
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The CDC recommends 4 doses of polio vaccine for children
The CDC recommends that all children receive 4 doses of the polio vaccine as part of their routine childhood vaccination schedule. This vaccination schedule has been in place for decades and is still ongoing. The polio vaccine is administered by shot in the arm or leg, depending on the child's age. The vaccine is known as inactivated polio vaccine (IPV), and it is the only polio vaccine that has been used in the United States since 2000. IPV is highly effective, protecting 99–100% of people who receive all recommended doses.
The routine childhood vaccination schedule includes a series of 4 doses of IPV, with one dose administered at each of the specified ages. Children who are delayed in receiving all the recommended doses should follow a recommended catch-up schedule to complete their vaccination series. This is particularly important as polio still occurs in other parts of the world, and an unvaccinated individual travelling to these areas could bring the disease back to the United States.
The CDC also provides recommendations for adults who may have received poliovirus vaccination outside of the United States. These individuals should ensure they meet the U.S. recommendation for poliovirus vaccination, which includes protection against all three poliovirus types. In some cases, adults may require additional doses of IPV to complete their primary series.
The importance of polio vaccination cannot be overstated. Before the polio vaccine became available, several polio epidemics occurred between 1948 and 1955, causing widespread fear and avoidance of public gatherings. The development of the polio vaccine led to mass inoculations, significantly reducing the number of polio cases in the United States. Today, wild poliovirus has been eliminated in the country, thanks to the vaccine. However, as demonstrated by a case of paralytic polio in an unvaccinated adult in New York in 2022, the risk of poliovirus importation and transmission remains. Therefore, maintaining high vaccination rates is crucial to preventing the re-emergence of this once-feared disease.
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The risk of polio in the US
Poliovirus can cause poliomyelitis and lifelong paralysis. Although wild poliovirus types 2 and 3 have been eradicated, wild poliovirus type 1 and vaccine-derived polioviruses are still circulating in multiple countries worldwide. In 2022, a case of paralytic polio caused by vaccine-derived poliovirus type 2 was identified in an unvaccinated young adult in New York. This case and subsequent detection of community transmission highlighted the ongoing risk of poliovirus importation into the United States and the risk of poliomyelitis among unvaccinated persons.
The best way to protect against polio is to get vaccinated. Polio vaccination has been part of the routine childhood immunization schedule in the United States for decades. It is still part of the routine, and all children in the United States should get the inactivated polio vaccine (IPV) to protect against polio. The CDC recommends that all children receive four doses of IPV before or at school entry. IPV is the only polio vaccine that has been administered in the United States since 2000. It is given by shot in the arm or leg, depending on the person's age.
Most adults in the United States have likely been vaccinated against poliovirus during childhood. However, adults with increased exposure risk may receive one lifetime IPV booster. If an adult is known or suspected to be unvaccinated or incompletely vaccinated, they should receive polio vaccination according to the Advisory Committee on Immunization Practice's (ACIP) routine and catch-up schedules. The ACIP previously recommended polio vaccination for adults only if they were at increased risk of exposure. However, the detection of a polio case in an unvaccinated adult in 2022 led to updated recommendations in June 2023, which now include all unvaccinated or incompletely vaccinated adults.
The last cases of paralytic poliomyelitis caused by endemic transmission of wild poliovirus in the United States occurred in 1979, with an outbreak among the Amish in several Midwest states. Since then, polio vaccination campaigns have been highly successful, with the annual number of polio cases falling drastically. Today, wild poliovirus has been eliminated in the United States, thanks to the polio vaccine. However, the ongoing global circulation of polioviruses and the risk of importation into the United States highlight the continued importance of maintaining high vaccination rates.
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Frequently asked questions
Yes, polio vaccination has been part of the routine childhood immunization schedule in the United States since the 1950s.
The inactivated polio vaccine (IPV) is the only polio vaccine that has been used in the United States since 2000. It is given by shot in the arm or leg, depending on the person's age.
The CDC recommends that all children get four doses of the polio vaccine.
Most adults in the United States have likely been vaccinated against polio during childhood. However, adults with an increased risk of exposure to poliovirus may receive one lifetime IPV booster.
All 50 states and Washington, D.C., have laws requiring children entering childcare or public schools to have certain vaccinations, including polio.
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