Sarah Bennett
Polio vaccination has been a part of the routine childhood immunization schedule in the United States for decades. The polio vaccine provides lifelong immunity, and most adults in the U.S. are presumed to be immune. Two doses of the inactivated polio vaccine (IPV) are 90% effective or more against paralytic polio, and three doses are 99% to 100% effective. While it is not known exactly how long people who received IPV will be protected against polio, they are likely protected for many years. A 2009-2010 national survey showed that a high percentage of adults had protective antibodies against poliovirus, even those who had received the oral polio vaccine (OPV) as children decades earlier.
| Characteristics | Values |
|---|---|
| Does my childhood polio vaccine still protect me? | Yes, the polio vaccine provides lifelong immunity. |
| How many doses are required for protection? | 90% or more of vaccine recipients are immune after 2 doses of poliovirus vaccine and at least 99% immune after 3 doses. |
| Is there a booster dose? | Booster doses are not recommended unless there are specific reasons to believe an individual was not vaccinated. |
| Is polio vaccination still relevant? | Yes, polio still occurs in other parts of the world and can be spread by people who travel. |
| What are the polio vaccine types? | There are two types of polio vaccines: inactivated poliovirus vaccine (IPV) and oral poliovirus vaccine (OPV). |
| Which vaccine is used in the US? | Since 2000, the US has only used IPV to eliminate the risk of vaccine-derived poliovirus that can occur with OPV. |
| Which vaccine is used in other countries? | OPV is still used in a few countries where the risk of getting infected with poliovirus is high, and it is low-cost and easy to administer. |
| What is the effectiveness of IPV? | Two doses provide at least 90% protection, and three doses provide at least 99% protection. |
| Are there any side effects to IPV? | Mild side effects like soreness, fever, pain, redness, or swelling in the area of the shot are possible, but serious reactions are rare. |
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What You'll Learn
Polio vaccines provide lifelong immunity
The standard polio vaccination schedule for children involves four doses. The first dose is given when the child is two months old, followed by the second dose at four months, and the third dose between six and eighteen months. The fourth and final dose is given when the child is between four and six years old.
IPV is highly effective in protecting against severe disease caused by poliovirus. Two doses provide at least 90% protection, while three doses offer at least 99% protection. Although it is not known exactly how long the protection lasts, those who have received a complete series of IPV are likely protected for many years. A 2009-2010 national survey showed that a high percentage of adults had protective antibodies against poliovirus, even those who had received the oral polio vaccine (OPV) as children decades earlier.
While polio has largely disappeared from the United States due to successful vaccination programs, it is important to maintain high vaccination rates to prevent future outbreaks. Most adults in the United States are presumed to be immune to polio due to routine childhood immunization. However, adults who know they were not vaccinated as children or suspect they may be incompletely vaccinated should speak to their doctor about getting vaccinated.
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Two types of polio vaccines exist
Polio vaccination has been part of the routine childhood immunization schedule in the United States for decades. Since 2000, the US has used an injectable or inactivated polio vaccine (IPV). IPV is given by shot in the arm or leg, depending on the person's age. Two doses of IPV are 90% effective or more against paralytic polio; three doses are 99% to 100% effective. A person is considered fully vaccinated if they received four doses of any combination of IPV and trivalent oral polio vaccine (tOPV) or a primary series of at least three doses of IPV or tOPV. The last dose in either series should be given after four years of age and at least six months after the previous dose.
However, many parts of the world still use the oral polio vaccine (OPV), which uses a weakened form of the live poliovirus. In April 2016, all countries that were still using OPV stopped using tOPV and switched to using bivalent OPV (bOPV) in routine immunization. If a person only received bOPV, they are not vaccinated against type 2 poliovirus and need to complete an IPV 3-dose or 4-dose series depending on their age to be fully protected. OPV doses administered after 1 April 2016 should not be counted as tOPV doses unless written documentation specifies that the dose was tOPV.
The Global Polio Eradication Initiative is constantly assessing the optimal use of the different types of vaccines to prevent paralytic polio and stop poliovirus transmission in different areas of the world.
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IPV is the only polio vaccine used in the US since 2000
Since 2000, the United States has exclusively used the inactivated polio vaccine (IPV) to immunise its population against the poliovirus. IPV is administered by injection in the arm or leg, depending on the recipient's age. It is safe and effective, offering 99–100% protection against polio after the recommended number of doses.
IPV is distinct from the oral polio vaccine (OPV) used in many other countries, which is administered by mouth. OPV contains a weakened form of the live poliovirus, whereas IPV does not contain any live virus and cannot cause polio. The switch to IPV in the US was implemented to eliminate the risk of vaccine-derived poliovirus that can occur with OPV.
In the US, children are recommended to receive four doses of IPV as part of their routine childhood immunisations. The first dose is typically given when a child is 2 months old, followed by a second dose at 4 months, a third dose between 6 and 18 months, and a final dose between 4 and 6 years of age. Children who are unvaccinated or incompletely vaccinated should complete the polio vaccine series.
Most adults in the US are presumed to be protected against polio due to routine childhood immunisation. Unless there are specific reasons to believe otherwise, adults born and raised in the US can assume they received the polio vaccine as children. While the duration of protection from IPV is unknown, individuals who received IPV are likely protected for many years. Adults who completed their polio vaccination series as children but are at higher risk of polio exposure may receive a single lifetime IPV booster dose.
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OPV is still used in some countries
OPV, or oral polio vaccine, is still used in some countries, while others have switched to IPV, or the injectable or inactivated polio vaccine. The United States, for instance, has used IPV exclusively since 2000. However, OPV is still used in many parts of the world. In April 2016, all countries that were using OPV switched from trivalent OPV (tOPV) to bivalent OPV (bOPV) for routine immunisation. This switch means that individuals vaccinated with bOPV are not protected against type 2 poliovirus and require additional doses of IPV to be fully protected.
The continued use of OPV in some countries is due to several factors. Firstly, IPV is more expensive to produce and has specific storage and administration requirements that may be impractical in developing countries. OPV, on the other hand, is less costly and does not require cold storage. Additionally, OPV is more effective at preventing transmission and provides better intestinal immunity compared to IPV, reducing the risk of infection after virus contraction.
Despite its effectiveness, OPV has been associated with rare cases of Vaccine-Associated Paralytic Poliovirus (VAPP) and, very rarely, circulating vaccine-derived poliovirus (cVDPV). This has led to the re-emergence of poliovirus in some countries, including Israel, the US, and the UK, where vaccine-derived poliovirus has been detected in sewage samples. The likely source of these outbreaks is attributed to the spread of live strains of poliovirus from individuals vaccinated with OPV overseas returning to their countries.
To address the challenges posed by OPV, including the risk of cVDPV outbreaks, the global health community has introduced novel OPV solutions. One such solution is nOPV2, which is essential for controlling cVDPV outbreaks in countries where polio is endemic. Implementing mass vaccination campaigns can help increase awareness about the benefits of vaccines and improve routine immunisation coverage with nOPV2, reducing the risk of new polio outbreaks.
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Booster doses for adults at higher risk of polio exposure
Inactivated polio vaccine (IPV) is the only polio vaccine that has been administered in the United States since 2000. It is given as an injection in the arm or leg, depending on the person's age. While it is unclear how long people who received IPV will be protected against polio, they are likely to be protected for many years after a complete series of IPV.
A 2009-2010 national survey showed that a high percentage of children and adults had protective antibodies against poliovirus, including adults who had received the oral polio vaccine (OPV) as children decades earlier.
The CDC recommends that adults who completed their polio vaccination series as children but are at higher risk of polio exposure may receive one lifetime IPV booster. This includes adults who:
- Are travelling to countries where polio is epidemic or endemic.
- Are laboratory or healthcare workers who handle specimens that might contain polioviruses.
- Are healthcare workers or caregivers who have close contact with a person who could be infected with poliovirus.
- Have been identified by public health authorities as being part of a group or population at increased risk of exposure due to an outbreak.
- Have had three or more doses of the polio vaccine in the past and are at increased risk of exposure to poliovirus.
The CDC also recommends that adults who received poliovirus vaccination outside the United States should meet the country's poliovirus vaccination requirements, which include protection against all three poliovirus types.
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Frequently asked questions
Yes, the polio vaccine provides lifelong immunity. You are most likely protected for many years after a complete series of IPV.
Children should receive four doses of the polio vaccine, one each at 2 months, 4 months, between 6-18 months, and between 4-6 years. Two doses of IPV provide at least 90% protection, while three doses provide at least 99% protection.
There are two types of polio vaccines: inactivated poliovirus vaccine (IPV) and oral poliovirus vaccine (OPV). Since 2000, only IPV has been used in the United States to eliminate the risk of vaccine-derived poliovirus that can occur with OPV.
Booster doses are generally not recommended for the polio vaccine. However, adults who completed their polio vaccination series as children and are at higher risk for polio exposure can receive one lifetime IPV booster.
