From the Guidelines
Most infants who receive the polio vaccine experience no side effects or only mild reactions, with the inactivated polio vaccine (IPV) being extremely safe and the only form used in many countries today. Common side effects include low-grade fever (occurring in about 1 in 10 children), fussiness or irritability, soreness or redness at the injection site, and temporary loss of appetite. Rarely, some infants may develop a more significant fever (over 102°F or 39°C). Very rarely, serious allergic reactions can occur, typically within minutes to hours after vaccination, with symptoms including difficulty breathing, hoarseness, wheezing, hives, paleness, weakness, fast heartbeat, or dizziness. According to the Advisory Committee on Immunization Practices (ACIP) recommendations 1, the use of IPV has eliminated the risk of vaccine-associated paralytic poliomyelitis (VAPP), which was a rare but serious side effect associated with the use of oral poliovirus vaccine (OPV) 2.
The side effects of the polio vaccine are generally temporary and resolve without treatment. Parents should contact a healthcare provider if their child experiences a high fever or signs of an allergic reaction. The minimal risks of vaccination are far outweighed by the protection against polio, which can cause permanent paralysis and death. The body's immune system response to the vaccine components is what causes these mild side effects as it builds protection against the disease. Key points to consider include:
- The safety and efficacy of the IPV vaccine
- The rare but potential side effects of the vaccine, such as allergic reactions
- The importance of monitoring for signs of an allergic reaction after vaccination
- The significant protection against polio provided by the vaccine, which outweighs the minimal risks associated with vaccination.
From the Research
Side Effects of Polio Vaccination in Infants
- The oral polio vaccine (OPV) contains live attenuated virus, which can, in rare cases, cause a paralysis known as vaccine-associated paralytic polio (VAPP), and also vaccine-derived polioviruses (VDPVs) due to acquired neurovirulence after prolonged duration of replication 3.
- There were no data regarding VAPP cases in the comparison of IPV-OPV and IPV alone 3.
- No serious adverse events related to newborn OPV or IPV dosing were reported, including no cases of acute flaccid paralysis 4.
- The live-attenuated Sabin strains of OPV can revert to neurovirulence and cause vaccine-associated paralytic poliomyelitis in vaccinees or lead to emergence of vaccine-derived poliovirus strains 5.
- OPV can rarely cause paralysis and generate revertant polio strains 6.
Comparison of IPV-OPV and OPV Schedules
- IPV-OPV versus OPV: it may reduce VAPP cases by 54% to 100% (three nationwide studies; low-certainty evidence) 3.
- There is little or no difference in vaccination coverage between IPV-OPV and OPV-only schedules (risk ratio (RR) 1.01, 95% confidence interval (CI) 0.96 to 1.06; 1 ITS study; low-certainty evidence) 3.
- Similarly, there is little or no difference between the two schedule types for the number of serious adverse events (SAEs) (RR 0.88, 95% CI 0.46 to 1.70; 4 studies, 1948 participants; low-certainty evidence) 3.
Comparison of IPV-OPV and IPV Schedules
- IPV-OPV versus IPV: there may be little or no difference between the schedules in number of SAEs (RR 0.92, 95% CI 0.60 to 1.43; 2 studies, 1063 participants, low-certainty evidence) 3.
- IPV-OPV probably reduces the number of people with P3 poliovirus faecal excretion after OPV challenge with IIO and IIOO sequences (moderate-certainty evidence), and may reduce the number with P2 (low-certainty evidence), but not with P1 (very low-certainty evidence) 3.