Does he need the Inactivated Poliovirus Vaccine (IPV)?

Adult Polio Vaccination Recommendations

Most adults in the United States do not need IPV vaccination unless they fall into specific high-risk categories. 1

General Recommendations for Adults

Routine poliovirus vaccination of adults (persons aged >18 years) residing in the United States is generally not necessary because:

• Most adults have minimal risk for exposure to polioviruses in the United States
• Most adults are already immune as a result of childhood vaccination 1

Who Needs IPV Vaccination

IPV vaccination is recommended only for certain adults who are at greater risk for exposure to polioviruses:

• Travelers to areas or countries where polio is epidemic or endemic
• Members of communities or specific population groups with disease caused by wild polioviruses
• Laboratory workers who handle specimens that might contain polioviruses
• Healthcare workers who have close contact with patients who might be excreting wild polioviruses
• Unvaccinated adults whose children will be receiving oral poliovirus vaccine 1, 2

Vaccination Schedule for Unvaccinated Adults at Risk

If an adult is unvaccinated and falls into a high-risk category, the following IPV vaccination schedule is recommended:

• Standard schedule: Two doses of IPV at intervals of 4-8 weeks, followed by a third dose 6-12 months after the second dose

If protection is needed sooner:

• If >8 weeks available: Three doses of IPV at least 4 weeks apart
• If 4-8 weeks available: Two doses of IPV at least 4 weeks apart
• If <4 weeks available: A single dose of IPV 1

The remaining doses should be administered later at the recommended intervals if the person remains at increased risk.

Previously Vaccinated Adults

Adults who have previously completed a primary series of OPV or IPV and who are at increased risk need only a single lifetime booster dose of IPV 1, 2

Administration of IPV

• IPV can be administered intramuscularly or subcutaneously in the deltoid area in adults 3
• IPV can be administered simultaneously with other vaccines using separate syringes at separate sites 1, 3

Precautions and Contraindications

IPV should not be administered to persons who have experienced:

• Severe allergic (anaphylactic) reaction after a previous dose of IPV
• Anaphylactic reaction to streptomycin, polymyxin B, or neomycin (trace amounts present in the vaccine) 1, 2, 3

Non-anaphylactic reactions to these antibiotics are not contraindications for vaccination.

Special Considerations

• Pregnancy: Although no adverse effects have been documented, vaccination of pregnant women should be avoided on theoretical grounds. However, if a pregnant woman is at increased risk and requires immediate protection, IPV can be administered 1, 2

• Immunodeficiency: IPV is the only vaccine recommended for immunodeficient persons and their household contacts. While a protective immune response cannot be ensured in immunodeficient persons, IPV is safe and might confer some protection 1, 2

Common Pitfalls to Avoid

1. Assuming all adults need polio vaccination: Most adults in the US have already been vaccinated as children and have minimal risk of exposure

2. Confusing OPV with IPV: OPV is no longer used in the US due to the risk of vaccine-associated paralytic poliomyelitis (VAPP)

3. Overlooking high-risk groups: Certain adults (travelers to endemic areas, laboratory workers, etc.) should still receive IPV vaccination

4. Misinterpreting allergic reactions: Only anaphylactic reactions to vaccine components are true contraindications; minor reactions are not