What is the recommended number of inactivated poliovirus vaccine (IPV) doses for an adult?

Adult Polio Vaccination Requirements

For adults who have never been vaccinated against polio, a primary series of three doses of IPV is required, with the first two doses given 4-8 weeks apart and the third dose 6-12 months after the second dose. 1

Vaccination Schedule for Unvaccinated Adults

The Centers for Disease Control and Prevention (CDC) recommends the following schedule for previously unvaccinated adults:

• Primary series: Three doses of Inactivated Poliovirus Vaccine (IPV)
  • First and second doses: 4-8 weeks apart
  • Third dose: 6-12 months after the second dose 2

If expedited protection is needed due to travel to polio-endemic areas or other risk factors, alternative schedules may be followed:

• If more than 8 weeks are available: Three doses of IPV at least 4 weeks apart
• If fewer than 8 weeks but more than 4 weeks are available: Two doses of IPV at least 4 weeks apart
• If fewer than 4 weeks are available: A single dose of IPV 2

Booster Doses for Previously Vaccinated Adults

For adults who have previously completed a primary polio vaccination series and are at increased risk of exposure:

• A single lifetime booster dose of IPV is sufficient 1
• Available data do not indicate the need for more than one lifetime booster dose for adults 2

Who Needs Polio Vaccination?

While routine poliovirus vaccination is not necessary for most adults residing in the United States, certain groups at higher risk should be vaccinated:

• Travelers to areas where polio is epidemic or endemic
• Members of communities with disease caused by wild polioviruses
• Laboratory workers handling specimens that might contain polioviruses
• Healthcare workers with close contact with patients who might be excreting wild polioviruses 2, 1

Important Considerations

• Adults without documentation of vaccination status should be considered unvaccinated 2
• IPV is the only polio vaccine currently available in the United States
• IPV is safe with no serious adverse events documented, though it contains trace amounts of streptomycin, polymyxin B, and neomycin 2
• Recent evidence from a 2022 study showed that even a single dose of IPV can boost seropositivity rates to 98.4-100% in previously vaccinated adults 3

Contraindications

• IPV should not be administered to persons who have experienced severe allergic reactions to previous doses of IPV or to antibiotics contained in the vaccine (streptomycin, polymyxin B, or neomycin) 2, 1
• While no adverse effects have been documented, vaccination during pregnancy should be avoided on theoretical grounds unless immediate protection is required 2

The 2023 updated recommendations from the Advisory Committee on Immunization Practices (ACIP) emphasize the importance of polio vaccination for all unvaccinated or incompletely vaccinated U.S. adults, highlighting the ongoing risk of poliovirus importation and potential for community transmission 4.