Is the inactivated poliovirus vaccine (IPV) administered intramuscularly?

Administration Route of Inactivated Poliovirus Vaccine (IPV)

Yes, the inactivated poliovirus vaccine (IPV) is administered intramuscularly as the standard route of administration in the United States and most countries. 1

Standard Administration Routes for IPV

• Primary route: Intramuscular (IM) injection - This is the standard and recommended route for IPV administration 2, 1
• Secondary route: Subcutaneous (SC) injection - This is an alternative route that may be used in certain situations 1

Anatomical Sites for Administration

• In infants and small children: The mid-lateral aspect of the thigh is the preferred site 1
• In older children and adults: The deltoid area is the preferred site for intramuscular administration 1

Special Considerations

Patients with Bleeding Disorders

• IPV may be administered subcutaneously in patients with thrombocytopenia or bleeding disorders 2
• For patients on oral anticoagulation therapy requiring intramuscular administration:
  • Use a fine needle (≤23-gauge)
  • Apply firm pressure to the injection site for 2 minutes after administration 2
  • Intramuscular injection is considered safe if platelet count is ≥30,000-50,000 cells/mm³ 2

Dose-Sparing Strategies

While not standard practice in the United States, research has explored intradermal administration of fractional doses of IPV:

• Intradermal administration of fractional doses (typically 1/5 of the standard dose) has shown promise in research settings 3, 4, 5
• This approach could potentially reduce costs while maintaining adequate immune response 6, 7
• However, this is not the current standard of care in the United States and most developed countries

Safety Profile of IPV

IPV has an excellent safety profile with no serious side effects documented 8. Minor side effects may include:

• Local reactions at the injection site
• Hypersensitivity reactions in persons allergic to vaccine components 8

Important Distinctions from Oral Polio Vaccine (OPV)

It's important to note that IPV is different from the oral poliovirus vaccine (OPV):

• IPV is administered by injection (intramuscular or subcutaneous)
• OPV is administered orally
• OPV is not currently used in the United States due to the rare risk of vaccine-associated paralytic poliomyelitis 8

Contraindications

IPV should not be administered to individuals with:

• History of anaphylactic reactions to streptomycin, neomycin, or polymyxin B (trace amounts present in the vaccine) 8
• Non-anaphylactic reactions to these antibiotics are not contraindications for IPV use

Remember that IPV should never be administered intravenously 1.