How can polio be prevented?

Polio Prevention

The most effective way to prevent polio is through vaccination with inactivated poliovirus vaccine (IPV), which is recommended as a four-dose series for all children at ages 2,4,6-18 months, and 4-6 years. 1

Vaccination Recommendations for Children

Routine Childhood Vaccination Schedule

• All children should receive four doses of IPV at ages 2,4, and 6-18 months and 4-6 years 1
• The first and second doses induce primary immune response, while the third and fourth doses ensure antibody titers are boosted to high levels 1
• The fourth dose is not needed if the third dose is administered on or after the fourth birthday 1

Incomplete Vaccination

• Children with inadequate protection should complete the recommended vaccination series 1
• No additional doses are needed if more time than recommended elapses between doses 1
• If vaccines are administered according to licensed indications, four doses of OPV or IPV in any combination by age 4-6 years is considered a complete series 1

Administration Considerations

• IPV can be administered simultaneously with other routine childhood vaccines (DTP, DTaP, Hib, HepB, varicella, MMR) 1
• To minimize the number of injections at 2 and 4-month visits, consider:
  • Administering HepB at birth and ages 1 and 6 months 1
  • Using available combination vaccines such as DTaP-IPV (Kinrix) for children aged 4-6 years 2
  • Scheduling additional visits if follow-up is reliable 1

Adult Vaccination Recommendations

• Routine poliovirus vaccination is not necessary for most adults in the United States 1
• Vaccination is recommended for certain high-risk adults:
  • Travelers to polio-endemic or epidemic areas 1
  • Members of communities with wild poliovirus circulation 1
  • Laboratory workers handling poliovirus specimens 1
  • Healthcare workers with close contact with patients potentially excreting wild polioviruses 1

Adult Vaccination Schedule

• Unvaccinated adults at increased risk should receive a primary series with IPV 1
• Standard schedule: two doses 4-8 weeks apart, with a third dose 6-12 months after the second 1
• If accelerated protection is needed:
  • If >8 weeks available: three doses at least 4 weeks apart 1
  • If 4-8 weeks available: two doses at least 4 weeks apart 1
  • If <4 weeks available: single dose of IPV 1
• Adults with prior primary series who remain at risk need only a single lifetime booster dose 1

Safety and Contraindications

• IPV should not be administered to persons with history of severe allergic reaction to previous IPV dose or to streptomycin, polymyxin B, or neomycin 1
• No serious adverse events have been linked to IPV use in the United States since its expanded use in 1996 1
• IPV is safe and eliminates the risk of vaccine-associated paralytic poliomyelitis (VAPP) that was associated with oral polio vaccine (OPV) 1, 3

Global Polio Eradication Context

• The United States has been free of indigenous wild poliovirus cases since 1979 1
• The Western Hemisphere was certified polio-free in 1994 1
• The global polio eradication initiative has reduced worldwide polio cases by >80% since the mid-1980s 1
• High vaccination coverage remains essential to maintain population immunity and prevent reintroduction of poliovirus 1
• The Advisory Committee on Immunization Practices (ACIP) strongly supports the global polio eradication initiative 1

Special Considerations

• Children who began vaccination with OPV should complete the series with IPV 1
• A minimum interval of 4 weeks should elapse if IPV is administered after OPV 1
• IPV produces immunity as measured by antibody concentrations at least as good as OPV, and in some circumstances better 3
• IPV reduces replication of living poliovirus and produces herd immunity 3
• Combination vaccines like DTaP-IPV can help maintain high coverage levels by reducing the number of required injections 2