How to Order a Polio Titer Test
Order a serum neutralizing antibody test for all three poliovirus serotypes (types 1,2, and 3), which is the CDC-endorsed gold standard for assessing polio immunity. 1
Test Ordering Specifications
- Request specifically: Neutralizing antibody testing against poliovirus serotypes 1,2, and 3 2
- Specimen type: Single serum sample is sufficient for immunity assessment 1
- Important caveat: Assays other than neutralization tests (such as complement fixation) are difficult to interpret due to inadequate standardization and relative insensitivity, and should be avoided 2
Laboratory Options
- Commercial laboratories: Most commercial labs can perform neutralizing antibody tests, though you should confirm they use the CDC-recommended neutralization protocol 2
- CDC Enterovirus Laboratory: Available for consultation and specimen testing at (404) 639-2749 2
- Critical update: Serology for immunity assessment is increasingly limited due to reduced availability of antibody testing against type 2 poliovirus, and is no longer recommended by CDC for children with questionable vaccination documentation 3
Interpretation Guidelines
- Protective immunity: Presence of protective antibody levels against all three serotypes indicates immunity 1
- Do not confuse with diagnostic testing: A fourfold rise in antibody titer between acute and convalescent specimens is diagnostic for active infection, not immunity assessment 2, 1
Clinical Context and Limitations
- Current CDC stance: For individuals without clear vaccination records, revaccination with IPV according to the age-appropriate U.S. schedule is now preferred over serologic testing 3
- Reason for change: The global switch from trivalent OPV to bivalent OPV in 2016 has made type 2 antibody testing increasingly unavailable 3
- Most practical approach: In the absence of documented vaccination with IPV or trivalent OPV, proceed directly to vaccination rather than ordering titers 3