IPV Vaccination in Children
All healthy children should receive a 4-dose series of inactivated poliovirus vaccine (IPV) administered at 2 months, 4 months, 6-18 months, and 4-6 years of age. 1, 2, 3
Standard Dosing Schedule
The routine IPV vaccination schedule consists of:
- Dose 1: 2 months of age (minimum age 6 weeks) 1, 2, 3
- Dose 2: 4 months of age 1, 2
- Dose 3: 6-18 months of age 1, 2
- Dose 4 (booster): 4-6 years of age 1, 2
The final dose must be administered at age ≥4 years regardless of the number of previous doses. 1, 4 This fourth dose is critical for long-term immunity and should not be omitted even if the child has received earlier doses. 1
Minimum Intervals Between Doses
Understanding minimum intervals is essential for catch-up vaccination:
- Doses 1 to 2: Minimum 4 weeks 1, 2
- Doses 2 to 3: Minimum 4 weeks (though 8 weeks preferred) 1, 2
- Doses 3 to 4: Minimum 6 months 1, 2
Avoid using minimum intervals in the first 6 months of life unless the child faces imminent poliovirus exposure (e.g., travel to endemic regions or during an outbreak), as shorter intervals result in lower seroconversion rates. 1 This is a common pitfall—accelerated schedules compromise immune response when not medically necessary.
Administration Protocol
Route and site of administration:
- Infants and small children: Intramuscular injection in the mid-lateral aspect of the thigh 3
- Older children: Intramuscular or subcutaneous injection in the deltoid area 3
- Dose: 0.5 mL per dose 3
Never administer IPV intravenously. 3 Do not use divided or reduced doses, even in premature infants. 5
Special Considerations for Combination Vaccines
When using DTaP-IPV/Hib (Pentacel) for doses at 2,4,6, and 15-18 months, an additional fifth dose of IPV-containing vaccine must be administered at 4-6 years since Pentacel is not indicated for the booster dose. 1 This results in an acceptable 5-dose IPV series with a minimum 6-month interval between doses 4 and 5. 1
Premature Infants
Premature infants should receive IPV at the same chronological ages as full-term infants (2,4,6-18 months, 4-6 years) regardless of birth weight or gestational age. 5 Full doses are required—never use reduced doses in premature infants. 5
Incomplete Vaccination Series
If a child has missed doses or the schedule is interrupted, continue the series without restarting, regardless of time elapsed between doses. 4, 3 Simply administer the remaining doses needed to complete the 4-dose series, ensuring the final dose is given at age ≥4 years. 1
Contraindications
IPV is contraindicated only in persons with hypersensitivity to vaccine components including 2-phenoxyethanol, formaldehyde, neomycin, streptomycin, or polymyxin B. 2, 4, 3
Immunocompromised Children
IPV should be used for all immunocompromised children and household contacts of immunocompromised individuals. 3 This includes children with HIV infection, severe combined immunodeficiency, hypogammaglobulinemia, leukemia, lymphoma, or those receiving immunosuppressive therapy. 3 Oral poliovirus vaccine (OPV) is never appropriate in these populations due to the risk of vaccine-associated paralytic poliomyelitis.
Simultaneous Administration with Other Vaccines
IPV can be administered simultaneously with other routine childhood vaccines including DTaP, Hib, hepatitis B, varicella, and MMR using separate syringes at separate sites. 2, 3 No immunological interference has been observed. 3
Common Pitfalls to Avoid
- Do not delay the fourth dose beyond age 6 years—it is essential for long-term protection 1
- Do not use accelerated schedules in the first 6 months without specific indication—this reduces immune response 1
- Do not restart the series if doses are delayed—simply continue where you left off 4, 3
- Do not administer Pentacel as the 4-6 year booster—use standalone IPV or DTaP-IPV instead 1