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Poliovirus vaccination

John F Modlin, MD
Section Editors
Martin S Hirsch, MD
Morven S Edwards, MD
Deputy Editor
Elinor L Baron, MD, DTMH


Immunization against poliovirus infection represents one of the world's greatest medical achievements. The last cases of naturally occurring wild type paralytic poliomyelitis in the United States occurred during a small outbreak due to type 1 poliovirus in an unvaccinated religious community in 1978 to 1979 [1]. All nations in the Western Hemisphere, Europe, Southeast Asia, and the Pacific Region are now free of poliomyelitis.

Issues related to paralytic poliomyelitis, the post-polio syndrome, and global eradication of poliomyelitis are discussed separately. (See "Polio and infectious diseases of the anterior horn" and "Post-polio syndrome" and "Global poliomyelitis eradication".)


Both inactivated poliovirus vaccine (IPV) and live attenuated oral poliovirus vaccine (OPV) were developed in the 1950s and have been used worldwide [2-4]:

IPV is the only vaccine available for routine infant and childhood immunization in the United States and is the preferred vaccine for developed countries since it does not cause vaccine-associated paralytic poliomyelitis (VAPP).

OPV has been the polio vaccine recommended by the World Health Organization (WHO) Expanded Program on Immunization (EPI) for routine infant immunization in developing countries and for supplementary immunization activities in countries at increased risk of poliovirus transmission. Advantages of OPV include low cost, ease of administration, induction of mucosal immunity, and transmission of vaccine virus to unimmunized contacts; the major disadvantage is that OPV can cause VAPP in rare cases. (See 'Adverse effects' below.)


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Literature review current through: Sep 2016. | This topic last updated: May 17, 2016.
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