- John F Modlin, MD
John F Modlin, MD
- Deputy Director, Polio Research
- Global Development
- Bill and Melinda Gates Foundation
- Section Editors
- Martin S Hirsch, MD
Martin S Hirsch, MD
- Editor-in-Chief — Infectious Diseases
- Section Editor — Viral Infections
- Professor of Medicine
- Harvard Medical School
- Morven S Edwards, MD
Morven S Edwards, MD
- Section Editor — Pediatric Infectious Diseases
- Professor of Pediatrics
- Baylor College of Medicine
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 . 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.)
- Kim-Farley RJ, Bart KJ, Schonberger LB, et al. Poliomyelitis in the USA: virtual elimination of disease caused by wild virus. Lancet 1984; 2:1315.
- Francis T, Napier JA, Voight RB, et al. Evaluation of the 1954 Field Trial of Poliomyelitis Vaccine. Final Report. Vaccine Evaluation Center, Department of Epidemiology, University of Michigan, Ann Arbor, MI 1957.
- Sabin AB. Oral poliovirus vaccine: history of its development and use and current challenge to eliminate poliomyelitis from the world. J Infect Dis 1985; 151:420.
- SALK JE. Studies in human subjects on active immunization against poliomyelitis. I. A preliminary report of experiments in progress. J Am Med Assoc 1953; 151:1081.
- Liao G, Li R, Li C, et al. Safety and immunogenicity of inactivated poliovirus vaccine made from Sabin strains: a phase II, randomized, positive-controlled trial. J Infect Dis 2012; 205:237.
- McBean AM, Thoms ML, Albrecht P, et al. Serologic response to oral polio vaccine and enhanced-potency inactivated polio vaccines. Am J Epidemiol 1988; 128:615.
- Estívariz CF, Pallansch MA, Anand A, et al. Poliovirus vaccination options for achieving eradication and securing the endgame. Curr Opin Virol 2013; 3:309.
- Swartz TA, Handsher R, Stoeckel P, et al. Immunologic memory induced at birth by immunization with inactivated polio vaccine in a reduced schedule. Eur J Epidemiol 1989; 5:143.
- Resik S, Tejeda A, Sutter RW, et al. Priming after a fractional dose of inactivated poliovirus vaccine. N Engl J Med 2013; 368:416.
- Estívariz CF, Jafari H, Sutter RW, et al. Immunogenicity of supplemental doses of poliovirus vaccine for children aged 6-9 months in Moradabad, India: a community-based, randomised controlled trial. Lancet Infect Dis 2012; 12:128.
- John J, Giri S, Karthikeyan AS, et al. Effect of a single inactivated poliovirus vaccine dose on intestinal immunity against poliovirus in children previously given oral vaccine: an open-label, randomised controlled trial. Lancet 2014; 384:1505.
- NATHANSON N, LANGMUIR AD. THE CUTTER INCIDENT. POLIOMYELITIS FOLLOWING FORMALDEHYDE- INACTIVATED POLIOVIRUS VACCINATION IN THE UNITED STATES DURING THE SPRING OF 1955. I. BACKGROUND. Am J Hyg 1963; 78:16.
- SABIN AB. Properties and behavior of orally administered attenuated poliovirus vaccine. J Am Med Assoc 1957; 164:1216.
- HENDERSON DA, WITTE JJ, MORRIS L, LANGMUIR AD. PARALYTIC DISEASE ASSOCIATED WITH ORAL POLIO VACCINES. JAMA 1964; 190:41.
- Patriarca PA, Wright PF, John TJ. Factors affecting the immunogenicity of oral poliovirus vaccine in developing countries: review. Rev Infect Dis 1991; 13:926.
- Kew OM, Wright PF, Agol VI, et al. Circulating vaccine-derived polioviruses: current state of knowledge. Bull World Health Organ 2004; 82:16.
- Harjulehto T, Aro T, Hovi T, Saxén L. Congenital malformations and oral poliovirus vaccination during pregnancy. Lancet 1989; 1:771.
- Krugman RD, Hardy GE Jr, Sellers C, et al. Antibody persistence after primary immunization with trivalent oral poliovirus vaccine. Pediatrics 1977; 60:80.
- John TJ, Jayabal P. Oral polio vaccination of children in the tropics. I. The poor seroconversion rates and the absence of viral interference. Am J Epidemiol 1972; 96:263.
- John TJ. Oral polio vaccination of children in the tropics. II. Antibody response in relation to vaccine virus infection. Am J Epidemiol 1975; 102:414.
- Dömök I, Balayan MS, Fayinka OA, et al. Factors affecting the efficacy of live poliovirus vaccine in warm climates. Efficacy of type 1 Sabin vaccine administered together with antihuman gamma-globulin horse serum to breast-fed and artificially fed infants in Uganda. Bull World Health Organ 1974; 51:333.
- de Brito Bastos NC, Carvalho Filho ES de+CARVALHOAAFILHO ES, Schatzmayr H, et al. Antipoliomyelitis program in Brazil; a erologic study of immunity levels. Bull Pan Am Health Organ 1974; 8:54.
- Lasch EE, Abed Y, Abdulla K, et al. Successful results of a program combining live and inactivated poliovirus vaccines to control poliomyelitis in Gaza. Rev Infect Dis 1984; 6 Suppl 2:S467.
- WHO Collaborative Study Group on Oral Poliovirus Vaccine. Effect of diarrhea on seroconversion to oral poliovirus vaccine. In: 32nd Interscience Conference on Antimicrobial Agents and Chemotherapy, Anaheim CA 1992.
- Myaux JA, Unicomb L, Besser RE, et al. Effect of diarrhea on the humoral response to oral polio vaccination. Pediatr Infect Dis J 1996; 15:204.
- Kim-Farley RJ, Rutherford G, Lichfield P, et al. Outbreak of paralytic poliomyelitis, Taiwan. Lancet 1984; 2:1322.
- Grassly NC, Fraser C, Wenger J, et al. New strategies for the elimination of polio from India. Science 2006; 314:1150.
- Cáceres VM, Sutter RW. Sabin monovalent oral polio vaccines: review of past experiences and their potential use after polio eradication. Clin Infect Dis 2001; 33:531.
- Sutter RW, John TJ, Jain H, et al. Immunogenicity of bivalent types 1 and 3 oral poliovirus vaccine: a randomised, double-blind, controlled trial. Lancet 2010; 376:1682.
- Grassly NC, Jafari H, Bahl S, et al. Mucosal immunity after vaccination with monovalent and trivalent oral poliovirus vaccine in India. J Infect Dis 2009; 200:794.
- el-Sayed N, el-Gamal Y, Abbassy AA, et al. Monovalent type 1 oral poliovirus vaccine in newborns. N Engl J Med 2008; 359:1655.
- World Health Organization Polio Eradication. Wild Poliovirus Weekly Update, 2009. http://www.polioeradication.org/casecount.asp (Accessed on October 12, 2011).
- Anand A, Zaman K, Estívariz CF, et al. Early priming with inactivated poliovirus vaccine (IPV) and intradermal fractional dose IPV administered by a microneedle device: A randomized controlled trial. Vaccine 2015; 33:6816.
- O'Ryan M, Bandyopadhyay AS, Villena R, et al. Inactivated poliovirus vaccine given alone or in a sequential schedule with bivalent oral poliovirus vaccine in Chilean infants: a randomised, controlled, open-label, phase 4, non-inferiority study. Lancet Infect Dis 2015; 15:1273.
- Garon J, Seib K, Orenstein WA, et al. Polio endgame: the global switch from tOPV to bOPV. Expert Rev Vaccines 2016; 15:693.
- Alexander JP Jr, Gary HE Jr, Pallansch MA. Duration of poliovirus excretion and its implications for acute flaccid paralysis surveillance: a review of the literature. J Infect Dis 1997; 175 Suppl 1:S176.
- Macadam AJ, Stone DM, Almond JW, Minor PD. The 5' noncoding region and virulence of poliovirus vaccine strains. Trends Microbiol 1994; 2:449.
- Minor PD, Dunn G, Ramsay ME, Brown D. Effect of different immunisation schedules on the excretion and reversion of oral poliovaccine strains. J Med Virol 2005; 75:153.
- DeVries AS, Harper J, Murray A, et al. Vaccine-derived poliomyelitis 12 years after infection in Minnesota. N Engl J Med 2011; 364:2316.
- Platt LR, Estívariz CF, Sutter RW. Vaccine-associated paralytic poliomyelitis: a review of the epidemiology and estimation of the global burden. J Infect Dis 2014; 210 Suppl 1:S380.
- Alexander LN, Seward JF, Santibanez TA, et al. Vaccine policy changes and epidemiology of poliomyelitis in the United States. JAMA 2004; 292:1696.
- Sutter RW, Prevots DR. Vaccine-associated paralytic poliomyelitis among immunodeficient persons. Infect Med 1994; 11:426.
- Wyatt HV. Letter: Risk of live poliovirus in immunodeficient children. J Pediatr 1975; 87:152.
- Centers for Disease Control and Prevention (CDC). Update on vaccine-derived polioviruses--worldwide, January 2006-August 2007. MMWR Morb Mortal Wkly Rep 2007; 56:996.
- Kew O, Morris-Glasgow V, Landaverde M, et al. Outbreak of poliomyelitis in Hispaniola associated with circulating type 1 vaccine-derived poliovirus. Science 2002; 296:356.
- Estívariz CF, Watkins MA, Handoko D, et al. A large vaccine-derived poliovirus outbreak on Madura Island--Indonesia, 2005. J Infect Dis 2008; 197:347.
- Kew OM, Sutter RW, de Gourville EM, et al. Vaccine-derived polioviruses and the endgame strategy for global polio eradication. Annu Rev Microbiol 2005; 59:587.
- Technical Consultative Group to the World Health Organization on the Global Eradication of Poliomyelitis. "Endgame" issues for the global polio eradication initiative. Clin Infect Dis 2002; 34:72.
- World Health Organization Global Poliomyelitis Eradication Program. Global Eradication Initiative Strategic Plan, 2004-2008 http://www.polioeradication.org/content/publications/2004stratplan.pdf (Accessed on October 12, 2011).
- Polio vaccines: WHO position paper – March, 2016. Wkly Epidemiol Rec 2016; 91:145.
- Prevots DR, Burr RK, Sutter RW, et al. Poliomyelitis prevention in the United States. Updated recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 2000; 49:1.
- Committee on Infectious Diseases. Report of the Committee on Infectious Diseases 2003.
- Centers for Disease Control and Prevention (CDC). Updated recommendations of the Advisory Committee on Immunization Practices (ACIP) regarding routine poliovirus vaccination. MMWR Morb Mortal Wkly Rep 2009; 58:829.
- American Academy of Pediatrics Committee on Infectious Diseases. Poliovirus. Pediatrics 2011; 128:805.
- Wallace GS, Seward JF, Pallansch MA, Centers for Disease Control and Prevention. Interim CDC guidance for polio vaccination for travel to and from countries affected by wild poliovirus. MMWR Morb Mortal Wkly Rep 2014; 63:591.
- Ehrenfeld E, Chumakov K. Monovalent oral poliovirus vaccines--a good tool but not a total solution. N Engl J Med 2008; 359:1726.
- Ljungman P, Duraj V, Magnius L. Response to immunization against polio after allogeneic marrow transplantation. Bone Marrow Transplant 1991; 7:89.
- Pauksen K, Hammarström V, Ljungman P, et al. Immunity to poliovirus and immunization with inactivated poliovirus vaccine after autologous bone marrow transplantation. Clin Infect Dis 1994; 18:547.
- Centers for Disease Control and Prevention. CDC Health Advisory. Guidance to US clinicians regarding new WHO polio vaccination requirements for travel by residents of and long-term visitors to countries with active polio transmission. http://emergency.cdc.gov/han/han00362.asp (Accessed on June 03, 2014).
- Centers for Disease Control and Prevention. Chapter 3. Infections diseases related to travel: Poliomyelitis. http://wwwnc.cdc.gov/travel/yellowbook/2014/chapter-3-infectious-diseases-related-to-travel/poliomyelitis (Accessed on June 03, 2014).
- WHO statement on the meeting of the International Health Regulations Emergency Committee concerning the international spread of wild poliovirus. http://www.who.int/mediacentre/news/statements/2014/polio-20140505/en/ (Accessed on June 03, 2014).
- Global Polio Eradication Initiative. Polio Public Health Emergency: Temporary Recommendations to Reduce International Spread of Poliovirus. http://www.polioeradication.org/Keycountries/PolioEmergency.aspx (Accessed on May 17, 2016).
- POLIOVIRUS VACCINES
- Inactivated poliovirus vaccine (IPV)
- - Immune response and efficacy
- - Adverse effects
- Live attenuated oral poliovirus vaccine (OPV)
- - Trivalent vaccine
- - Bivalent and monovalent vaccines
- - Trivalent OPV to bivalent OPV switch
- - Adverse effects
- RECOMMENDATIONS OF THE WHO
- RECOMMENDATIONS OF THE CDC
- Infants and children
- Pregnant women
- Immunocompromised patients
- Recommendations for travelers
- SOCIETY GUIDELINE LINKS
- INFORMATION FOR PATIENTS