II. Indications

  1. Primary Immunization series
  2. Unvaccinated or partialy vaccinated adults (CDC/ACIP recommendation, 2023)
  3. Travel to endemic area
    1. Asia
    2. Africa

III. Contraindications: Enhanced Inactivated Polio Vaccine (EIPV)

  1. Allergy to EIPV Vaccine or its components present in trace amounts (neomycin, polymyxin, Streptomycin)

IV. Contraindications: Oral Polio Vaccine (OPV)

  1. Immunodeficiency disorders
  2. Household contacts of immunodeficient person
  3. Pregnancy
  4. Hypersensitivity to Vaccine
  5. Anaphylactic reaction to neomycin or Streptomycin

V. Pathophysiology

  1. Reasoning in switch from oral live (OPV) to injected inactivated (EIPV)
    1. Rare risk of Poliomyelitis with Oral Polio Vaccine (OPV)
    2. See Oral Polio Vaccine complications below
  2. All Inactivated Polio Vaccine (EIPV) will result in no cases of polio in those vaccinated
    1. EIPV however offers less mucosal (GI, mucus membrane) Immunity
      1. Gastrointestinal infection and stool transmission still occurs despite full Vaccination with EIPV
      2. Returning travelers from endemic regions may asymptomatically expose those unvaccinated
      3. Unvaccinated adult developed paralysis from polio in New York City, 2022
        1. NY Public health found the polio virus had been present in wastewater for at least 7 months
        2. Link-Gelles (2022) MMWR Morb Mortal Wkly Rep 71(33): 1065-8 [PubMed]
    2. Polio Virus is still not eradicated worldwide
      1. Circulating types include wild types 1 and Vaccine-derived polio virus
      2. Endemic areas include China and India

VI. Medications

  1. Enhanced Inactivated Polio Vaccine (EIPV, Sabin Vaccine, preferred)
    1. EIPV replaced Oral Polio Vaccine for universal Vaccination in U.S. 1999
    2. Has decades of safety and efficacy data supporting its use
  2. Oral Polio Vaccine (OPV, Salk Vaccine rare use after 1999)
    1. Trivalent Oral Polio Vaccine was introduced in 1960s
    2. Eradicated wild poliovirus from the U.S. by 1979
    3. Oral Polio Vaccine is among the greatest preventive health success stories (author opinion)

VII. Dosing: Adults (EIPV)

  1. Adults: EIPV 0.5 ml SC
  2. Adult Booster for exposure risk (e.g. travel, lab worker): Single lifetime booster dose
  3. Unvaccinated adults (3 dose series)
    1. Dose 1
    2. Dose 2: Give 4 to 8 weeks after dose 1
    3. Dose 3: Give 6 to 12 months after dose 2

VIII. Dosing: Primary Series Schedule (EIPV)

  1. Dose 1: Age 2 months
  2. Dose 2: Age 4 months
  3. Dose 3: Age 6 to 18 months
  4. Dose 4: Age 4 to 6 years

IX. Precautions

  1. EIPV is Safe in HIV and Pregnancy
    1. However, delay Vaccination until after pregnancy unless high risk for exposure
  2. Avoid OPV in HIV and Pregnancy

X. Complications: Oral Polio Vaccine (OPV)

  1. Cases per year Poliomyelitis associated with OPV: 8
    1. One case per 2 million doses
    2. EIPV results in no cases of Poliomyelitis

XI. Resources

Images: Related links to external sites (from Bing)

Related Studies

Ontology: Poliovirus Vaccines (C0032374)

Definition (MSH) Vaccines used to prevent POLIOMYELITIS. They include inactivated (POLIOVIRUS VACCINE, INACTIVATED) and oral vaccines (POLIOVIRUS VACCINE, ORAL).
Definition (CSP) vaccine used to prevent poliomyelitis, including inactivated and oral vaccines.
Concepts Pharmacologic Substance (T121) , Immunologic Factor (T129) , Organic Chemical (T109)
MSH D023321
SnomedCT 111164008, 415129008
English POLIOMYELITIS VACCINE, POLIOVIRUS VACCINE, Poliovirus Vaccines [Chemical/Ingredient], poliovirus vaccine, poliomyelitis vaccine, poliovirus vaccines, Poliovirus Vaccines, Vaccines, Poliovirus, Poliomyelitis vaccines, Poliovirus vaccine, Poliomyelitis vaccine, Poliovirus vaccine (product), Poliovirus vaccine (substance)
Dutch poliomyelitis-vaccin
French Vaccin anti-poliomyélite, Vaccins anti-poliomyélitiques, Vaccins antipoliomyélitiques, Vaccins poliomyélitiques
Italian Vaccino antipoliomielitico, Vaccini poliomielitici
Portuguese Vacina antipoliomielite, Vacinas contra Poliovirus, Vacinas Antipoliovirus, Vacinas contra Poliomielite
Spanish Vacuna de poliomielitis, vacuna antipoliomielítica (producto), vacuna antipoliomielítica, vacuna antipoliomielítica (sustancia), Vacunas contra Poliovirus
Japanese 灰白髄炎ワクチン接種, カイハクズイエンワクチンセッシュ
Swedish Poliovacciner
Czech poliovirové vakcíny, Vakcína proti poliomylitidě
Finnish Poliorokotteet
Russian POLIOMIELIT, VAKTSINY, VAKTSINY PROTIV POLIOMIELITA, ВАКЦИНЫ ПРОТИВ ПОЛИОМИЕЛИТА, ПОЛИОМИЕЛИТ, ВАКЦИНЫ
Polish Szczepionki przeciw poliomyelitis, Szczepionki przeciw wirusom poli
Hungarian Poliomyelitis vakcina
German Poliomyelitis-Vakzine, Poliovirusvakzine, Poliomyelitis-Impfstoff

Ontology: Oral Poliovirus Vaccine (C0032375)

Definition (HL7V3.0) <p>poliovirus vaccine, live, oral</p>
Definition (NCI) A vaccine that contains live attenuated polio virus. It is administered orally as polio prophylaxis in many areas of the world, but not in the U.S. since 2000.
Definition (MSH) A live vaccine containing attenuated poliovirus, types I, II, and III, grown in monkey kidney cell tissue culture, used for routine immunization of children against polio. This vaccine induces long-lasting intestinal and humoral immunity. Killed vaccine induces only humoral immunity. Oral poliovirus vaccine should not be administered to immunocompromised individuals or their household contacts. (Dorland, 28th ed)
Concepts Organic Chemical (T109) , Immunologic Factor (T129) , Pharmacologic Substance (T121)
MSH D011055
SnomedCT 125690004, 268590009, 111164008, 396436004
HL7 02, 2
English Poliovirus Vaccine, Oral, Sabin Vaccine, Vaccine, Oral Poliovirus, Vaccine, Sabin, Oral Poliovirus Vaccine, Poliovirus Vaccine, Oral [Chemical/Ingredient], oral poliomyelitis vaccine, opv, sabin vaccine, oral polio vaccine (OPV), topv, Oral Polio Vaccine, poliovirus vaccine, live, oral, Oral polio vaccine, Poliomyelitis vaccine, Oral, OPV, Pol/Vac (oral), Sabin vaccine, TOPV, Poliovirus Vaccine Live Oral
Swedish Poliovaccin, oralt
Czech poliovirová vakcína orální
Spanish Vacuna Sabin, vacuna Sabin, Vacuna Oral contra Poliovirus, vacuna de Sabin, Vacuna Antipolio Oral
Finnish Oraalinen poliovirusrokote
Italian Vaccino di Sabin, Vaccino poliomielitico orale
Russian SEIBINA VAKTSINA, VAKTSINA PROTIV POLIOMIELITA ORAL'NAIA, SABINA VAKTSINA, ВАКЦИНА ПРОТИВ ПОЛИОМИЕЛИТА ОРАЛЬНАЯ, САБИНА ВАКЦИНА, СЕЙБИНА ВАКЦИНА
Polish Szczepionka przeciw poliomyelitis doustna, Szczepionka Sabina
Japanese ポリオウイルス経口生ワクチン, ポリオウイルス経口ワクチン, 経口生ワクチン-ポリオウイルス, 経口ポリオワクチン, 経口3価ワクチン-ポリオウイルス, ポリオウイルス経口生3価ワクチン, 経口生3価ワクチン-ポリオウイルス, 経口ワクチン-ポリオウイルス, ポリオウイルス経口3価ワクチン, セービンワクチン, 経口ポリオウイルスワクチン, ポリオウイルスワクチン-経口, ポリオワクチン-経口, ワクチン-ポリオ-経口
French Sabin, vaccin, Vaccin antipoliomyélitique buccal, Vaccin antipoliomyélitique Sabin
German Polio-Lebendimpfstoff, Poliomyelitis-Vakzine, orale, Sabin-Impfstoff, Sabin-Vakzine
Portuguese Vacina Antipólio Oral, Vacina Sabin

Ontology: Salk Vaccine (C0036106)

Concepts Pharmacologic Substance (T121) , Immunologic Factor (T129)
MSH D011054
English Vaccine, Salk, inactivated poliovirus vaccine (Salk), salk vaccine, Salk Vaccine
Portuguese Vacina Salk
Spanish Vacuna Salk
French Vaccin Salk
German Salk-Vakzine
Italian Vaccino di Salk

Ontology: Poliovirus Vaccine, Inactivated (C0718003)

Definition (HL7V3.0) <p>poliovirus vaccine, inactivated</p>
Definition (NCI) A vaccine consisting of inactivated poliovirus (IPV) types 1,2 and 3, with active immunizing activity against poliomyelitis. Upon intramuscular vaccination, inactivated poliovirus vaccine (IPV) activates the immune system to develop antibodies against polioviruses.
Definition (MSH) A suspension of formalin-inactivated poliovirus grown in monkey kidney cell tissue culture and used to prevent POLIOMYELITIS.
Concepts Pharmacologic Substance (T121) , Immunologic Factor (T129)
MSH D011054
SnomedCT 125688000, 396435000
CPT 90713
HL7 10
LNC LP91385-2
English Inactivated poliomyelitis vac, diphtheria + tetanus toxoid + inactivated polio vaccine (IPV) (medication), diphtheria + tetanus toxoid + inactivated polio vaccine (IPV), diphtheria + tetanus toxoid + poliovirus vaccine, IPV, polio vaccine, inactivated (monkey kidney), poliovirus vaccine, inactivated, poliomyelitis vaccine (inactivated), Poliovirus Vaccine, Inactivated [Chemical/Ingredient], inactivated poliovirus vaccine, IPV, inactivated poliovirus vaccine, IPV (medication), inactivated polio vaccine, inactivated poliomyelitis vaccine, Inactivated Poliovirus Vaccine, Vaccine, Inactivated Poliovirus, poliomyelitis vaccine,killed, IPV, Inactivated poliomyelitis vaccine, Pol/Vac (inact), Inactivated poliovirus vaccine (product), Inactivated poliovirus vaccine (substance), Inactivated poliovirus vaccine, Poliovirus Vaccine, Inactivated, POLIOVIRUS VACCINE INACTIVATED, Poliovirus Vaccine Inactivated
Swedish Poliovaccin, avdödat
Czech poliovirová vakcína inaktivovaná
Finnish Inaktivoitu poliovirusrokote
Russian SOLKA VAKTSINA, VAKTSINA PROTIV POLIOMIELITA INAKTIVIROVANNAIA, INAKTIVIROVANNAIA VAKTSINA SOLKA, ВАКЦИНА ПРОТИВ ПОЛИОМИЕЛИТА ИНАКТИВИРОВАННАЯ, ИНАКТИВИРОВАННАЯ ВАКЦИНА СОЛКА, СОЛКА ВАКЦИНА
Polish Szczepionka przeciw poliomyelitis inaktywowana, Szczepionka Salka
Spanish Vacuna Antipoliomielítica de Virus Inactivados, Vacuna Inactivada contra Poliovirus, IPV, Vacuna Inactivada del Virus de la Poliomielitis, vacuna antipoliomielítica a virus inactivados (sustancia), vacuna antipoliomielítica a virus inactivados, vacuna antipoliomielítica de virus inactivados (producto), vacuna antipoliomielítica de virus inactivados (sustancia), vacuna antipoliomielítica de virus inactivados, Vacuna Antipolio de Virus Inactivados
Portuguese IPV, Vacina Inativada Contra Pólio, Vacina Inativada contra Poliovirus, Vacina de Poliovirus Inativado, Vacina Antipólio de Vírus Inativado
French Vaccin antipoliomyélitique inactivé, Vaccin antipoliomyélitique injectable, Vaccin inactivé contre la poliomyélite
German Poliomyelitisvirus-Vakzine, inaktivierte
Italian Vaccino poliomielitico inattivato