infectious diseases
Poliomyelitis
Prevention of Poliomyelitis
All infants and children should be immunized with Poliomyelitis Vaccine . The American Academy of Pediatrics recommends vaccination at ages 2 months, 4 months, and 6 to 18 months and a booster dose at age 4 to 6 years (see Salk inactivated poliovirus vaccine (IPV) is preferred to Sabin live-attenuated oral polio vaccine (OPV). The attenuated virus in OPV replicates in the intestines of recipients and is transiently excreted in feces and thus is capable of fecal-oral spread to other individuals, potentially immunizing some who had not directly received the vaccine. However, such passage through multiple individuals can lead to mutations of the vaccine virus, very rarely to a strain (vaccine-derived poliovirus) that can cause paralytic poliomyelitis, which results in about 1 case per 2,400,000 OPV doses. This mutation usually occurs in the type 2 poliovirus component of the vaccine. Because of this, OPV is no longer available in the United States. Also, poliovirus type 2 was removed from OPV in 2016 because of outbreaks resulting from genetically divergent circulating vaccine-derived virus despite official eradication of wild-type poliovirus type 2. Serious adverse effects have not been associated with IPV. Adults are not routinely vaccinated. Nonimmunized adults traveling to endemic or epidemic areas should receive primary vaccination with IPV, including 2 doses given 4 to 8 weeks apart and a 3rd dose given 6 to 12 months later. At least 1 dose is given before travel. Immunized adults traveling to endemic or epidemic areas should be given 1 dose of IPV. New York residents in areas with repeated poliovirus detection may be at higher risk of infection and should follow updated vaccination recommendations from the New York State Department of Health (seeNew York State Department of Health: Polio Vaccine). Immunocompromised patients and their household contacts should not be given OPV. 