Polio Vaccine. By: Lia Schmitz, Pharm.D. Poliomylitis is a viral infection for which vaccination is generally given

Transcription

1 Polio Vaccine By: Lia Schmitz, Pharm.D. Poliomylitis is a viral infection for which vaccination is generally given to infants and small children, and to people planning to travel to countries in which the infection is still endemic. Poliovirus is transmitted by fecal oral route and used to exist over most of the globe. An inactive vaccine was first used in 1955 and the disease was rapidly controlled. In the United States the last indigenous case was in Since the late 1980's most of the world has eradicated polio. The poliovirus causes an infection that involves in the upper respiratory, gastrointestinal tract, and sometimes the central nervous system. Most infections are asymptomatic, though in some cases the Page 1 of 5

2 infected person can suffer flaccid paralysis of some or all limbs, and they can die from respiratory failure. The treatment is symptomatic, meaning they keep the fever under control and if necessary intubate the patient and give mechanical ventilation. Vaccination is included in the standard regimen of all infant and childhood vaccines. Since year 2000, we use an inactive trivalent vaccine, which means the virus in the injection is chemically inactivated with formaldehyde, and includes antigen from three types of poliovirus. There is also a live attenuated oral polio vaccine that used to be administered, and is still used in parts of the world where poliovirus is common. The Center for Disease Control still maintains a supply of it in case outbreak ever strikes in the USA. The live attenuated oral vaccine is no longer used because in the United States, we did such a thorough job of eradicating poliovirus that the only cases were from contracting the virus from the vaccine itself. Use of the live attenuated vaccine carries a small risk of infecting the individual with polio, about a one in 6.2 million doses. It is not possible to contract polio from the currently used inactivated vaccine. Island Drug uses the inactive trivalent vaccine, sometimes referred to as its brand name, IPOL. It can be given to infants as young as 6 Page 2 of 5

3 weeks old. Not all Island Drug pharmacists administer vaccines to infants, so if you are looking to vaccinate a small child, please phone ahead. The recommended schedule is to administer it to infants at 2 months, 4 months, 6 months, and 4 years old. Each injection contains three types of polio. Protective antibodies develop to all three types in at least 90% of children after just the first two doses. After the third dose, 99% are immune. After the fourth dose at age 4 years, long term immunity results. No booster shots are generally recommended for adults. If travel is planned to an area of the world where infection with poliovirus is risky, and an adult got the polio vaccine series as a child, then a one-time booster vaccination is given to adults. It is the same IPOL inactive trivalent poliovirus vaccine that children receive. If an adult was not completely vaccinated as a child, and plans to travel to a polio area, then they should receive the series of polio vaccine shots. The CDC maintains an updated list of countries for which travel polio vaccination is recommended. It currently includes Afghanistan, Cameroon, Ethiopia, Israel, Kenya, Nigeria, Pakistan, Somalia, and Syria. Some other countries are recommended as well, if the travel includes high risk exposure. Page 3 of 5

4 Adverse effects to the vaccine are usually quite mild. It is an intramuscular shot, which is given in the deltoid muscle of the shoulder. Like most such vaccines, it can result in soreness of the shoulder muscle, or redness and swelling at the vaccination site. No serious reactions are reported, except for allergy. Vaccination is not recommended if a person has had severe allergic reaction to the polio vaccine itself or to the three antibiotics which can be found in trace amounts in the vaccine: neomycin, streptomycin, and polymyxin b. The vaccine also contains trace amounts of preservatives phenoxyethanol and formaldehyde, both of which do not seem to cause problems for vaccine recipients. The vaccine does not contain aluminum or mercury, and it may be given to women who are pregnant or breastfeeding, as well as to people who are immunosuppressed for any reason. Your pharmacist or doctor can help answer any questions about the polio vaccine. Thank you for listening! Sources: Page 4 of 5

5 IPOL package insert found at 3/9/14 Page 5 of 5