Poliomyelitis

Question 1

What types of poliomyelitis vaccines are available? (2)

Answer 1

1. Inactivated (for injection; only available in combined preparations)
2. Live (oral)

Question 2

Which type of polio vaccine is recommended for routine immunisation?

Answer 2

Inactivated (for injection in combined preparations)

Question 3

What is the primary immunisation schedule for polio vaccination?

Answer 3

3 doses of a combined preparation containing inactivated poliomyelitis vaccine starting at 2 mo with intervals of 1 month between doses

A course of 3 doses should also be given to all unimmunised adults (no adult should remain unimmunised against polio)

Question 4

When should polio boosters be given?

Answer 4

1. Before school entry (3 years 4 mo)
2. Before leaving school (between 13-18 yo, but usually given at the same time as Men ACWY at 13-15 yo)

Further booster doses are only necessary for adults at special risk, such as travelers to endemic areas or laboratory staff, healthcare workers; such individuals should ONLY be given a booster every 10 years

Question 5

Why is inactivated polio vaccine preferred to live (oral)?

Answer 5

The live (oral) vaccine poses a very rare risk of vaccine-associated paralytic polio because the attenuated strain of the virus can revert to a virulent form. For this reason the live (oral) vaccine must not be used for immunosuppressed individuals or their household contacts. The use of inactivated poliomyelitis vaccines removes the risk of vaccine-associated paralytic polio altogether.

Question 6

Is the live (oral) polio vaccine available for routine use?

Answer 6

No; may be considered during large outbreaks but advice should be sought from Public Health England

Question 7

Can the live (oral) vaccine be given to immunosuppressed individuals? Their household contacts?

Answer 7

No and No due to the risk of vaccine-associated paralytic polio

Question 8

What polio vaccine regimen should be offered to unimmunised travelers?

Answer 8

Unimmunised travelers to areas where incidence of polio is high should receive a full primary course (3 doses) of inactivated poliomyelitis vaccine

Question 9

What polio vaccine regimen should be offered to IMMUNISED travelers?

Answer 9

Immunised travelers who have not been vaccinated in the last 10 years should receive a booster dose (Revaxis = diptheria, tetanus, and inactivated polio)