Oral polio vaccine and inactivated polio vaccine

Definition:

The words polio (grey) and myelon (marrow, indicating the spinal cord) are derived from the Greek. It is
the effect of poliomyelitis virus on the spinal cord that leads to the classic manifestation of paralysis.

 Polio, or poliomyelitis, is a disabling and life-threatening disease caused by

the poliovirus.
 The virus spreads from person to person and can infect a person’s spinal cord, causing
paralysis (can’t move parts of the body).

Infection Agent:

Poliovirus is an enterovirus and a member of the Picornaviridae family; types 1, 2 and 3 cause
disease, although type 2 has been eradicated as a wild-type virus. Type 3 virus has not been
detected anywhere since November 2012; therefore, type 1 virus now appears to be the only
circulating wild virus globally.

Mode of transmission:

Wild poliovirus is spread through faeces and saliva. It is primarily transmitted through
faecal–oral spread and is an important consideration where sanitation is poor.

‘Live’ oral polio vaccine (OPV) virus can be shed in the faeces for 6 weeks and may
lead to infection in unvaccinated contacts. Unvaccinated household contacts of a case
should be vaccinated at the same time. Stressing the importance of handwashing for
parents following nappy changing and disposal is important.

 Poliovirus is very contagious and spreads through person-to-person

contact.
 It lives in an infected person’s throat and intestines.

Poliovirus only infects people. It enters the body through the mouth and spreads
through:

 Contact with the feces (poop) of an infected person.

 Droplets from a sneeze or cough of an infected person (less common).

You can get infected with poliovirus if:

  You have feces on your hands, and you touch your mouth.
 You put in your mouth objects like toys that are contaminated with feces.

An infected person may spread the virus to others immediately before and up to
2 weeks after symptoms appear.

 The virus can live in an infected person’s feces for many weeks. It can
contaminate food and water in unsanitary conditions.
 People who don’t have symptoms can still pass the virus to others and
make them sick.

Incubation period:

The incubation period is between 3 and 35 days; for paralytic cases, it is 7–14 days.

Signs and Symptoms:

Polio symptoms include:

 headache
 nausea and vomiting
 fatigue
 stiffness in the back and neck
 muscle pain, often severe
 paralysis.

Symptoms usually start about 3 to 35 days after catching polio.

Sufferers of polio have the following symptoms:

• In mild cases — headache, slight fever, nausea and vomiting for up to three days
• In slightly more severe cases — moderate fever, muscle pain, a stiff neck and back, fatigue
• In most severe cases — fever, muscle pain or spasms, muscle weakness, stiffness, constipation,
tremors and difficulty with swallowing

Risk Factors:

You may be at risk of polio if you have not been immunised against the disease. Although polio affects
people of all ages, there are certain groups of people such as infants, children, older people and pregnant
women who are more vulnerable to the infection. A person with a weakened immune system, like those
with HIV or under extreme stress, is also at a higher risk of polio infection.
Difference of OPv and IPV

Inactivated polio vaccine (IPV) consists of inactivated (killed) strains of all three poliovirus types
(1, 2 and 3). IPV is given as an injection and must be administered by a trained health worker.
IPV causes the body to produce antibodies in the blood to all three types of poliovirus. In the
event of infection, these antibodies prevent the spread of the virus to the central nervous system
and protect against paralysis. In this way, IPV prevents that person from being paralyzed if
exposed to polio, but it does not stop transmission of the virus.

The oral polio vaccine (OPV) consists of live, attenuated (weakened) poliovirus strains of one or
two poliovirus types. OPV is given as a drop in the mouth. It can be administered by trained
volunteers and does not require a nurse, doctor or midwife for administration. When fully
immunized, a person develops “gut immunity” and will no longer transmit the virus type included
in the vaccine even if they are exposed (e.g. if they are vaccinated with type 2-containg OPV,
they will no longer transmit type 2 virus). Thanks to this gut immunity, OPV is the only effective
weapon to stop transmission of the poliovirus when an outbreak is detected. Bivalent OPV
protects against poliovirus type 1 and 3, while monovalent OPV 2 protects against type 2.

Combining inactivated polio vaccine (IPV) and oral polio vaccine (OPV) provides the best form
of protection from polio. IPV and OPV each cause a different kind of immune reaction, and
together they strengthen your child’s protection. It protects your child and helps protect our
community.

Vaccine name:

The first step in fighting against the emergence of polio is receiving one dose of the
inactivated polio vaccine (IPV) intravenously. The next step is completing the polio vaccine
(OPV) through oral drops.
When a child receives OPV, the weakened form of the virus found in this vaccine replicates
in the intestines and develops immunity within the child by building up antibodies.

Child age per dose:

In the Philippines, oral polio vaccine is routinely given to children at 1 ½, 2 ½, and 3 ½ months,
and inactivated polio vaccine at 3 ½ months.

Number of Dosage:

Children need multiple doses of oral polio vaccine to be fully protected. Until a child is fully
immunized, they are still at risk from polio. This is why every child must be immunized during
every immunization campaign against polio. Every missed child is a place for the poliovirus to
hide.
Interval between doses

The minimum interval between the next-to-last and last doses in the polio vaccination series

is 6 months and the last dose should be at age 4 years or older.

Dose and route:

Single-antigen IPV (IPOL) is distributed in single-dose syringes or in 10-dose vials.

The recommended dose for both children and adults is 0.5 mL. It can be
administered by the intramuscular or subcutaneous route, using a needle length
appropriate for the age and size of the person receiving the vaccine.

Site:

Preferred injection sites:

 Infants and small children: anterolateral aspect of the thigh

 Older children and adults: deltoid muscle for intramuscular injection or the
posterior aspect of the upper arm for subcutaneous injection

Side effects are usually minor. For example, those vaccinated with inactivated polio vaccine
may experience pain and redness at the injection site. People sometimes temporarily feel faint
after being vaccinated – they should be encouraged to lie down until it passes.

2 months One dose

4 months One dose

6 to 18
One dose
months

4 to 6 years Booster dose

 Health teaching after injections:

Side effects of polio vaccines

Immunisations containing the vaccine against polio are effective and safe, although all
medications can have unwanted side effects. 

Side effects from polio vaccines are uncommon and usually mild and temporary
(occurring in the first few days after vaccination). They may include:

 muscle aches
 localised pain, redness, itchiness and swelling at the injection site (usually for
one to two days)
 occasionally, an injection-site lump (nodule) that may last many weeks –
treatment is not needed
 low-grade temperature (fever)
 children can be unsettled, irritable, cry, are generally unhappy, drowsy and tired.

Specific treatment is not usually required. However, treatment options that can reduce
the side effects of the polio vaccine include:

 giving extra fluids to drink and not overdressing if there is a fever

 although routine use of paracetamol after vaccination is not recommended, if
pain or fever is present, paracetamol can be given. Check the label for the correct dose
or speak with your pharmacist, (especially when giving paracetamol to children).

Concerns about immunisation side effects

If the side effect following immunisation is unexpected, persistent or severe, or if you

are worried about yourself or your child’s condition after a vaccination, see your doctor
or immunisation nurse as soon as possible or go directly to a hospital. 

Immunisation side effects may be reported to AEFI-CAN – the national Adverse Events
Following Immunisation Clinical Assessment Network. This vaccine safety and central
reporting service is known as SAEFVIC in Victoria.

It is also important to seek medical advice if you (or your child) are unwell, as this may
be due to other illness rather than because of the vaccination.
 OPV ( Oral Polio Vaccine ) Type of Vaccine Live attenuated vaccine Form of Vaccine Liquid vaccine
Minimum Age at 1st Dose 6 weeks Number of Doses to Complete the Immunization 3 Interval 4 weeks /
minimum of 28 days Reason The extent of protection against polio is increased the earlier the OPV is
given Number of Doses per Ampule 20 ( 10 children ) Dosage 2 drop Route of Administration Oral Site of
Administration Mouth Storage Temperature -15 C to -25 C ( at the freezer ) Note: It is easily damaged by
heat but is not harmed by freezing. Special Precautions Children known to have rare congenital immune
deficiency syndrome should receive IPV ( injectable polio vaccine ) rather OPV Side Effect Causes almost
no side-effects. Less than 1% of the people who receive the vaccine develop a headache, diarrhea or
muscle pain. Contraindication None Health Teaching Nothing by mouth (NPO) 30 minutes before and
after OPV. Do not touch the tip dropper bottle to the tongue

Rare side effects of immunisation

There is a very small risk of a serious allergic reaction (anaphylaxis) to any vaccine.
This is why you are advised to stay at the clinic or medical surgery for at least 15
minutes following immunisation in case further treatment is required. 

Another rare side effect of some vaccines is the hypotonic-hyporesponsive episode

(HHE), which only occurs in babies. The baby may show signs of paleness, limpness
and be unresponsive. This may occur from 1 – 48 hours following vaccination. The
whole episode may last from a few minutes to 36 hours. If your baby shows signs of
HHE, call triple zero (000) for an ambulance immediately.

Follow-up of children with HHE shows no long-term neurological or other side effects.

Why Is the IPV Vaccine Recommended?

The vaccine offers protection against polio, which can cause paralysis and death.

What Are the Possible Side Effects of IPV Immunization?

Side effects include fever and redness or soreness at the injection site. There is a very small chance
of an allergic reaction with any vaccine.

When to Delay or Avoid IPV Immunization

The vaccine is not recommended if your child:

 has a severe allergy to the antibiotics neomycin, streptomycin, or polymyxin B

 had a serious allergic reaction to an earlier IPV shot
 Caring for Your Child After IPV Immunization
IPV may cause mild fever, and soreness and redness where the shot was given for several days.
Check with your doctor to see if you can give either acetaminophen or ibuprofen for pain or fever
and to find out the right dose.

When Should I Call the Doctor?

Call the doctor if:

 You aren't sure whether the vaccine should be postponed or avoided.

 Your child has any problems after getting the vaccine.

Two types of vaccine are available: • An inactivated (killed) polio vaccine (IPV) and A live attenuated
(weakened) oral polio vaccine (OPV).

Jennalyn

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Jennalyn

(OPV) Route Site Number of Dose Age at First Dose Minimum Intervals between Doses Dosage Storage
Temperature Oral Mouth 3 doses 6 weeks after birth 4 weeks 2 drops -15 to -25 °C

Jennalyn

Polio Vaccine Adverse Reactions • Rare local reactions (IPV) • No serious reactions to IPV have been
documented • Paralytic poliomyelitis (OPV) Polio Vaccine Contraindications and Precautions • Severe
allergic reaction to a following a prior dose of vaccine • Moderate or severe acute illness