Recent Recommendations for Adult Polio Vaccination
In June 2023, the Advisory Committee on Immunization Practices (ACIP) updated its guidelines for adult polio vaccination. The guidance addresses vaccination needs for those unvaccinated or incompletely vaccinated. The inactivated poliovirus vaccine (IPV), the only polio vaccine used in the U.S. since 2000, uses a killed virus and is considered safe and effective.
Who needs a primary series?
Adults with uncertain or incomplete vaccination history, especially those who grew up outside the U.S. without records, should receive a three-dose primary series of IPV.
Who needs a booster dose?
Adults who completed their primary series but are at increased risk of exposure may need a single lifetime booster of IPV. This includes those traveling to areas where polio is present, working in healthcare or laboratory settings with potential poliovirus exposure, or identified as high-risk by public health during an outbreak.
Understanding the Risk
While most older U.S. adults are low risk due to high vaccination rates, the 2022 case in New York shows risk persists globally and in undervaccinated communities. Poliovirus can enter the U.S., and rare cases of vaccine-derived poliovirus can occur.
History of Polio Vaccination in the U.S.
Polio vaccination in the U.S. started with the Salk IPV in 1955. The oral polio vaccine (OPV), which used a live weakened virus, was phased out by 2000 due to a small risk of vaccine-associated paralysis. The U.S. now exclusively uses IPV.
Checking Your Polio Vaccination Status
Finding childhood records can be challenging. Potential sources include:
- Family members: Parents or older relatives might have information.
- Healthcare provider: Your doctor may have past records.
- State registry: Some states have immunization systems, though older records may be unavailable.
- School or military records: These institutions might have vaccination information.
- Re-vaccinate if unsure: If records are unobtainable, re-vaccination is generally considered safe and is often recommended.
The Role of the IPV
IPV is an injected vaccine that helps the body produce antibodies to prevent the virus from affecting the nervous system and causing paralysis. IPV is safe, typically causing only mild side effects like soreness at the injection site.
Polio Survivors and Post-Polio Syndrome
Older adults who had polio in the past may develop Post-Polio Syndrome (PPS) later in life, characterized by new muscle weakness, fatigue, and pain. PPS is not contagious and cannot be prevented after an initial polio infection. However, vaccination prevents new polio infections, thereby preventing PPS in those who have never had the disease.
Comparison of Vaccination Scenarios for Older Adults
| Scenario | Recommendation | Dosing Schedule | Rationale |
|---|---|---|---|
| Unvaccinated/Incomplete History | Receive a primary series | 3 doses of IPV: 4-8 weeks between dose 1 & 2; 6-12 months between dose 2 & 3 | Protection when status is unconfirmed or incomplete. |
| Fully Vaccinated, Low-Risk | No action needed | None beyond primary series | Protected based on high historical vaccination rates. |
| Fully Vaccinated, High-Risk | Consider a single lifetime booster | 1 booster dose of IPV | Increased protection for elevated exposure risk, e.g., travelers. |
Conclusion: Making an Informed Decision
Older adults should consider polio vaccination based on their history and risk. The recent case underscores the importance of addressing unconfirmed vaccination status or living in high-risk areas. Consulting a healthcare provider is recommended. Most U.S.-born seniors are likely protected, but those with incomplete history or increased exposure should consider a primary series or a booster, following CDC guidance. For more detailed information on polio vaccination guidelines, visit {Link: CDC https://www.cdc.gov/polio/vaccines/index.html}.
