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Am Fam Physician. 1999;59(1):125-126

See related article on the poliovirus vaccine.

What is polio?

Poliomyelitis (polio, for short) is caused by a virus. The virus can be spread by drinking water with the polio virus in it. It can also be passed by close contact, such as kissing an infected person. Polio is a serious illness. It can cause paralysis (can't move your arms and legs) or even death. Before the first polio vaccine was developed in the 1950s, thousands of children got polio every year. Fortunately, the use of vaccines has made polio very rare today.

How can polio be prevented?

You can keep your children from getting polio by making sure they get the polio vaccine.

What is the polio vaccine?

A vaccine is a medicine you take to keep you from getting a disease. The polio vaccine comes in two forms. Inactivated polio vaccine (called IPV) is given by injection (a “shot”). Oral polio vaccine (called OPV) is given by drops in the mouth.

Which vaccine should my child get?

Both types of vaccine work well to protect against polio. Your doctor will talk with you about which type is best for your child. The chart on the next page lists some of the pros and cons of each vaccine. For most children, a schedule that starts with IPV is recommended.

When should my child be vaccinated?

Most children get four doses of polio vaccine on this schedule:

  • First dose when they are 2 months old.

  • Second dose when they are 4 months old.

  • Third dose when they are 6 to 18 months old.

  • Last dose when they are 4 to 6 years old.

Polio vaccine can be given as all shots (IPV), all drops (OPV), or a combination of both. If both vaccines are used, the shots are given first.

Should my child get only shots or only drops?

Your child shouldn't get the OPV drops if you, your child or anyone who takes care of your child can't fight infections, is taking long-term steroid medicines, has cancer or AIDS or HIV infection.

Your child shouldn't get the IPV shots if he or she is behind on receiving the shots or is allergic to these medicines: neomycin, streptomycin or polymyxin B.

What are the risks of the vaccine?

Vaccines carry a small risk of serious harm, such as a severe allergic reaction. On very rare occasions, OPV can cause polio because it contains live, but weakened, poliovirus. IPV can't cause polio because it does not contain live poliovirus. Most people have no problems from IPV or OPV.

OPV drops onlyIPV shots onlyCombining IPV shots & OPV drops
How it's givenDrops 4 timesShots 4 timesShots 2 times, drops 2 times
Protection from polioExcellentExcellentExcellent
Gut protection*Good after 2nd dosePoorerGood after 4th dose
Risk of getting polio from the vaccineRare—about one in 2.4 million doses distributedNo riskVery rare

What if my child has a reaction to the vaccine?

If your child has any reaction after getting the polio vaccine, call your doctor as soon as possible. In addition, if your child gets hives (swelling, itching and a burning sensation of the skin), has problems breathing, or goes into shock (becomes weak, faint, cold, clammy and sweaty), call 911 or take your child to a hospital emergency room. Be sure to tell the doctors caring for your child the day and time your child received the vaccine. Ask your doctor to file a Vaccine Adverse Event Report form with the CDC, or you can do it yourself by calling 800-822-7967.

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Copyright © 1999 by the American Academy of Family Physicians.

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