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Institute for Vaccine Safety

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All inactivated poliomyelitis vaccine schedule recommended for the U.S.

The Centers for Disease Control and Prevention and the American Academy of Pediatrics have announced that only the inactivated polio vaccine (IPV) schedule is recommended for all children, effective January 1, 2000. Detailed recommendations were published by the AAP in the December issue of Pediatrics. The Academy recommendations differ only slightly from the CDC guidelines which were announced publicly in June, but will be published as part of the revised Recommended Childhood Immunization Schedule in January 2000. The AAP notes that some physicians will have remaining stocks of oral poliomyelitis vaccine (OPV) as of January 1, 2000. Although the Academy recommends IPV for all children at 2, 4, 6-18 months and 4-6 years of age, small remaining stocks of OPV may be used for children aged 4-6 years who have previously received 3 doses of any polio vaccine. Also acceptable is the administration of OPV to children who have received at least 2 doses of IPV or OPV.

The manufacturer, Wyeth Lederle Vaccines, a division of American Home Products, has agreed to allow physicians to turn in any remaining stock of OPV for credit with the company. [info on returning OPV] Both the CDC and the AAP make some exceptions for the use of OPV including the possibility of importations of wild type poliovirus and the need for mass immunization campaigns. The Academy also allows for the use of OPV for children of parents who do not accept the recommended number of injections needed to complete the current childhood immunization schedule, but the AAP notes that OPV should not be given for the first or second dose for these reasons. The only other exception noted by the Academy is the potential use of OPV for unvaccinated children who will be traveling in less than four weeks to polio endemic countries because there would be insufficient time for administering the needed 2 doses of IPV. One wonders whether any OPV will be available for these circumstances. In the situation noted above, physicians could give a single dose of IPV and either provide parents with a second dose of IPV to take with them or make arrangements for the child to obtain the remaining doses of vaccine in the country on arrival. John Salamone, President of Informed Parents Against VAPP, has publicly criticized allowing continued use of any OPV [see New York Times achieves] because some physicians could continue to use OPV for primary immunization in infancy. Georges Peter, Chair of the National Vaccine Advisory Committee, in a comment in the New York Times on December 7, 1999 noted that no cases of VAPP have occurred in recent years in children who previously received 2 doses of IPV or 2 doses of OPV. The Institute for Vaccine Safety applauds the completion of the transition to IPV. Hopefully, no cases of VAPP will occur in the United States in the year 2000 or beyond.

posted January 2000