Polio Vaccines

Authored by
Staff
Last reviewed
April 10, 2021

Polio Vaccines

Polio can be prevented with a vaccine. Since 2000, the inactivated polio vaccine (IPV) is most often given in the USA. It is administered by a shot in the arm or leg, depending on the person’s age, says the U.S. CDC.

The CDC recommends that children in the USA get polio vaccinated to protect against poliomyelitis. The CDC's Advisory Committee on Immunization Practices Vaccine Recommendations is published on this webpage.

The oral polio vaccine (OPV) is offered in other countries.

The Global Polio Eradication Initiative (GPEI) map indicates various countries continue to report new poliovirus cases. Since the launch of the GPEI in 1988, it successfully decreased wild poliovirus cases by over 99%. A listing of polio cases over the past 12-months is published at this GPEI link.

U.S. FDA Authorized Polio Vaccines

IPOL is a sterile suspension of three types of poliovirus: Type 1 (Mahoney), Type 2 (MEF-1), and Type 3 (Saukett). IPOL vaccine is a highly purified, inactivated poliovirus vaccine with enhanced potency administered intramuscularly or subcutaneously.

Combination Polio Vaccines

Kinrix (Diphtheria and Tetanus Toxoids and Acellular Pertussis Adsorbed and Inactivated Poliovirus Vaccine) is a noninfectious, sterile vaccine. 

Pediarix is a vaccine indicated for active immunization against diphtheria, tetanus, pertussis, and infection caused by all known subtypes of hepatitis B virus and poliomyelitis.

Quadracel contains diphtheria toxoid, tetanus toxoid, acellular pertussis [pertussis toxoid (PT), filamentous haemagglutinin (FHA), pertactin (PRN), fimbriae types 2 and 3 (FIM)], inactivated poliomyelitis vaccine.

Pentacel is indicated for active immunization against diphtheria, tetanus, pertussis, poliomyelitis, and invasive disease due to H influenzae type b. Pentacel vaccine is approved for use as a 4-dose series in children 6 weeks through 4 years of age (before the fifth birthday).

All combination vaccines that also protect disease from Polio include the three types of poliovirus: Type 1 (Mahoney), Type 2 (MEF-1), and Type 3 (Saukett).

WHO Prequalified Polio Vaccine

Eupolio is the first Sabin-IPV to obtain WHO prequalification. The main advantage of using attenuated Sabin poliovirus strains in IPV production is that there is a lower biosafety risk than wild-type polioviruses used to manufacture conventional IPVs potential to pose a biosafety hazard in case they escape from the manufacturing facility.

nOPV2M4a Polio Vaccine candidate is derived from the live, infectious virus. It has been ‘triple-locked using genetic engineering to prevent it from becoming harmful. nOPV2M4a is genetically more stable than existing OPVs, with a lower risk of reversion to neurovirulence.

nOPV2 Vaccine Candidate

The GPEI established a novel oral polio vaccine type 2 (nOPV2) Working Group to manage and coordinate the rapid and effective rollout of nOPV2. The vaccine is a modified version of the existing type 2 monovalent OPV (mOPV2). Clinical trials have shown comparable protection against poliovirus while being more genetically stable and less likely to revert into a form that can cause paralysis.

The World Health Organization’s (WHO) Prequalification program issued an Emergency Use Listing recommendation for the nOPV2 vaccine on November 13, 2020. This announcement enables the rollout of the nOPV2 vaccine for use in countries affected by circulating vaccine-derived poliovirus type 2 (cVDPV2) outbreaks.

The phased replacement during 2021 of Sabin OPV2 with novel OPV2 is expected to substantially reduce the source of cVDPV2 emergence, transmission, and subsequent risk of international spread.  Full licensure and pre-qualification of nOPV2 are not expected before 2022; therefore, all countries at risk of cVDPV2 outbreak should consider preparing for nOPV2 use under the WHO Emergency Use Listing procedure.

Polio Vaccination News

April 7, 2021 - The Global Polio Eradication Initiative summary of new WPV and cVDPV viruses this week (AFP cases and ES positives): Afghanistan: five cVDPV2 cases and eight cVDPV2 positive environmental samples; Pakistan: two WPV1 and three cVDPV2 positive environmental samples; Burkina Faso: one cVDPV2 case; Côte d’Ivoire: four cVDPV2 positive environmental samples; Liberia: one cVDPV2 positive environmental sample; Sierra Leone: one cVDPV2 case.

March 31, 2021 - The Global Polio Eradication Initiative confirmed Afghanistan and Senegal reported polio cases over the last week, involving circulating vaccine-derived poliovirus type 2 (cVDPV2). And a map showing the latest number of WPV1 and cVDPV cases in each affected country was updated.

March 26, 2021 - The WHO's global update on circulating vaccine-derived poliovirus type 2 (cVDPV2) outbreaks and events is summarized as of February 2021. In 2020, 959 human cases of circulating vaccine-derived poliovirus type 2 (cVDPV2) and 411 cVDPV2-positive environmental samples were reported globally from 27 countries, of which 21 countries were from the African Region and six countries from reported from the regions of the Eastern Mediterranean, Europe, and the Western Pacific. The number of cVDPV cases and environmental samples increased in 2020 compared to 2019 when 366 cVDPV2 cases and 173 cVDPV2-positive environmental samples were reported. The latest epidemiological information on circulating vaccine-derived poliovirus is updated weekly. 

March 24, 2021 -  The Global Polio Eradication Initiative reported new polio cases involving circulating vaccine-derived poliovirus type 2 (cVDPV2) in South Sudan and Tajikistan. The total circulating vaccine-derived poliovirus cases can be found at this link.

March 19, 2021 - As of March 18, 2021, 4 paralytic cases of children infected with circulating vaccine-derived poliovirus type 2 (cVDPV2) have been reported in Tajikistan, with several cVDPV2 cases detected in community and close contacts. The first cVDPV2 case with onset of acute flaccid paralysis (AFP) was reported on 22 November 2020 in Khatlon Province, linked to a virus strain currently circulating in Pakistan. The second case of cVDPV2 was confirmed in February 2021 in a child presented with AFP in Khatlon Province. On 8 March, 2 more cVDPV2 cases with AFP were confirmed in Hisor District. Also, 3 environmental samples from the newly established surveillance site in Dushanbe were reported cVDPV2 positive.

March 17, 2021 - Ecuador's Ministry of Public Health issued an international appeal for polio vaccine to organizations including Direct Relief and nations including Mexico. In its communication to Direct Relief, the Ministry warned of "a critical shortage of basic vaccines" as a side effect of the COVID-19 pandemic. Ecuador requested 95,000 doses of the polio vaccine and 138,000 doses of other vaccines commonly given to children. The Government of Mexico responded to the appeal, offering to donate the polio vaccine from its stockpile at the national vaccine agency BIRMEX.

March 17, 2021 - The Global Polio Eradication Initiative confirmed three countries reported polio cases last week, all involving circulating vaccine-derived poliovirus type 2.

March 13, 2021 - To rapidly and sustainably stop outbreaks of circulating vaccine-derived poliovirus type 2 (cVDPV2) in African countries, a modified vaccine, known as novel oral polio vaccine type 2 (nOPV2) is now being rolled out.

March 13, 2021 - The ECDC reported 41 cases of polioviruses (WPV1 and cVDPV2) had been confirmed last week, one of which was caused by the WPV1 strain and 40 by the cVDPV2 strain.

March 10, 2021 - The Global Polio Eradication Initiative's latest weekly report indicated six countries reported polio cases this week, all involving circulating vaccine-derived poliovirus type 2 (cVDPV2).

March 3, 2021 - Summary of new WPV and cVDPV viruses this week (AFP cases and ES positives): Afghanistan: one cVDPV2 case and nine cVDPV2 positive environmental samples; Pakistan: three WPV1 environmental samples, three cVDPV2 cases, and 10 cVDPV2 positive environmental samples; Egypt: two cVDPV2 positive environmental samples, Ethiopia: one cVDPV2 case and one positive environmental sample, Liberia: three cVDPV2 positive environmental samples, South Sudan: seven cVDPV2 cases, Tajikistan: one cVDPV2 positive environmental sample.

February 24, 2021 - According to the Global Polio Eradication Initiative weekly update, six countries reported new poliovirus cases: Afghanistan, Pakistan, the Republic of the Congo, Ethiopia, Guinea, and Mali.

February 22, 2021 - Prensa Latina reported the 60th National Bivalent Oral Polio Vaccination Campaign begins today in Cuba. Minors under the age of three will receive the anti-polio vaccine, while nine-year-old children will have a second vaccine dose. The vaccines will be applied in polyclinics and the family doctor's offices. This immunization plan takes place until February 27, and a second stage will be from March 1 to 9, 2021. Cuba was the first country in Latin America that was declared free of poliomyelitis.

February 19, 2021 - The twenty-seventh meeting of the Emergency Committee under the International Health Regulations (2005) (IHR) on the international spread of poliovirus was convened by the WHO Director-General on 1 February 2021 with committee members and advisers attending via video conference, supported by the WHO Secretariat.  The Emergency Committee reviewed the data on wild poliovirus (WPV1) and circulating vaccine-derived polioviruses (cVDPV). The Committee unanimously agreed that the risk of international spread of poliovirus remains a Public Health Emergency of International Concern (PHEIC) and recommended the extension of Temporary Recommendations for three months.  The Committee recognizes the concerns regarding the lengthy duration of the polio PHEIC. Still, it concludes that the current situation is extraordinary, with a clear ongoing and increasing risk of international spread and ongoing need for a coordinated international response.

February 17, 2021 - The Global Polio Eradication Initiative reported (7) countries reported additional polio cases this week, all involving circulating vaccine-derived poliovirus type 2 (cVDPV2).

February 10, 2021 - The weekly update from the Global Polio Eradication Initiative disclosed (6) countries reported new polio cases involving vaccine-derived types, including the first cVDPV2 case reported in Tajikistan.

February 4, 2021 - The U.S. CDC issued a Level 2 Alert, stating there are polio outbreaks in several countries in Asia. The CDC recommends that all travelers to these countries be vaccinated fully against polio. Polio outbreaks have been reported in these Asian countries (see map). Before traveling to these countries, adults who completed their routine polio vaccine series as children should receive a single, lifetime adult booster dose of polio vaccine. The World Health Organization recommends that these countries require residents and long-term (4 weeks or more) visitors to show polio vaccination before leaving these countries.

February 3, 2021 - According to the latest update from the Global Polio Eradication Initiative, new WPV and cVDPV cases were reported (AFP cases and ES positives) in Afghanistan: one WPV1 and 14 cVDPV2 cases and two cVDPV2 positive environmental samples; Pakistan: three WPV1 and 18 cVDPV2 positive environmental samples and eight cVDPV2 cases; Benin: one cVDPV2 case and two positive environmental samples; and Nigeria: one cVDPV2 case.

February 2, 2021 - The U.S. CDC reported 0 confirmed Acute Flaccid Myelitis (AMF) cases in 2021 out of 4 reports of patients under investigation (PUIs). In 2020, there were 30 confirmed cases out of 59 reports of PUIs. There have been 648 confirmed cases since CDC began tracking AFM in August of 2014. CDC has been thoroughly investigating cases since that time. We have seen increases in AFM cases, mostly in young children, in 2014, 2016, and 2018.

January 27, 2021 - The first Polio News edition of 2021 was published containing the latest program updates, news, and donor information. Additionally, the summary of new WPV and cVDPV viruses this week (AFP cases and ES positives) include Pakistan: 9 WPV1 positive environmental samples and six cVDPV2 cases; Afghanistan: 18 cVDPV2 positive environmental samples; Burkina Faso: three cVDPV2 cases; Mali: seven cVDPV2 cases; and Yemen: one cVDPV1 case.

January 20, 2021 - The Global Polio Eradication Initiative's weekly report highlighted new WPV and cVDPV viruses (AFP cases and ES positives): Pakistan: 10 WPV1 and three cVDPV2 positive environmental samples; Afghanistan: 15 cVDPV2 cases and two cVDPV2 positive environmental samples; Burkina Faso: one cVDPV2 case; Chad: four CVDPV2 cases; Guinea: three cVDPV2 cases; Sudan: four cVDPV2 cases.

January 18, 2021 - Afghanistan has launched a nationwide campaign to administer the polio vaccine to nearly 10 million children under five, the nation’s Public Health Ministry announced. Some 65,000 health workers will implement the campaign over a five-day period.

January 13, 2021 - Summary of new WPV and cVDPV viruses this week (AFP cases and ES positives): Pakistan: six WPV1 and one cVDPV2 positive environmental samples, one cVDPV2 case; Sudan: four cVDPV2 cases; Yemen: nine cVDPV1 cases, reported the Global Polio Eradication Initiative.

January 7, 2021 - South Korea-based LG Chem announced that its Sabin-Inactivated Polio Vaccine (Sabin-IPV) Eupolio™ received World Health Organization (WHO) prequalification effective December 21, 2020. The main advantage of using attenuated Sabin poliovirus strains in IPV production is that there is a lower biosafety risk than wild-type polioviruses used to manufacture conventional IPVs potential to pose a biosafety hazard in case they escape from the manufacturing facility.

January 6, 2021 - Summary of new WPV and cVDPV viruses this week (AFP cases and ES positives): Pakistan: one WPV1 case, seven WPV1, and 16 cVDPV2 positive environmental samples; Benin: one cVDPV2 positive environmental sample; Chad: one cVDPV2 case; Cote D’Ivoire: three cVDPV2 cases, and the Democratic Republic of the Congo: one cVDPV2 case.

January 4, 2021 - The U.S. CDC issued a Level 2 Travel Alert, which says there are vaccine-derived polio outbreaks in many countries in Africa. The CDC recommends that all travelers to these countries be vaccinated fully against polio.

December 30, 2020 - The Global Polio Eradication Initiative weekly update confirmed Afghanistan: one WPV1 positive environmental sample and 26 cVDPV2 cases; Pakistan: five WPV1 positive environmental samples; Nigeria: one cVDPV2 case and two cVDPV2 positive environmental samples; Guinea: seven cVDPV2 cases; Liberia: two cVDPV2 positive environmental samples; Sierra Leone: three cVDPV2 cases.

December 23, 2020 - The GPEI has published a global cVDPV resource document to provide a high-level overview of cVDPVs, their importance to the program, and their strategy for responding to them, including nOPV2. Available here in various languages, this resource can be used at global, regional, and country levels, for high-level advocacy with government counterparts, internal staff, donors, or other partners, as appropriate.

December 23, 2020 - The Afghan Ministry of Health launched a five-day nationwide campaign between Nov. 30 and Dec. 4, 2020, to vaccinate at least 9.9 million children, a public relations officer for the anti-polio campaign, Mir Jan Rasikh, told the Deutsche Presse-Agentur. However, the health officers could only reach 6.5 million of the country's children across 34 provinces.

December 22, 2020 - Dr. Peter Salk, president of the Jonas Salk Legacy Foundation, talked about lessons learned from the polio vaccine applied to the COVID-19 vaccine.

December 17, 2020 - The new vaccine, called nOPV2, might conclusively end the outbreaks caused by the live virus in the vaccine reverting to a virulent form. But expedited approval means skipping the real-world testing of large clinical trials. Instead, key questions about the vaccine’s effectiveness will be answered in the field. “The nOPV strains have been tested in a small number of volunteers, and we do not see a reversion to neurovirulence,” says Vincent Racaniello, a virologist at Columbia University, “but when they are used for mass immunization of millions of individuals, rare events can become evident.”

December 10, 2020 - A Duke University spinout has developed an immune-boosting technology using variations of the polio vaccine that does more than wipe out a targeted solid tumor. Istari Oncology's primary technology platform is the Polio Virus Sabin-Rhinovirus Poliovirus (PVSRIPO). The results from multiple trials and preclinical research streams indicate that PVSRIPO can treat various solid tumors previously thought of as untreatable. “It clears the body of others as well, not just where it’s injected,” said Matt Stober, CEO of RTP-based Istari Oncology.

December 9, 2020 - The Global Polio Eradication Initiative reported 4 countries reported additional polio cases involving vaccine-derived polio.

December 9, 2020 - The Lancet study: Safety and immunogenicity of two novel types 2 oral poliovirus vaccine candidates compared with a monovalent type 2 oral poliovirus vaccine in children and infants: two clinical trials. Both novel OPV2 candidates were safe, well-tolerated, and immunogenic in children and infants. Novel OPV2 could be an important addition to our resources against poliovirus, given the current epidemiological situation.

December 9, 2020 - Editorial published by The Lancet: Poliovirus vaccine options: another step forward.

December 9, 2020 - Adult study review published by The Lancet: Safety and immunogenicity of two novel types 2 oral poliovirus vaccine candidates compared with a monovalent type 2 oral poliovirus vaccine in healthy adults: two clinical trials. Phase 2 trials in 1,200 adults, young children, and infants suggest new poliovirus vaccine may have the potential to overcome outbreaks caused by a mutated polio strain linked to the oral vaccine that typically circulates in areas of low immunization coverage and poses one of the most significant barriers to eradication.

December 1, 2020 - How Covid-19 Drove New Polio Cases in Afghanistan. Due to the pandemic, 50 million children did not receive the polio vaccine in Afghanistan and Pakistan.

November 18, 2020 - Outbreaks of vaccine-derived poliovirus have been reported in the African countries listed on this map. The U.S. CDC reissued a Level 2 Travel Alert regarding these polio outbreaks. Although wild-type polio was eradicated in Africa in 2020, vaccine-derived poliovirus can cause outbreaks in low vaccination rates.

November 18, 2020 - In a recent paper, Adam Lauring, M.D., Ph.D., of the department of microbiology & immunology and the division of infectious disease and a collaborative team describe an enterprising study that allowed them to view the evolution of the vaccine virus into a more dangerous form in real-time. “Most outbreaks of type 2 poliovirus are caused by the vaccine. Then you have a problem where our best weapon is that same vaccine, so you’re fighting fire with fire,” says Lauring.

November 15, 2020 - South Sudan recently launched a campaign to vaccinate 1.5 million children against polio located in northern Africa.

November 13, 2020 - The WHO Prequalification program issued an Emergency Use Listing (EUL) recommendation for the type 2 novel oral polio vaccine (nOPV2). This will allow the vaccine's rollout for limited initial use in countries affected by circulating vaccine-derived poliovirus type 2 (cVDPV2) outbreaks. The issuance of a EUL recommendation for nOPV2 follows months of analysis from clinical trials of the vaccine that has shown it to be safe and provide comparable protection against polio as the currently used type 2 monovalent OPV (mOPV2). nOPV2 is a modified version of mOPV2 and has been in development for close to a decade, thanks to the collaboration of an extensive network of global experts.

November 5, 2020 - The World Health Organization and UNICEF issued an urgent call to action to avert major measles and polio epidemics worldwide.

November 4, 2020 - The Global Polio Eradication Initiative reported new polio cases in various countries.

October 29, 2020 - New polio vaccine poised to get emergency WHO approval. Nicholas Grassly, an infectious disease epidemiologist at Imperial College London, says that the roll-out can’t wait. He says the world responds to cVDPV outbreaks using hundreds of millions of doses of the old type 2 polio vaccine, which are themselves seeding more outbreaks. He adds that the new vaccine “is the only tool we have to stop this cycle.” Results from phase I trials of the vaccine were published in 2019. Two-phase II trials have been completed, but results are as yet unpublished. However, in Bandung, Indonesia, manufacturer Bio Farma has produced 160 million doses in anticipation that the WHO will grant an emergency-use listing while further trials are in progress.

According to the latest Global Polio Eradication Initiative report, October 25, 2020 - Ten countries reported a total of 87 new polio cases during the week of October 21, 2020. 

October 23, 2020 - The Lancet study: Safety and immunogenicity of inactivated poliovirus vaccine schedules for the post-eradication era: a randomized open-label, multicentre, phase 3, non-inferiority trial.

October 23, 2020 - World Polio Day is when the world comes together to celebrate the determination that has brought us 99% of the way to ending polio and reflect on the heights we must scale to rout the disease. In the last eight months, immunization services have taken a devastating hit. An estimated 80 million children under one may have missed critical vaccines.

October 22, 2020 - The 26th meeting of the Emergency Committee under the International Health Regulations (2005) (IHR) on the international spread of poliovirus was convened and opened by the WHO Deputy Director-General. The committee was very concerned that the global spread of cVDPV2 continues, causing recent outbreaks in Guinea, South Sudan, and Sudan, the latter two due to the importation of a cVDPV2 lineage that emerged in Chad in 2019.  The same virus has also been detected in sewage in Cairo, Egypt but with no evidence of local circulation. The number of sub-types / lineages seen so far in 2020 is 27, compared to 42 for the whole of 2019, and the number of newly emerged viruses is only seven so far this year, compared to 38 during 2019. 

October 1, 2020 - Nearly 10 million doses of polio vaccine arrived in Khartoum. During the National Polio Campaign, these vaccines will be used for October to immunize 8.6 million of the country's children under five. On 8 August, vaccine-derived poliovirus type 2 (cVDPV2) was confirmed in Sudan. This strain of poliovirus results from low immunity and under-immunization of communities rather than a vaccine problem.

September 19, 2020 - Study: National immunization campaigns with oral polio vaccine may reduce all-cause mortality: An analysis of 13 years of demographic surveillance data from an urban African area.

August 2020 - Update on polio eradication efforts in Afghanistan for August 2020.

July 8, 2020 - The World Health Organization (WHO) Polio Emergency Committee recommended that the international risk of poliovirus spread remains a Public Health Emergency of International Concern under the International Health Regulations during a June 23, 2020, meeting. The global situation remains of great concern with the increased number of WPV1 cases in 2019, continuing in 2020.

December 15, 2020 - The US Centers for Disease Control and Prevention increased the polio outbreak Travel Alert for 14 African countries. In a new Level 2 Travel Alert published on December 11, 2019, the CDC said that ‘there are confirmed polio outbreaks in various countries primarily located in central and eastern Africa.’

April 1, 2020 - Study: Events in Israel following the silent polio outbreak may indicate that polio vaccination's social norms are changing. After the outbreak, the Israel Ministry of Health switched back to a routine vaccination schedule that includes two IPV doses followed by an OPV booster. This schedule has been well accepted among the Israeli population (35), possibly indicating a shift to a more prosocial norm.

June 25, 2019 - Study: Immunogenicity of Oral Polio Vaccine and Salk Inactive Polio Vaccine Against Xinjiang Imported Type 1 Wild Poliovirus.

October 30, 2018 - Study: OPV Vaccination and Shedding Patterns in Mexican and US Children.

May 19, 2016 - Humoral and intestinal immunity induced by new schedules of bivalent oral poliovirus vaccine and one or two doses of inactivated poliovirus vaccine in Latin American infants: an open-label randomized controlled trial.

October 15, 2009 - Time for a Worldwide Shift from Oral Polio Vaccine to Inactivated Polio Vaccine.

Poliomyelitis (polio) Overview

Poliomyelitis (polio) is a highly infectious viral disease that primarily affects children 5 years of age and under. There are 3 strains of wild poliovirus (type 1, type 2, and type 3).

Wild poliovirus type 2 was eradicated in 1999, and no case of wild poliovirus type 3 has been found since the last reported case in Nigeria in November 2012. Both strains have officially been certified as globally eradicated. 

As of 2020, wild poliovirus type 1 is still found in Pakistan and Afghanistan.

Polio is transmitted person-to-person, mainly through the fecal-oral route or, less frequently, by consuming contaminated food or water.  The virus multiplies in the intestine, from where it can invade the nervous system and cause paralysis. Initial symptoms are fever, fatigue, headache, vomiting, stiffness in the limbs' neck, and pain.

One in 200 infections leads to irreversible paralysis (usually in the legs). Among those paralyzed, 5% to 10% die when their breathing muscles become immobilized, says Sanofi.

In the USA, all infants and children should receive 4 doses of IPV at ages 2, 4, 6–18 months, and 4–6 years. The first dose may be given as early as 6 weeks of age. The final dose should be administered at 4 years of age or older, regardless of the number of previous doses, and should be given 6 months or more after the previous dose. A fourth dose in the routine IPV series is unnecessary if the third dose was given at 4 years of age or older and 6 months or more after the previous dose.

Note: This content has been aggregated from the CDC, WHO, pharmaceutical vaccine producers, and the PrecisionVaccinations news network and has been reviewed by healthcare providers, such as Dr. Bob Carlson.