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Poliomyelitis Vaccine

By William D. Surkis, MD, Clinical Associate Professor of Medicine; Director, Internal Medicine Residency Program, Jefferson Medical College; Lankenau Medical Center
Jerome Santoro, MD, Clinical Professor of Medicine; Chief, Department of Medicine, Jefferson Medical College; Lankenau Medical Center

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Inactivated poliovirus vaccine (IPV) contains a mixture of formalin-inactivated poliovirus types 1, 2, and 3. IPV may contain trace amounts of streptomycin, neomycin, and polymyxin B. The live-attenuated oral formulation is no longer available in the US because it causes polio in about 1 of every 2.4 million people who are given the vaccine.

Combination vaccines with IPV, DTaP, and sometimes also hepatitis B or Hib are also available.


IPV is a routine childhood vaccine (see Table: Recommended Immunization Schedule for Ages 0–6 yr).

Routine primary poliovirus vaccination of adults living in the US is not recommended. Unimmunized or incompletely immunized adults who may be exposed to wild poliovirus (eg, travelers to endemic areas, laboratory workers who handle specimens that may contain poliovirus) should be vaccinated with IPV. Completely vaccinated adults who are at an increased risk of exposure to poliovirus can be given a booster dose of IPV. For current information about which countries are considered at high risk for polio, see the CDC Travel Destinations List and Polio: Traveler Information.

Contraindications and Precautions

The main contraindication is

  • A severe allergic reaction (eg, anaphylaxis) after a previous dose of the vaccine or to a vaccine component

The main precaution is

  • Moderate or severe acute febrile illness (vaccination is postponed until the illness resolves)


The dose is 0.5 mL IM or sc.

A 4-dose IM series is given at age 2 mo, 4 mo, 6 to 18 mo, and 4 to 6 yr. Typically, a combination vaccine is used for the first 3 vaccinations and a single-antigen vaccine for the last dose. If children miss an IPV dose at age 4 to 6 yr, they should be given a booster dose as soon as possible.

When DTaP-IPV/Hib (Pentacel®) is used for the 4-dose schedule (at ages 2, 4, 6, and 15 to 18 mo), an additional booster dose of IPV-containing vaccine (IPV or DTaP-IPV [Kinrix®]) should be given at age 4 to 6 yr, resulting in a 5-dose schedule; however, DTaP-IPV/Hib should not be used for the booster dose at age 4 to 6 yr. The minimum interval between doses 4 and 5 should be ≥ 6 mo to optimize the booster response.

A primary series of IPV is recommended for unvaccinated adults at increased risk of exposure to poliovirus. The recommended interval between doses 1 and 2 is 1 to 2 mo; the 3rd dose is given 6 to 12 mo later. If protection is needed in 2 to 3 mo, 3 doses are given ≥ 1 mo apart. If it is needed in 1 to 2 mo, 2 doses are given ≥ 1 mo apart, and if it is needed in < 1 mo, 1 dose is given.

Adverse Effects

No adverse effects have been associated with IPV. Because it may contain trace amounts of neomycin, streptomycin, and polymyxin B, people who are sensitive to any of these drugs may have an allergic reaction to the vaccine.

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