Merck Manual

Please confirm that you are a health care professional

honeypot link

Poliomyelitis Vaccine


Margot L. Savoy

, MD, MPH, Lewis Katz School of Medicine at Temple University

Reviewed/Revised Jul 2023

Extensive vaccination has almost eradicated polio Poliomyelitis Poliomyelitis is an acute infection caused by a poliovirus (an enterovirus). Manifestations include a nonspecific minor illness (abortive poliomyelitis), sometimes aseptic meningitis without... read more worldwide. But cases still occur in areas with incomplete immunization, such as sub-Saharan Africa and southern Asia.

Preparations of Poliomyelitis Vaccine

Inactivated poliovirus vaccine (poliovirus vaccine, inactivated, 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 poliovirus vaccine is no longer available in the United States because it can mutate to a strain that causes polio in about 1 of every 2.4 million people who are given the vaccine.

Inactivated polio vaccine is the only polio vaccine that has been given in the United States since 2000. The following combination vaccines are also available:

  • Diphtheria toxoid/inactivated poliovirus vaccine

  • Diphtheria toxoid/hepatitis B vaccine/inactivated poliovirus vaccine

  • Diphtheria toxoid/Haemophilus influenzae type B conjugate vaccine/inactivated poliovirus vaccine

  • Diphtheria toxoid/Haemophilus influenzae type B conjugate vaccine/hepatitis B vaccine/inactivated poliovirus vaccine

Indications for Poliomyelitis Vaccine

IPV is a routine childhood vaccine (see CDC: Child and Adolescent Immunization Schedule by Age).

Routine primary poliovirus vaccination of adults living in the United States is not recommended (see CDC: Adult Immunization Schedule by Age). 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 of polio, see the Centers for Disease Control and Prevention's (CDC) Travelers' Health: Destinations and Travelers Health: Polio.

In the United States, a case of vaccine-derived polio was identified in an unvaccinated person who acquired it in New York State in July 2022 (see also New York State Department of Health: Wastewater Surveillance). New York residents in areas with repeated poliovirus detection may be at higher risk of infection and should follow updated vaccination recommendations from the New York State Department of Health (see New York State Department of Health: Polio Vaccine).

Contraindications and Precautions for Poliomyelitis Vaccine

The main contraindication for IPV is

The main precautions with IPV are

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

  • Pregnant women who are not at increased risk of polio (they should not be given the polio vaccine even though there is no evidence that the vaccine harms pregnant women or their fetus; however, if pregnant women are at increased risk of exposure to poliovirus and require immediate protection, IPV can be given)

Administration of Poliomyelitis Vaccine

The IPV dose is 0.5 mL IM or subcutaneous.

A 4-dose IM series is given at age 2 months, 4 months, 6 to 18 months, and 4 to 6 years. 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 years, they should be given a booster dose as soon as possible.

When DTaP-IPV/Hib is used for the 4-dose schedule (at ages 2, 4, 6, and 15 to 18 months), an additional booster dose of IPV-containing vaccine (IPV or DTaP-IPV) should be given at age 4 to 6 years, resulting in a 5-dose schedule; however, DTaP-IPV/Hib should not be used for the booster dose at age 4 to 6 years. The minimum interval between doses 4 and 5 should be ≥ 6 months 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 months; the third dose is given 6 to 12 months later. If protection is needed in 2 to 3 months, 3 doses are given ≥ 1 month apart. If it is needed in 1 to 2 months, 2 doses are given ≥ 1 month apart. If it is needed in < 1 month, 1 dose is given. In all cases, the remaining doses of vaccine should be given later, at the recommended intervals, if the person remains at increased risk.

Adverse Effects of Poliomyelitis Vaccine

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.

More Information

The following English-language resources may be useful. Please note that THE MANUAL is not responsible for the content of these resources.

Drugs Mentioned In This Article

Drug Name Select Trade
No brand name available
No brand name available
Kinrix , Quadracel
Engerix-B, Engerix-B Pediatric, H-B-Vax, HEPLISAV-B, PreHevbrio, RDNA H-B Vax II, Recombivax HB, Recombivax HB Pediatric/Adolescent
NOTE: This is the Professional Version. CONSUMERS: View Consumer Version
quiz link

Test your knowledge

Take a Quiz!