Changing the US Polio Immunization Schedule Would Be Bad Public Health Policy

Last October, a 10-member advisory committee to the United States (US) Centers for Disease Control and Prevention (CDC) voted to change the US government's well-established polio immunization policy. The current polio immunization schedule, consisting of a regimen of four doses of oral poliovaccine (OPV), is widely credited with effectively eradicating polio in the US and the western hemisphere. In fact, the last naturally occurring case of polio occurred in the US in 1979 and in the western hemisphere in 1991. Because OPV contains a live but weakened virus, it has, on very rare occasions, been associated with paralytic polio. In the hope of preventing some of the 8 to 10 cases of vaccine-associated paralytic poliomyelitis (VAPP) diagnosed each year, the CDC's Advisory Committee on Immunization Practices (ACIP) has recommended a combined immunization schedule of two doses of inactivated polio virus (IPV), which is delivered by injection, followed by two doses of OPV.