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Div. of Media Relations
1600 Clifton Road
MS D-14
Atlanta, GA 30333
(404) 639-3286
Fax (404) 639-7394 |
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June 17, 1999
Contact: (404) 639-3286
ACIP Vote Regarding
Routine Childhood Polio Vaccination Recommendations
- On June 17, 1999, the Advisory Committee for Immunization Practices (ACIP) voted to
change the recommendation for routine childhood polio vaccination beginning in 2000 to a
schedule using only the inactivated poliovirus vaccine (IPV) to eliminate the occurrence
of vaccine-associated paralytic poliomyelitis (VAPP) in the United States. The committee
vote was 8 in favor of a change to four doses of IPV, with 1 abstaining and 3 absent. The
vote does not become a final recommendation until it is accepted by CDC through
publication in its "Morbidity and Mortality Weekly Report" (MMWR) series. If the
recommendation is accepted by CDC, to be protected against polio, all children will need
to get 4 doses of IPV at 2, 4, 6-18mo, and 4-6 yrs beginning in January 2000. The
committee voted that oral polio vaccine will be acceptable only in special circumstances.
- Since 1979, the only polio disease in the United States has been caused by the oral
poliovirus vaccine (OPV) vaccine, which had been used routinely for childhood vaccination
since 1965. Until recently, because of the risk of polio epidemics in the United States,
the risk from the vaccine, about 1 case for every 2.4 million doses, was outweighed by the
benefit from the vaccine in protecting against epidemics. Although both vaccines protect
children against polio, OPV provides better protection against epidemics. IPV is not known
to cause VAPP.
- Because of the success of the global polio eradication campaign using OPV, by the mid
1990's, the risk of polio epidemics in the U.S. was much less, and the risk of polio from
the OPV became greater than the risk from the disease in the U.S. For these reasons, in
Jan. 1997, the polio vaccination schedule was changed to a sequential schedule of two
doses of the IPV followed by two doses of OPV. In 1997, CDC confirmed 4 cases of VAPP in
the United States. In 1998, one case of VAPP was confirmed. Prior to the change to a
sequential schedule, there were 8-10 cases of paralytic polio caused by OPV each year.
- In the past two years, the sequential schedule has been well accepted. No declines in
childhood immunization coverage were observed despite the need for additional injections.
Because of this, and the fact that the polio eradication campaign has led to continued
declines in polio cases outside the United States., the ACIP determined that the
recommended childhood polio vaccination schedule should be changed to an exclusive IPV
schedule to completely eliminate the risk of VAPP while still providing protection to
children and adults. Until polio is eradicated, all children still need to be vaccinated
for polio.
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