Usage
- Polio vaccines are prescribed to prevent poliomyelitis (polio), a highly contagious disease caused by the poliovirus. Polio can affect the nervous system and, in severe cases, cause paralysis.
- Pharmacological classification: Active Immunizing Agent, Viral Vaccine.
- Mechanism of action: Polio vaccines stimulate the immune system to produce antibodies against the poliovirus. These antibodies provide immunity against future poliovirus infection. Inactivated polio vaccine (IPV) contains inactivated (killed) poliovirus, while oral polio vaccine (OPV), used in some parts of the world, contains weakened but live poliovirus.
Alternate Names
- Inactivated poliovirus vaccine (IPV), Oral poliovirus vaccine (OPV) (no longer used in many developed countries such as Australia and the USA), Sabin vaccine (OPV), Salk vaccine (IPV).
- Brand names: IPOL®, Kinrix®, Pediarix®, Pentacel®, Quadracel®, VAXELIS® (some of these are combination vaccines containing IPV).
How It Works
- Pharmacodynamics: IPV works by introducing inactivated poliovirus into the body, stimulating an immune response without causing infection. This leads to the production of specific antibodies that neutralize the virus if a person is exposed to it later. OPV, while more rarely used now in developed countries due to the risk of vaccine-associated paralytic polio (VAPP), replicates in the intestine and induces mucosal immunity, providing a broader range of protection.
- Pharmacokinetics: IPV is administered intramuscularly (IM) or subcutaneously (SC). The vaccine components are processed by the immune system, with negligible systemic absorption. OPV is administered orally and replicates primarily in the gut, with limited systemic spread. Both vaccines induce long-lasting antibody production, providing immunity.
- Mode of action: The inactivated virus in IPV, and the attenuated virus in OPV, act as antigens, triggering B cells to produce antibodies that recognize and bind to the poliovirus, preventing it from infecting cells.
- Receptor binding, enzyme inhibition, or neurotransmitter modulation: Polio vaccines act by inducing antibody production, and do not involve direct receptor binding, enzyme inhibition, or neurotransmitter modulation.
- Elimination pathways: The inactivated viruses in IPV are cleared through normal immune system processes. The weakened live viruses in OPV are shed primarily in the stool and eventually eliminated.
Dosage
Standard Dosage
Adults:
- Primary series for unvaccinated adults at increased risk: Three 0.5 mL doses of IPV IM or SC. The first two doses are given 1-2 months apart, and the third dose is given 6-12 months after the second dose.
- Booster dose for completely vaccinated adults at increased risk: One 0.5 mL dose of IPV IM or SC.
Children:
- Primary series: Four 0.5 mL doses of IPV IM or SC at 2, 4, 6-18 months, and 4-6 years of age.
Special Cases:
- Elderly Patients: Same as adult dosing.
- Patients with Renal/Hepatic Impairment/Comorbid Conditions: Standard dosing is generally used.
Clinical Use Cases
Polio vaccines are used for prevention of poliomyelitis and are not indicated in settings like intubation, surgical procedures, mechanical ventilation, ICU use, or emergency situations as a treatment.
Dosage Adjustments
If protection is needed within specific time frames prior to potential exposure, adapted adult schedules can be used (e.g., three doses 1 month apart if 2-3 months are available; two doses 1 month apart if only 1-2 months are available; single dose if less than a month).
Side Effects
Common Side Effects
- Redness, pain, and swelling at the injection site.
- Mild fever.
Rare but Serious Side Effects
- Allergic reactions (e.g., hives, difficulty breathing, swelling of face or throat).
Long-Term Effects
- No long-term side effects associated with IPV have been reported.
Adverse Drug Reactions (ADR)
Contraindications
- Severe allergic reaction to a previous dose of IPV or any of its components (neomycin, streptomycin, polymyxin B).
Drug Interactions
- Immunosuppressive therapy may reduce the immune response to IPV.
Pregnancy and Breastfeeding
- IPV can be given during pregnancy if the benefit outweighs the risk (e.g., travel to polio-endemic areas), following the adult schedule.
- IPV is considered safe during breastfeeding.
Drug Profile Summary
- Mechanism of Action: Stimulates active immunity against poliovirus by inducing antibody production.
- Side Effects: Injection site reactions (redness, pain, swelling), mild fever, rare allergic reactions.
- Contraindications: Severe allergic reaction to IPV or its components.
- Drug Interactions: Immunosuppressants.
- Pregnancy & Breastfeeding: Generally safe; consult guidelines for pregnancy.
- Dosage: See detailed dosage section above.
- Monitoring Parameters: Monitor for allergic reactions post-vaccination.
Popular Combinations
IPV is often combined with diphtheria, tetanus, and pertussis vaccines (DTaP-IPV), and sometimes with other vaccines (e.g., hepatitis B, Hib).
Precautions
- Screen for contraindications prior to administration.
- Observe patient for allergic reactions after administration.
- Ensure appropriate needle length and injection site based on age and size.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Polio Vaccine?
A: See detailed dosage section above.
Q2: Which type of polio vaccine is recommended in developed countries?
A: IPV is predominantly recommended due to the risk of VAPP associated with OPV.
Q3: What is the difference between IPV and OPV?
A: IPV contains inactivated poliovirus, while OPV contains live attenuated poliovirus. IPV is safer but might provide slightly less comprehensive immunity than OPV.
Q4: Is a booster dose of polio vaccine needed for adults?
A: Routine boosters are not recommended for most adults in countries where polio has been eliminated. However, a single lifetime booster may be given to adults traveling to polio-endemic areas.
Q5: Can pregnant women receive the polio vaccine?
A: Yes, IPV can be administered during pregnancy if there is an increased risk of exposure and a need for immediate protection.
Q6: Are there any specific precautions for administering polio vaccines to immunocompromised individuals?
A: IPV is the preferred vaccine for immunocompromised individuals. While they may not develop a full immune response, IPV is safe and may offer some protection.
Q7: Can polio vaccines be administered with other vaccines?
A: Yes, IPV can be administered concurrently with other vaccines, at separate injection sites.
Q8: How long does immunity from polio vaccination last?
A: Completing the recommended series of polio vaccination is thought to provide lifelong protection against paralytic polio.
Q9: What are the signs of an allergic reaction to the polio vaccine?
A: Hives, swelling of the face and throat, difficulty breathing, a rapid heartbeat, dizziness, or weakness. Seek immediate medical attention if these occur.
