Usage
- Poliomyelitis virus type 3 vaccine is prescribed for the prevention of poliomyelitis caused by poliovirus type 3. It is typically administered as part of a trivalent or bivalent vaccine that also includes protection against other poliovirus types (1 and 2).
- Pharmacological classification: Vaccine.
- Mechanism of action: The inactivated polio vaccine (IPV) contains inactivated (killed) poliovirus. It works by stimulating the body’s immune system to produce antibodies against the virus without causing infection. These antibodies provide immunity against future exposure to live poliovirus. The oral poliovirus vaccine (OPV – not available in some countries such as the US) uses a weakened, live version of the virus, but because it is not related to inactivated poliovirus type 3, it won’t be discussed further in this guide.
Alternate Names
- Inactivated Poliovirus Vaccine (IPV) containing type 3, IPOL (single-antigen IPV).
- Brand Names: (Note: Brand names can vary by region. Consult local formularies for availability) IPOL, Infanrix hexa, Vaxelis, Infanrix IPV, Quadracel, Adacel Polio, Boostrix-IPV, Pentacel, Pediarix, Kinrix.
How It Works
- Pharmacodynamics: IPV stimulates a humoral immune response. The body produces specific antibodies that neutralize poliovirus, preventing it from infecting motor neurons in the central nervous system.
- Pharmacokinetics: IPV is administered intramuscularly (IM) or subcutaneously (SC). The inactivated virus does not replicate. The antigens in the vaccine are processed by antigen-presenting cells, leading to B-cell activation and antibody production. The pharmacokinetic properties in terms of absorption, distribution, metabolism, and elimination are not typically measured or relevant for inactivated vaccines.
- Mode of Action: The vaccine’s inactivated poliovirus antigens are recognized as foreign by the immune system. This triggers an immune response, involving B cells and T cells. The B cells produce antibodies specific to the poliovirus types present in the vaccine (including type 3). These antibodies circulate in the bloodstream, providing immunity against future infection.
- Elimination Pathways: IPV does not replicate or distribute widely like live vaccines. The inactivated viral particles are eventually broken down and eliminated by the body’s natural processes.
Dosage
Standard Dosage
Adults:
- Primary Vaccination: 3 doses of 0.5 mL (IM or SC).
- Intervals: First two doses are given 1-2 months apart or 4-8 weeks apart. The third dose is given 6-12 months after the second dose.
- Booster Dose: A single booster dose of 0.5 mL may be given to adults at increased risk of exposure (e.g., travelers to endemic regions, laboratory workers). Some countries recommend boosters every 10 years for high-risk individuals.
Children:
- Primary Vaccination: 4 doses of 0.5 mL (IM or SC).
- Schedule: 2 months, 4 months, 6-18 months, and 4-6 years of age.
- Some combination vaccines may alter the number of IPV doses needed.
Special Cases:
IPV dosing is generally the same across age groups, but check local guidelines for potential specific circumstances for the elderly or individuals with impaired organ function.
Clinical Use Cases
IPV is for pre-exposure prophylaxis, not treatment, and is not indicated in clinical settings like intubation, surgical procedures, mechanical ventilation, ICU use, or emergency situations.
Dosage Adjustments
No specific dosage adjustments are required based on renal/hepatic dysfunction, metabolic disorders, or genetic polymorphisms. However, individuals with immunodeficiencies should be evaluated individually.
Side Effects
Common Side Effects:
- Pain, redness, or swelling at the injection site
- Mild fever
Rare but Serious Side Effects:
- Allergic reactions (e.g., hives, difficulty breathing, swelling of the face)
Long-Term Effects:
No long-term adverse effects from IPV have been reported.
Adverse Drug Reactions (ADR):
Rarely, severe allergic reactions (anaphylaxis) may occur.
Contraindications
- Severe allergic reaction to a previous dose of IPV or any component of the vaccine.
- Moderate or severe acute illness (vaccination should be postponed until recovery).
Drug Interactions
- Immunosuppressants (e.g., high-dose corticosteroids): These may reduce the immune response to the vaccine. Timing between these medications and IPV should be considered.
- Immunoglobulin: Similar to immunosuppressants, immunoglobulin can affect the immune response to IPV.
Pregnancy and Breastfeeding
IPV is considered safe during pregnancy and breastfeeding. Vaccination is recommended for pregnant women traveling to endemic or outbreak areas.
Drug Profile Summary
- Mechanism of Action: Stimulates an immune response and antibody production against poliovirus.
- Side Effects: Generally mild and localized to the injection site. Rarely, allergic reactions.
- Contraindications: Severe allergy to a previous dose or any component of the vaccine, moderate/severe acute illness.
- Drug Interactions: Immunosuppressants, immunoglobulin.
- Pregnancy & Breastfeeding: Safe.
- Dosage: See dosage section above.
- Monitoring Parameters: Observe for immediate allergic reactions post-vaccination.
Popular Combinations
IPV is often included in combination vaccines, such as:
- DTaP-IPV-Hib (e.g., Infanrix hexa, Pentacel, VAXELIS)
- DTaP-IPV-HepB (e.g., Pediarix)
- DTaP-IPV (e.g., Kinrix, Quadracel)
These combinations simplify the vaccination schedule and provide protection against multiple diseases.
Precautions
- Standard precautions for vaccine administration (e.g., proper injection technique, patient monitoring).
- Postpone in individuals with moderate/severe illness.
- Evaluate individuals with immunodeficiencies.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Poliomyelitis virus type 3?
A: See dosage section above.
Q2: Can IPV be given to immunocompromised individuals?
A: Immunocompromised individuals should be evaluated on a case-by-case basis. The efficacy of the vaccine may be reduced in these individuals.
Q3: What is the difference between IPV and OPV?
A: IPV contains inactivated (killed) poliovirus, while OPV contains weakened, live poliovirus. IPV is given by injection, OPV is given orally. OPV is no longer used in many countries.
Q4: How long does immunity from IPV last?
A: IPV provides long-lasting protection, but booster doses may be recommended for certain high-risk groups.
Q5: Can pregnant women receive the IPV vaccine?
A: Yes, IPV is considered safe during pregnancy. It’s recommended for pregnant women traveling to areas with a risk of polio exposure.
Q6: Are there any drug interactions I should be aware of?
A: Immunosuppressants and immunoglobulin can potentially reduce the immune response to IPV. Consult local or international guidelines for specific recommendations.
Q7: What should I do if a patient experiences an allergic reaction after receiving IPV?
A: Allergic reactions, including anaphylaxis, should be treated promptly according to established protocols. Epinephrine should be readily available.
A: Consult your local public health authority and internationally recognized bodies such as the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) for the latest recommendations.
Q9: How effective is the inactivated polio vaccine?
A: IPV is highly effective. Most individuals develop immunity after three doses, with nearly 100% immunity after a booster dose.
