Administration+and+Schedule

__**Polio vaccine comes in two forms:** __ __**(1.)Inactivated Poliovirus (IPV):** __ __**(2.)Oral Poliovirus (OPV):** __
 * **Inactivated Poliovirus (IPV)**
 * **Oral Poliovirus (OPV)**
 * **It is the only one available in the United States for routine childhood polio vaccine schedule.**
 * **Schedule: all children should receive four doses of IPV at 2 months, 4 months, 6 to 8 months, and 4 to 6 years of age.**
 * **IPV is available as a single vaccine or in combination with DTaP and hepatitis B vaccines (Pediarix; GlaxoSmithKline), DTaP and Hib vaccines (Pentacel; Sanofi Pasteur), or DTaP alone (Kinrix; GlaxoSmithKline).**
 *  **Pediarix is a hepatitis B vaccine and can be used for the first three doses of IPV AT 2, 4, and 6 months but a single IPV is needed for the fourth dose.**
 * **Pentacel (Hib vaccine) can also be used for any of the first three doses of IPV but a separate IPV would be needed at age 4 through 6 years.**
 * **Note: There is no need to interrupt the series if the primary immunization schedule is interrupted; the next dose in the series should be given.**
 * **Administration: injection**
 * **It is the major vaccine used in the worldwide eradication effort is OPV.**
 * **Advantages include ease of use, better induction of intestinal immunity to prevent wild polio virus spread than IPV, spread of vaccine virus to unvaccinated contacts, and lower cost than IPV.**
 * **Administration: orally**


 * __**Ø Why an all-IPV schedule in the United States?** __
 * <span style="font-family: Arial,Helvetica,sans-serif; font-size: 90%;">**OPV is related to rare risk of vaccine associated polio paralysis (VAPP) especially after the first dose while IPV is not.Overall risk is 1 in every 750,000 first doses.**
 * <span style="font-family: Arial,Helvetica,sans-serif; font-size: 90%;">**No new cases of VAPP have reported since the institution of an all-IPV schedule in the United States in 2000.**
 * <span style="font-family: Arial,Helvetica,sans-serif; font-size: 90%;">**Disadvantage: IPV is more expensive than OPV and there is increased number of injections.**
 * <span style="font-family: Arial,Helvetica,sans-serif; font-size: 90%;">**Ø NOTE:Polio vaccine is not routinely recommended for persons 18 years of age or older in theUnited States because the risk from wild virus is low. However, if vaccine is needed, such as for persons traveling to polio-endemic areas, previously unvaccinated adults should receive two doses of IPV at intervals of 4 to 8 weeks and a third dose 6 to 12 months after the second. Adults who have had a primary series of OPV or IPV and who are at increased risk for exposure to poliovirus may receive an additional dose of IP**

<span style="font-family: Arial,Helvetica,sans-serif; font-size: 90%;">**(Mandell et al., 2009)** <span style="font-family: Arial,Helvetica,sans-serif; font-size: 90%;">**(Perry et al., 2011)**