Do not use oral polio vaccine (OPV) in patients or patients whose contacts have immunosuppression

Do not use oral polio vaccine (OPV) in patients or patients whose contacts have immunosuppression
Anjali Subbaswamy MD
What To Do – Make a Decision, Take Action
Live vaccines are composed of viral or bacterial strains that are deprived of their pathogenicity but can still replicate in the organism into which it is injected. These vaccines can provoke a nonpathogenic infection in vaccinated subjects, both inducing an antibody and a cellular immune response. Live attenuated vaccines, such as measles, mumps, and rubella (MMR) or yellow fever vaccine, have been widely used with proven efficacy. The oral poliomyelitis vaccine is composed of three attenuated strains prepared from the three wild virus types and is efficacious but mutations of the virus (in particular for type 3) can induce polio-associated paralysis by giving it back its original neurovirulence (number of cases 2:1,000,000). The emergence of circulating vaccine-derived poliovirus (cVDPV) strains is a real risk associated with the use of OPV. The cVDPV strains result form point mutations that occur in the Sabin (developer of oral vaccine) OPV strains. There may or may not be an exchange of parts of the viral genome with related nonpolio enteroviruses. This exchange typically occurs in areas where the live OPV is used and immunization rates are low. The oral polio vaccine is still used in most parts of the world to prevent transmission (cheaper than injected form). Since the World Health Assembly launched its polio eradication goal, outbreaks caused by cVDPV have been seen in the Amish populations in the United States.

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Jul 1, 2016 | Posted by in PEDIATRICS | Comments Off on Do not use oral polio vaccine (OPV) in patients or patients whose contacts have immunosuppression

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