CDC: Vaccinate immigrant, refugee children against all three types of polio
MelissaJenco, News Content Editor
Pediatricians should ensure children who recently entered the U.S. are vaccinated
against all three types of poliovirus, health officials said Thursday.
Physicians will have to verify immunization status through documentation instead of
antibody testing, according to the Centers for Disease Control and Prevention (CDC)
“Given the large number of refugees coming from different countries who may have different
schedules, they (the CDC) wanted to clarify what would be considered an up-to-date
vaccination in the U.S.,” said Yvonne A. Maldonado, M.D., FAAP, vice chair of the
AAP Committee on Infectious Diseases who provided input on the guidance.
The Academy and the CDC’s Advisory Committee on Immunization Practices recommend children
in the U.S. receive four doses of inactivated polio vaccine (IPV), which protects
against all three virus types. The immunization schedule calls for doses to be given at ages 2 months, 4 months, 6 through 18 months, and
4 through 6 years and lays out additional guidance on timing and catch-up vaccination.
While wild poliovirus type 2 has been declared eradicated, people in countries using
live attenuated vaccines could contract a vaccine-derived type 2 virus, according
to the CDC. That led 155 countries last year to switch from a live attenuated trivalent oral poliovirus vaccine (tOPV) to a bivalent vaccine
that contains types 1 and 3.
The CDC’s updated guidance published Thursday in the Morbidity and Mortality Weekly Report calls for children living in the U.S. but vaccinated abroad to be vaccinated against
all three types. Doctors must rely on documentation alone to determine a child’s status.
“Right now there are few laboratories that have the type 2 virus because we don’t
want it reintroduced, so serologic testing for all three types is generally not available,”
said Walter A. Orenstein, M.D., FAAP, lead author of the 2015 AAP clinical report on polio eradication who also provided input on the CDC guidance.
Vaccination in other countries may be accepted if tOPV or IPV was used on a similar
or accelerated schedule to that of the U.S. The guidance details acceptable intervals.
If both were used, the total doses to complete the series should mirror U.S. recommendations.
If a child only received tOPV and the doses were given before age 4 years, he or she
should receive one dose of IPV at 4 years or older, at least six months after the
Children under age 18 who do not have documented evidence of tOPV or IPV should be
revaccinated with IPV using the U.S. schedule, according to the CDC.
“If you’re not certain that a child received a trivalent vaccine, you should not accept
those doses as adequate and (should) revaccinate that child,” Dr. Orenstein said.