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Revised IPV-OPV recommendations approved

The Board of Directors has approved the revised recommendations for immunization against poliomyelitis. The complete statement will be published in the January 1999 issue of Pediatrics.

Since 1997, when the American Academy of Pediatrics (AAP) issued revised guidelines for the prevention of poliomyelitis, substantial progress in global eradication of poliomyelitis has occurred. In the United States, the use of inactivated poliovirus vaccine (IPV) has increased considerably with a corresponding decrease in the use of oral poliovirus vaccine (OPV). Surveys indicate that the majority of physicians now routinely immunize children with the sequential IPV-OPV or IPV-only regimens. Nevertheless, vaccine-associated paralytic poliomyelitis (VAPP) continues to occur, albeit infrequently, in children who have received the OPV-only regimen and their contacts. In order to further reduce the risk of VAPP, the Academy now recommends that children in the U.S. receive IPV for the first 2 doses of the polio vaccine series in most circumstances. Either IPV or OPV can be administered for the third and fourth doses. Assuming continuing progress toward global eradication, a recommendation of IPV-only immunization for children in the United States is anticipated by 2001.