Poliomyelitis
Information about polio disease, vaccines and recommendations for vaccination from the Australian Immunisation Handbook
Recently added
This page was added on 28 May 2021.
Updates made
This page was updated on 07 December 2022. View history of updates
Vaccination for certain groups of people is funded under the National Immunisation Program.
Overview
What
Poliomyelitis or polio is an acute illness caused by gastrointestinal infection with 1 of the 3 types of poliovirus. The infection rate in households with susceptible young children can reach 100%.
Who
Inactivated poliovirus (IPV) vaccine or IPV-containing vaccine is recommended for:
- routine vaccination of infants
- routine booster vaccination in adults at higher risk of exposure to polio, such as healthcare workers and laboratory workers who may have contact with polio cases or poliovirus, and travellers to areas or countries where polio is epidemic or endemic
- vaccination of adults who have never received polio vaccine
How
IPV-containing vaccine is recommended for children at 2, 4 and 6 months and 4 years of age.
Vaccination is recommended every 10 years for adults at higher risk of exposure to polio.
Why
The Western Pacific region, including Australia, was declared polio-free in 2000. However, wild poliovirus from endemic countries can still be imported, and vaccination must continue until polio is eradicated around the world.
Recommendations
Infants and children
Inactivated poliovirus (IPV)–containing vaccine is recommended for infants and children in a 4-dose schedule at 2, 4 and 6 months and 4 years of age.
Infants can have their 1st dose of IPV-containing vaccine as early as 6 weeks of age. If the 1st dose of IPV-containing vaccine is given at the age of 6 weeks, infants should still receive their next scheduled doses at 4 and 6 months of age.
The vaccines usually received at each schedule point are:
- 2, 4 and 6 months of age — DTPa-hepB-IPV-Hib (diphtheria-tetanus-acellular pertussis, hepatitis B, inactivated poliovirus, Haemophilus influenzae type b)
- 4 years of age — DTPa-IPV (diphtheria-tetanus-acellular pertussis, inactivated poliovirus)
Infants and children aged <10 years who have not received polio-containing vaccine at the recommended schedule points may need extra doses of vaccine and/or an alternative schedule. Children who only need polio immunisation can receive inactivated poliovirus vaccine for catch-up.
See Catch-up vaccination for more details, including minimum intervals between doses.
View recommendation detailsAdolescents and adults who have never received polio vaccine
All adolescents and adults are recommended to receive 3 doses of inactivated poliovirus (IPV) vaccine or IPV-containing vaccine for primary vaccination. They should receive a 3-dose course if they did not receive polio vaccine in childhood. No adult should remain unvaccinated against polio.
See Catch-up vaccination for more details, including minimum intervals between doses.
View recommendation detailsHealthcare workers
Healthcare workers who may have contact with people with polio are recommended to receive a booster dose of inactivated poliovirus (IPV) vaccine or an IPV-containing vaccine every 10 years. They can receive this vaccine as dTpa-IPV (reduced antigen content diphtheria-tetanus-acellular pertussis-inactivated poliovirus) if they also need protection against other diseases.
View recommendation detailsLaboratory workers
Laboratory workers who may have contact with laboratory specimens that contain poliovirus are recommended to receive a booster dose of inactivated poliovirus (IPV) vaccine or an IPV-containing vaccine every 10 years. They can receive this vaccine as dTpa-IPV if they also need protection against other diseases.
View recommendation detailsTravellers
Travellers to areas or countries where people are infected with polio1 are recommended to receive a booster dose of inactivated poliovirus (IPV) vaccine or an IPV-containing vaccine every 10 years. They can receive this vaccine as dTpa-IPV if they also need protection against other diseases.
See also the World Health Organization International Travel and Health website2 and Vaccination for international travellers.
Travellers do not need documented evidence of polio vaccination under the International Health Regulations (2005).
However, if the World Health Organization recommends vaccination in response to the spread of wild or vaccine-derived poliovirus, countries may temporarily require documentation of vaccination or additional doses of polio vaccine. See Vaccination for international travellers.
View recommendation detailsVaccines, dosage and administration
Polio vaccines available in Australia
The Therapeutic Goods Administration website provides product information for each vaccine.
See also Vaccine information and Variations from product information for more details.
Monovalent vaccines
Registered for use in people aged ≥2 months.
Inactivated poliovirus (IPV) vaccine
Each 0.5 mL monodose pre-filled syringe contains:
- 40 D-antigen units inactivated poliovirus type 1 (Mahoney)
- 8 D-antigen units inactivated poliovirus type 2 (MEF-1)
- 32 D-antigen units inactivated poliovirus type 3 (Saukett)
- 2–3 µL 2-phenoxyethanol
- 2–20 µg formaldehyde
- polysorbate 80
Also contains traces of:
- neomycin
- streptomycin
- polymyxin B
- bovine serum albumin
For Product Information and Consumer Medicine Information about IPOL visit the Therapeutic Goods Administration website.
View vaccine detailsCombination vaccines
Registered as a booster in people aged ≥4 years.
dTpa-IPV — diphtheria-tetanus-acellular pertussis-inactivated poliovirus combination vaccine (reduced antigen formulation)
Each 0.5 mL monodose vial or pre-filled syringe contains:
- ≥2 IU diphtheria toxoid
- ≥20 IU tetanus toxoid
- 2.5 µg pertussis toxoid
- 5 µg filamentous haemagglutinin
- 3 µg pertactin
- 5 µg pertussis fimbriae types 2 and 3
- 40 D-antigen units inactivated poliovirus type 1 (Mahoney)
- 8 D-antigen units inactivated poliovirus type 2 (MEF-1)
- 32 D-antigen units inactivated poliovirus type 3 (Saukett)
- 0.33 mg aluminium as aluminium phosphate
- 0.6% v/v phenoxyethanol
Also contains traces of:
- formaldehyde
- glutaraldehyde
- polysorbate 80
- polymyxin
- neomycin
- streptomycin
For Product Information and Consumer Medicine Information about Adacel Polio visit the Therapeutic Goods Administration website.
View vaccine detailsRegistered as a booster in people aged ≥4 years.
dTpa-IPV — diphtheria-tetanus-acellular pertussis-inactivated poliovirus combination vaccine (reduced antigen formulation)
Each 0.5 mL monodose pre-filled syringe contains:
- ≥2 IU diphtheria toxoid
- ≥20 IU tetanus toxoid
- 8 µg pertussis toxoid
- 8 µg filamentous haemagglutinin
- 2.5 µg pertactin
- 40 D-antigen units inactivated poliovirus type 1 (Mahoney)
- 8 D-antigen units inactivated poliovirus type 2 (MEF-1)
- 32 D-antigen units inactivated poliovirus type 3 (Saukett)
Adsorbed onto 0.5 mg aluminium as aluminium hydroxide hydrate and aluminium phosphate.
Also contains traces of:
- formaldehyde
- polysorbate 80
- polymyxin
- neomycin
For Product Information and Consumer Medicine Information about Boostrix IPV vaccine visit the Therapeutic Goods Administration website.
View vaccine detailsRegistered for use in infants and children aged ≥6 weeks.
DTPa-hepB-IPV-Hib — diphtheria-tetanus-acellular pertussis-hepatitis B-inactivated poliovirus-Haemophilus influenzae type b combination vaccine
Each 0.5 mL monodose pre-filled syringe contains:
- ≥20 IU diphtheria toxoid
- ≥40 IU tetanus toxoid
- 25 µg pertussis toxoid
- 25 µg filamentous haemagglutinin
- 10 µg recombinant hepatitis B surface antigen (HBsAg)
- 40 D-antigen units inactivated poliovirus type 1 (Mahoney)
- 8 D-antigen units inactivated poliovirus type 2 (MEF-1)
- 32 D-antigen units inactivated poliovirus type 3 (Saukett)
- 12 µg purified Hib capsular polysaccharide conjugated to 22–36 µg tetanus toxoid
Adsorbed onto 0.6 mg aluminium as aluminium hydroxide.
May contain traces of:
- glutaraldehyde
- formaldehyde
- neomycin
- streptomycin
- polymyxin B
For Product Information and Consumer Medicine Information about Hexaxim visit the Therapeutic Goods Administration website.
View vaccine detailsRegistered for use in infants and children aged ≥6 weeks.
DTPa-hepB-IPV-Hib — diphtheria-tetanus-acellular pertussis-hepatitis B-inactivated poliovirus-Haemophilus influenzae type b combination vaccine
The vaccine consists of both a 0.5 mL monodose pre-filled syringe and a vial containing a lyophilised pellet.
The pre-filled syringe contains:
- ≥30 IU diphtheria toxoid
- ≥40 IU tetanus toxoid
- 25 µg pertussis toxoid
- 25 µg filamentous haemagglutinin
- 8 µg pertactin
- 10 µg recombinant hepatitis B surface antigen (HBsAg)
- 40 D-antigen units inactivated poliovirus type 1 (Mahoney)
- 8 D-antigen units inactivated poliovirus type 2 (MEF-1)
- 32 D-antigen units inactivated poliovirus type 3 (Saukett)
Adsorbed onto aluminium hydroxide/phosphate.
Also contains traces of:
- formaldehyde
- polysorbate 80
- polysorbate 20
- polymyxin
- neomycin
The vial containing a lyophilised pellet contains:
- 10 µg purified Hib capsular polysaccharide conjugated to 20–40 µg tetanus toxoid
May contain yeast proteins.
For Product Information and Consumer Medicine Information about Infanrix Hexa visit the Therapeutic Goods Administration website.
View vaccine detailsRegistered for primary immunisation in infants aged ≥6 weeks and as a booster in children aged ≤6 years.
DTPa-IPV — diphtheria-tetanus-acellular pertussis-inactivated poliovirus combination vaccine
Each 0.5 mL monodose pre-filled syringe contains:
- ≥30 IU diphtheria toxoid
- ≥40 IU tetanus toxoid
- 25 µg pertussis toxoid
- 25 µg filamentous haemagglutinin
- 8 µg pertactin
- 40 D-antigen units inactivated poliovirus type 1 (Mahoney)
- 8 D-antigen units inactivated poliovirus type 2 (MEF-1)
- 32 D-antigen units inactivated poliovirus type 3 (Saukett)
Adsorbed onto aluminium hydroxide hydrate.
Also contains traces of:
- formaldehyde
- polysorbate 80
- polymyxin
- neomycin
For Product Information and Consumer Medicine Information about Infanrix IPV visit the Therapeutic Goods Administration website.
View vaccine detailsRegistered for primary immunisation in infants aged 2–12 months and as a booster in children aged 15 months to 6 years.
DTPa-IPV — diphtheria-tetanus-acellular pertussis-inactivated poliovirus combination vaccine
Each 0.5 mL monodose vial contains:
- ≥30 IU diphtheria toxoid
- ≥40 IU tetanus toxoid
- 20 µg pertussis toxoid
- 20 µg filamentous haemagglutinin
- 3 µg pertactin
- 5 µg pertussis fimbriae types 2 and 3
- 40 D-antigen units inactivated poliovirus type 1 (Mahoney)
- 8 D-antigen units inactivated poliovirus type 2 (MEF-1)
- 32 D-antigen units inactivated poliovirus type 3 (Saukett)
- 1.5 mg aluminium phosphate
- ≤50 ng bovine serum albumin
- 0.6% v/v phenoxyethanol
Also contains traces of:
- formaldehyde
- glutaraldehyde
- polysorbate 80
- polymyxin
- neomycin
For Product Information and Consumer Medicine Information about Quadracel visit the Therapeutic Goods Administration website.
View vaccine detailsDose and route
The dose of IPOL is 0.5 mL given by subcutaneous injection. If IPOL is accidentally given intramuscularly, do not repeat the dose.
The dose of inactivated poliovirus (IPV)–containing combination vaccines is 0.5 mL given by intramuscular injection.
Co-administration with other vaccines
People can receive IPV-containing combination vaccines at any time before or after, or with, most other vaccines.
Interchangeability of oral and IPV vaccines
Oral polio vaccine (OPV) is no longer used in Australia.
OPV and IPV vaccine are interchangeable.
Children who started their polio vaccination schedule with OPV should finish it with IPV vaccine or an IPV-containing vaccine.3
Contraindications and precautions
Contraindications
The only absolute contraindications to inactivated poliovirus (IPV) vaccine or IPV-containing vaccine are:
- anaphylaxis after a previous dose of any IPV-containing vaccine
- anaphylaxis after any component of an IPV-containing vaccine
Precautions
IPV vaccine or IPV-containing vaccine are not routinely recommended for pregnant or breastfeeding women. However, pregnant or breastfeeding women can receive these vaccines if necessary.
See Vaccination for women who are planning pregnancy, pregnant or breastfeeding, and Table. Vaccines that are not routinely recommended in pregnancy: inactivated viral vaccines for more details.
Adverse events
Inactivated poliovirus (IPV) vaccine is a very well tolerated vaccine.
The most common adverse events in infants who receive IPV vaccine are:3
- erythema (in 0.5–1.5% of vaccine recipients)
- pain (in 14–29%)
- induration at the injection site (in 3–11%)
An extensive review of adverse events associated with polio vaccination suggested that no serious adverse events have been associated with the use of IPV vaccine in countries that use this vaccine.4
Repeat doses of IPV vaccine or IPV-containing vaccine are not associated with increased adverse events. Extra doses are safe, if needed.
Nature of the disease
Polioviruses are RNA enteroviruses from the family Picornaviridae.5 They can live transiently in the gastrointestinal tract.
There are 3 poliovirus serotypes: type 1, type 2 and type 3.
Polio is an acute illness caused by gastrointestinal infection with 1 of the 3 types of poliovirus. The virus enters through the mouth, multiplies in the pharynx and gut, and is excreted in faeces for several weeks. The virus invades local lymphoid tissue, enters the bloodstream, and may then infect and replicate in cells of the central nervous system.6
Polio has an incubation period of 3–21 days. People are most infectious from 7–10 days before symptoms start to 7–10 days after symptoms start.
Transmission is by the faecal–oral and, occasionally, the oral–oral route.7
Clinical features
Infection may:
- be asymptomatic
- result in a systemic illness
- cause paralytic polio
Symptoms of polio
If symptoms occur, they may include:
- headache
- gastrointestinal disturbance
- malaise
- stiffness of the neck and back (which suggests meningitis)
- paralysis (called paralytic polio), which is usually asymmetrical
The infection rate in households with susceptible young children can reach 100%.
Complications of polio
Paralytic polio is a complication of poliovirus meningitis, and may be:
- spinal (79%)
- bulbar (2%)
- bulbospinal (19%)
The ratio of asymptomatic infection to paralytic disease may be as high as 1000:1 in children and 75:1 in adults. The ratio depends on the poliovirus type, and on social and environmental conditions.8
The case-fatality rate for paralytic polio is 2–5% in children and 15–30% in adults. The case-fatality rate in bulbar polio is up to 75%.6
Post-polio syndrome is a complex of neuromuscular symptoms that occurs in 25–40% of people who survive paralytic polio. It typically occurs 15 years or more after the acute illness. Post-polio syndrome is diagnosed based on clinical signs and symptoms that include muscle weakness and muscle pain.9
Vaccine-associated paralytic polio from OPV
People given oral polio vaccine (OPV) can shed the oral vaccine virus in their faeces for up to 6 weeks after 1 dose,6 or for several years if they are immunocompromised.
Oral vaccine strains that are shed for many years or that infect people who are immunocompromised may mutate into neurovirulent strains.10-15
OPV causes disease in approximately 1 in 2.9 million people who receive the vaccine.9 The clinical features of vaccine-associated paralytic polio are usually similar to those caused by wild-type (naturally occurring) poliovirus and can include paralytic polio.
Epidemiology
Polio in Australia
Polio incidence fell dramatically from the early 1960s in Australia and worldwide.16
The most recent laboratory-confirmed case of polio caused by wild-type poliovirus in Australia was in 2007. This case was in an overseas-born student who acquired the disease during a visit to Pakistan.17 Before this, the last case of wild-type polio was in a person who arrived from Turkey in 1977.18,19
IPV vaccine is used for all polio vaccinations in Australia. This is because of the rapid progress in global polio eradication and the diminished risk of wild-type polio.1,20 The advantage of using IPV vaccine is that it cannot cause vaccine-associated paralytic polio.21
Polio in other countries
The World Health Organization’s intensified Global Polio Eradication Initiative has dramatically reduced the incidence of polio worldwide.22 Several regions have been certified free from polio:
- North America and South America in 199423
- the Western Pacific region (including Australia) in 200024
- the European region in 200225
- the Southeast Asian region in 201426
A few countries in Africa and Asia still have poliovirus transmission, but disease incidence is low. In these countries, polio cases are seen sporadically or as outbreaks among non-vaccinated people.
Vaccine-associated paralytic polio from OPV
Oral polio vaccine can be associated with:27,28
- emergence of highly evolved vaccine-derived polioviruses (VDPVs) in people with primary immunodeficiency and long-term excretion
- polio outbreaks due to circulating VDPVs, particularly in areas with low vaccine coverage27,28
Vaccine information
Inactivated poliovirus (IPV) vaccine and IPV-containing combination vaccines contain polioviruses of types 1, 2 and 3 inactivated by formaldehyde.
Immunogenicity in children
In early clinical studies of infants who received 3 doses of IPV vaccine, nearly 100% of infants formed serum neutralising antibodies to all polio types.29 Follow-up data for these children showed that 3 doses of IPV vaccine conferred immunity for at least 4 years and produced a strong immune response after challenge with oral polio vaccine.30
A randomised multicentre trial compared the hexavalent and pentavalent IPV-containing vaccines. Infants who received either vaccine at 2, 4 and 6 months of age had seroprotective levels of antibody to poliovirus types 1, 2 and 3.31
Immunogenicity in adults
A randomised controlled trial among adolescents and adults ≥14 years of age compared immunogenicity of various vaccine formulations containing dTpa, dT and IPV. Almost all study participants (99–100%) showed seroprotection to all poliovirus types after receiving an IPV-containing vaccine, regardless of their vaccination history.32
A follow-up study showed that 74% of participants had seroprotective antibody levels 10 years after the initial vaccination. After a booster dose, 98–100% of adults had seroprotective antibody levels for all poliovirus types.33
Transporting, storing and handling vaccines
Transport according to National Vaccine Storage Guidelines: Strive for 5.34 Store at +2°C to +8°C. Do not freeze. Protect from light.
Infanrix hexa vaccine must be reconstituted. Add the entire contents of the syringe to the vial and shake until the pellet completely dissolves. Use the reconstituted vaccine as soon as practicable. If it needs to be stored, hold at room temperature for no more than 8 hours.
Public health management
Polio is a notifiable disease in all states and territories in Australia.
State and territory public health authorities can provide advice about the public health management of polio, including management of cases and contacts.
Variations from product information
Routine vaccination
Infanrix hexa
The product information for Infanrix hexa states that this vaccine is for:
- primary immunisation of infants from the age of 6 weeks
- booster dose for children 18 months of age if they need boosting for all antigens
The Australian Technical Advisory Group on Immunisation (ATAGI) recommends that Infanrix hexa may also be used for catch-up of the primary schedule or as a booster in children <10 years of age.
Infanrix IPV
The product information for Infanrix IPV states that this vaccine is for:
- use in a 3-dose primary schedule for immunisation of infants from the age of 6 weeks
- a single booster dose for children ≤6 years of age who have previously been vaccinated against diphtheria, tetanus, pertussis and polio
ATAGI recommends that Infanrix IPV may also be used for catch-up of the primary schedule or as a booster in children <10 years of age.
Quadracel
The product information for Quadracel states that this vaccine is for:
- use in a 3-dose primary schedule from the age of 2 months to 12 months
- a booster dose for children from 15 months to 6 years of age who have previously been vaccinated against diphtheria, tetanus, pertussis and polio
ATAGI recommends that Quadracel may also be used for catch-up of the primary schedule or as a booster in children <10 years of age. ATAGI also recommends that the primary schedule can start at 6 weeks of age.
Adacel Polio, Boostrix and Boostrix-IPV
The product information for Adacel Polio, Boostrix and Boostrix-IPV states that vaccine is for use in people aged ≥4 years for booster doses only.
ATAGI recommends that Adacel Polio, Boostrix and Boostrix-IPV should not be used in people aged <10 years, except in certain circumstances.
Vaccination after tetanus-containing vaccines
The product information for Boostrix-IPV states that people should not receive dTpa-containing vaccine within 5 years of a tetanus-containing vaccine.
ATAGI recommends that, if the person needs protection against pertussis, they can receive dTpa-containing vaccine at least 4 weeks after a dT-containing vaccine.
Contraindications
The product information for all polio-containing vaccines except IPOL states that these vaccines are contraindicated in children with either:
- encephalopathy of unknown aetiology, or
- neurologic complications occurring within 7 days after a vaccine dose
ATAGI recommends that the only contraindications are:
- history of anaphylaxis to a previous dose
- history of anaphylaxis to any of the vaccine components
References
- World Health Organization (WHO). Polio vaccines: WHO position paper – March, 2016. Weekly Epidemiological Record 2016;91:145-68.
- World Health Organization (WHO). International travel and health. (Accessed Apr 2018).
- Vidor E. Poliovirus vaccine – inactivated. In: Plotkin SA, Orenstein WA, Offit PA, Edwards KM, eds. Plotkin's vaccines. 7th ed. Philadelphia, PA: Elsevier; 2018.
- Institute of Medicine. Polio vaccines. In: Stratton KR, Howe CJ, Johnston RB, Jr., eds. Adverse events associated with childhood vaccines: evidence bearing on causality. Washington, DC: National Academy Press; 1994.
- Drutz JE, Ligon BL. Polio: its history and its eradication. Seminars in Pediatric Infectious Diseases 2000;11:280-6.
- Centers for Disease Control and Prevention (CDC). Poliomyelitis. In: Hamborsky J, Kroger A, Wolfe C, eds. Epidemiology and prevention of vaccine-preventable diseases. 13th ed. Washington, DC: Public Health Foundation; 2015.
- World Health Organization (WHO). Introduction of inactivated poliovirus vaccine into oral poliovirus vaccine-using countries: WHO position paper. Weekly Epidemiological Record 2003;78:241-50.
- Centers for Disease Control and Prevention (CDC). Poliomyelitis. In: Atkinson W, Wolfe C, Hamborsky J, eds. Epidemiology and prevention of vaccine-preventable diseases. 12th ed. Washington, DC: Public Health Foundation; 2011.
- Sutter RW, Kew OM, Cochi SL, Aylward RB. Poliovirus vaccine – live. In: Plotkin SA, Orenstein WA, Offit PA, Edwards KM, eds. Plotkin's vaccines. 7th ed. Philadelphia, PA: Elsevier; 2018.
- Kew OM, Sutter RW, Nottay BK, et al. Prolonged replication of a type 1 vaccine-derived poliovirus in an immunodeficient patient. Journal of Clinical Microbiology 1998;36:2893-9.
- Bellmunt A, May G, Zell R, et al. Evolution of poliovirus type I during 5.5 years of prolonged enteral replication in an immunodeficient patient. Virology 1999;265:178-84.
- Kew OM, Wright PF, Agol VI, et al. Circulating vaccine-derived polioviruses: current state of knowledge. Bulletin of the World Health Organization 2004;82:16-23.
- MacLennan C, Dunn G, Huissoon AP, et al. Failure to clear persistent vaccine-derived neurovirulent poliovirus infection in an immunodeficient man. The Lancet 2004;363:1509-13.
- Kimman TG, Koopmans MP, van der Avoort HG. Ending polio immunization: when and how are we sure that the needle is out of the haystack? Vaccine 1999;17:624-7.
- Martín J, Odoom K, Tuite G, et al. Long-term excretion of vaccine-derived poliovirus by a healthy child. Journal of Virology 2004;78:13839-47.
- D'Souza RM, Kennett M, Watson C. Australia declared polio free. Communicable Diseases Intelligence 2002;26:253-60.
- Stewardson AJ, Roberts JA, Beckett CL, et al. Imported case of poliomyelitis, Melbourne, Australia, 2007. Emerging Infectious Diseases 2009;15:63-5.
- Burgess MA, McIntyre PB. Vaccine-associated paralytic poliomyelitis. Communicable Diseases Intelligence 1999;23:80-1.
- Kennett ML, Brussen KA, Wood DJ, et al. Australia's last reported case of wild poliovirus infection. Communicable Diseases Intelligence 1999;23:77-9.
- Chiu C, Dey A, Wang H, et al. Vaccine preventable diseases in Australia, 2005 to 2007. Communicable Diseases Intelligence 2010;34 Suppl:ix-S167.
- Alexander LN, Seward JF, Santibanez TA, et al. Vaccine policy changes and epidemiology of poliomyelitis in the United States. JAMA 2004;292:1696-701.
- Morales M, Tangermann RH, Wassilak SG. Progress toward polio eradication – worldwide, 2015–2016. MMWR. Morbidity and Mortality Weekly Report 2016;65:470-3.
- Centers for Disease Control and Prevention (CDC). Certification of poliomyelitis eradication – the Americas, 1994. MMWR. Morbidity and Mortality Weekly Report 1994;43:720-2.
- World Health Organization (WHO). Certification of poliomyelitis eradication. WHO Western Pacific Region, October 2000. Weekly Epidemiological Record 2000;75:399-400.
- World Health Organization (WHO). Certification of poliomyelitis eradication. European region, June 2002. Weekly Epidemiological Record 2002;77:221-3.
- World Health Organization (WHO). Polio-free certification of the WHO South-East Asia Region, March 2014. Weekly Epidemiological Record 2014;89:500-4.
- Centers for Disease Control and Prevention (CDC). Update on vaccine-derived polioviruses – worldwide, January 2008–June 2009. MMWR. Morbidity and Mortality Weekly Report 2009;58:1002-6.
- Kew OM, Sutter RW, de Gourville EM, Dowdle WR, Pallansch MA. Vaccine-derived polioviruses and the endgame strategy for global polio eradication. Annual Review of Microbiology 2005;59:587-635.
- Faden H, Modlin JF, Thoms ML, et al. Comparative evaluation of immunization with live attenuated and enhanced-potency inactivated trivalent poliovirus vaccines in childhood: systemic and local immune responses. Journal of Infectious Diseases 1990;162:1291-7.
- Faden H, Duffy L, Sun M, Shuff C. Long-term immunity to poliovirus in children immunized with live attenuated and enhanced-potency inactivated trivalent poliovirus vaccines. Journal of Infectious Diseases 1993;168:452-4.
- Arístegui J, Dal-Ré R, Díez-Delgado J, et al. Comparison of the reactogenicity and immunogenicity of a combined diphtheria, tetanus, acellular pertussis, hepatitis B, inactivated polio (DTPa-HBV-IPV) vaccine, mixed with the Haemophilus influenzae type b (Hib) conjugate vaccine and administered as a single injection, with the DTPa-IPV/Hib and hepatitis B vaccines administered in two simultaneous injections to infants at 2, 4 and 6 months of age. Vaccine 2003;21:3593-600.
- Grimprel E, von Sonnenburg F, Sänger R, et al. Combined reduced-antigen-content diphtheria–tetanus–acellular pertussis and polio vaccine (dTpa-IPV) for booster vaccination of adults. Vaccine 2005;23:3657-67.
- Kovac M, Rathi N, Kuriyakose S, Hardt K, Schwarz TF. Immunogenicity and reactogenicity of a decennial booster dose of a combined reduced-antigen-content diphtheria-tetanus-acellular pertussis and inactivated poliovirus booster vaccine (dTpa-IPV) in healthy adults. Vaccine 2015;33:2594-601.
- National vaccine storage guidelines: Strive for 5. 3rd ed. Canberra: Australian Government Department of Health and Ageing; 2019. https://www.health.gov.au/resources/publications/national-vaccine-storage-guidelines-strive-for-5
Page history
Update to remove guidance on co-administration with MenACWY vaccine.
Minor editorial corrections.
Guidance on co-administration of IPV-containing vaccines with other vaccines, including quadrivalent meningococcal vaccines, has been added.
Changes to 4.14.4 Vaccines and 4.14.12 Variations from product information.
4.14.4 Vaccines and 4.14.12 Variations from product information
Amendment of text due to the discontinuation of a vaccine type, Pediacel. (Refer also to Chapters, 4.2 Diphtheria, 4.3 Haemophilus influenzae type b, 4.12 Pertussis and 4.19 Tetanus).
Update to remove guidance on co-administration with MenACWY vaccine.
Minor editorial corrections.
Guidance on co-administration of IPV-containing vaccines with other vaccines, including quadrivalent meningococcal vaccines, has been added.
Changes to 4.14.4 Vaccines and 4.14.12 Variations from product information.
4.14.4 Vaccines and 4.14.12 Variations from product information
Amendment of text due to the discontinuation of a vaccine type, Pediacel. (Refer also to Chapters, 4.2 Diphtheria, 4.3 Haemophilus influenzae type b, 4.12 Pertussis and 4.19 Tetanus).