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polio virus vaccine,live, trivalent, oral (Orimune, OPV, Sabin vaccine, TOPV)

Indications: - active immunization against poliovirus Contraindications: 1) persistent vomiting or diarrhea 2) allergy to sorbitol, streptomycin or neomycin 3) hypersensitivity to inactivated poliovirus vaccine 4) immmunodeficiency [2] Caution: - the vaccine will not modify or prevent exsisting or incubating poliomyelitis pregnancy-category C safety in lactation ? Dosage: Infants: 1) 0.5 mL dose at 2, 4 & 18 months of age 2) optional dose at 6 months where poliovirus is endemic Older children, adolescents & adults: 1) two 0.5 mL doses 8 weeks apart 2) 3rd dose 6-12 months after 2nd dose 3) reinforcing dose of 0.5 mL should be given before entry to school in children who have received 3rd primary dose before their 4th birthday Oral: - trivalent vaccine: - mixture of type 1, 2 & 3 viruses growth in monkey kidney tissue, 0.5 mL - bivalent vaccine: - type 2 has not been detected since 1999, & its elimination confirmed in September 2015 - mixture of type 1 & 3 viruses [3] Adverse effects: - vaccine-derived type-2 poliomyelitis with Sabin OPV2 vaccine* [5] - all serious adverse reactions must be reported to the the Vaccine Adverse Event Reporting System (800-822-7967) * 2 new oral poliomyelitis virus type 2 vaccines (OPV2-c1 & OPV2-c2) designed to be less likely to revert to neurovirulence [5] Drug interactions: 1) may temporarily suppress tuberculin skin reactivity (4-6 weeks) 2) immunosuppressive agents 3) immune globulin Notes: - wild poliovirus cases have declined by >99.9%, from ~350,000 cases/year to 74 cases in 2 countries in 2015 [4] - decline primarily via use of trivalent oral poliovirus vaccine [4]

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polio virus

General

poliovirus vaccine live virus vaccine

References

  1. Kaiser Permanente Northern California Regional Drug Formulary, 1998
  2. Trimble R et al Vaccine-Associated Paralytic Poliomyelitis and BCG-osis in an Immigrant Child with Severe Combined Immunodeficiency Syndrome - Texas, 2013 MMWR Weekly, August 22, 2014 / 63(33);721-724 http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6333a1.htm
  3. Friedrich MJ Switch From Trivalent to Bivalent Oral Polio Vaccine. JAMA. 2016;315(23):2513. PMID: 27327789 http://jama.jamanetwork.com/article.aspx?articleID=2529641
  4. Marin M, Patel M, Oberste S, Pallansch MA. Guidance for Assessment of Poliovirus Vaccination Status and Vaccination of Children Who Have Received Poliovirus Vaccine Outside the United States. MMWR Morb Mortal Wkly Rep 2017;66:23-25
  5. De Coster I et al. Safety and immunogenicity of two novel type 2 oral poliovirus vaccine candidates compared with a monovalent type 2 oral poliovirus vaccine in healthy adults: Two clinical trials. Lancet 2020 Dec 9. PMID: 33308429 Free article https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)32541-1/fulltext