Do Kids Need an Extra Oral Polio Vaccine After 5-in-1 Shot?

Regarding the five-in-one vaccine issue?

Hello Dr.
Lin,
My son is 2.2 years old and has completed all doses of the pentavalent vaccine.
However, I recently saw news reports suggesting that children who receive the pentavalent vaccine should also receive a booster of the oral polio vaccine.
I inquired at the clinic, and they said it is not necessary.
Is this true? Could there be any issues? If a booster is needed, where should I go to get it? Thank you.

ann, 30~39 year old female. Ask Date: 2005/11/10

Dr. Lin Huizhen reply Pediatrics

Dear ANN,
This is Dr.
Lin Huizhen from the Pediatric Department of Tainan Hospital, Ministry of Health and Welfare.

Currently, there are two types of poliovirus vaccines available: 1.
Oral Polio Vaccine (OPV) and Inactivated Polio Vaccine (IPV).
The IPV is included in the pentavalent and hexavalent vaccines available in the country.
2.
If these two vaccines are administered according to the recommended vaccination schedule and dosage, they can effectively prevent poliovirus infection in individuals.
3.
The greatest advantage of OPV is that it can be excreted through feces after oral administration, allowing for indirect immunity in contacts and achieving herd immunity.
Additionally, it helps establish intestinal immunity to prevent the replication and excretion of wild-type viruses.
Although IPV provides sufficient protection for the vaccinated infants against infection, it does not maintain long-term gastrointestinal immunity to block the transmission and excretion of poliovirus.
4.
Despite Taiwan being a polio-free region, areas such as Africa and India have not eradicated the virus, and wild-type viruses still exist.
Recently, there have been outbreaks of poliovirus in Yemen and Indonesia, which poses a risk of reintroduction of poliovirus into Taiwan and endangers public health.
5.
To enhance herd immunity and for preventive considerations, the Advisory Committee on Immunization Practices recommends maintaining the routine vaccination policy for OPV at 2, 4, 6, and 18 months of age, and in the first grade of elementary school.
Additionally, for children who have received two or more doses of IPV or IPV-containing combination vaccines, at least two additional doses of OPV should be administered in conjunction with the schedule for other vaccines.
A third dose of OPV should also be given in the first grade of elementary school according to the routine vaccination schedule.
If parents wish to catch up on vaccinations, they can visit local health centers or hospitals and should call ahead for inquiries.
The Pediatric Department of Tainan Hospital cares about you.

Reply Date: 2005/11/10

More Info

The question of whether children need an extra oral polio vaccine (OPV) after receiving the 5-in-1 vaccine is an important one for parents to consider. The 5-in-1 vaccine typically includes protection against five diseases: diphtheria, tetanus, pertussis (whooping cough), hepatitis B, and Haemophilus influenzae type b (Hib). However, it does not provide the same type of immunity against poliovirus as the oral polio vaccine (OPV) does.

According to health authorities, including the Centers for Disease Control and Prevention (CDC) and various pediatric health organizations, the polio vaccination strategy can involve two types of vaccines: the inactivated polio vaccine (IPV) and the oral polio vaccine (OPV). IPV is included in the 5-in-1 vaccine, which provides strong individual protection against polio. However, IPV does not induce the same level of intestinal immunity that OPV does, which is crucial for preventing the transmission of the virus in the community.

In regions where polio has been eradicated, such as Taiwan, the risk of polio is significantly lower, but there are still concerns about the potential for the virus to be reintroduced from areas where it is still endemic. Recent outbreaks in countries like Yemen and Indonesia highlight the importance of maintaining high levels of immunity within the population to prevent any resurgence of the disease.

The recommendation from health authorities is that children who have received two or more doses of IPV (as part of the 5-in-1 vaccine) should also receive additional doses of OPV to enhance community immunity and provide a broader protective effect. This is particularly important for children who are at risk of exposure to the virus, either through travel or contact with individuals from regions where polio is still present.

If you are considering whether your child should receive an additional OPV dose, it is advisable to consult with your pediatrician or local health department. They can provide guidance based on your child's vaccination history and the current public health recommendations. In many cases, OPV can be administered at local health clinics or hospitals, and it is a straightforward process.

In summary, while the 5-in-1 vaccine provides essential protection against polio through IPV, it is recommended to supplement this with OPV to ensure both individual and community immunity against poliovirus. This is especially relevant in light of global health dynamics and the potential for polio to re-emerge. Always consult with healthcare professionals to make informed decisions regarding vaccinations for your child.

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