Which Adults Need Polio Boosters

The U.S. Centers for Disease Control and Prevention (CDC) vaccine advisory committee is discussing how to make the current polio vaccination recommendations easier to understand.

On February 23, 2023, Sarah Kidd, M.D., MPH, presented to the Advisory Committee on Immunization Practices (ACIP) proposed language for adult polio vaccinations in the U.S.

The CDC's current recommendations for Inactivated Polio Vaccine (IPV) for adults originated in 2000 and focus on those at increased risk of poliovirus exposure. However, it remains unclear when or if a booster was advised.

Dr. Kidd presented the ACIP members with two questions to consider, which are as follows:

1. Should the completion of a primary polio vaccination series with IPV be recommended for unvaccinated and incompletely vaccinated adults in the U.S.?
2. Should a booster IPV dose be recommended for adults who have previously completed a primary polio vaccination series?

While there are various pros and cons related to answering these questions, the ACIP is reviewing this proposed language:

• Adults who have received a primary series of tOPV or IPV in any combination and are at increased risk of poliovirus exposure may receive another dose of IPV. However, available data do not indicate the need for more than a single lifetime booster dose with IPV for adults.

This debate is very relevant today for two reasons.

In 2022, the greater New York City area reported over 100 wastewater samples were confirmed with a type of poliovirus related to one polio case in Rockland County, New York.

Furthermore, poliovirus was detected in London, Canada, and Israel wastewater systems.

Additionally, the CDC recently renewed and expanded its Alert - Level 2, Practice Enhanced Precautions regarding polio outbreaks and the continued detections of poliovirus in about 20 countries, including the Americas.

The Pan American Health Organization recently published its summary of polio cases for 2022.

On February 21, 2023, the CDC stated before traveling to any at-risk destination, it recommends that adults who previously completed the routine polio vaccine series receive a single, lifetime booster dose of polio vaccine.

This week's debate is essential as polio is a crippling and potentially deadly disease that affects the nervous system. And the virus that causes polio lives in the feces of an infected person and can spread to others. 

The good news is polio is a vaccine-preventable disease, says the CDC. Approved polio vaccines are generally available in clinics and pharmacies in the U.S.

Recently, a new polio vaccine was deployed internationally.

Approximately 585 million doses of the nOPV2 polio vaccine have been administered across 27 countries, with 14 additional countries pending as of February 26, 2023.