Health Officials Call for the Virtual Elimination of Live Polio Vaccine
"After the sequential schedule began, it cut down the use of the oral vaccine by half, and that cut the number of cases [of polio] by about half, so that rationale [for wholesale change] has been speaking for itself," says Marcuse.
According to the CDC, there were 5 confirmed cases of vaccine-associated polio in 1997 and 1 case in 1998. "There is hope that within the next decade we can eliminate polio vaccines altogether as the disease nears eradication," says Marcuse.
Even though the oral polio vaccine is a stronger guard against polio, health officials no longer believe the need to fight the disease is worth the risk as the prevalence of the polio has virtually disappeared in the U.S.
"It's hard to justify using a vaccine that could, although rarely, lead to a risk of polio as the risk of importation and epidemic has fallen," says CDC epidemiologist Rebecca Prevots, PhD.
"Given a painful shot with no risk or a painless drop with small risk, most parents are already choosing the shot," pediatrician Marc Tanenbaum, MD, tells WebMD. "I tell parents there is a four in 10 million chance of contracting the disease with the first oral dose but that's usually enough." Tanenbaum is with Pediatrics and Adolescent Medicine, a group practice in Atlanta.
Tanenbaum says that he will keep his current stock of oral vaccine in cases of parent preference. "I'm comfortable with the risk of the oral vaccine and none of us like shots, but I know it's in the child's best interest."
The AAP recommendations support keeping the oral vaccine in stock for cases in which the stronger vaccine will be necessary, such as when unvaccinated children are traveling within four weeks to countries where the disease still exists.
Marcuse says that although the injectable vaccine is weaker, it is more than adequate for domestic use. "The newer injectables are enhanced inactivated polio vaccines, and we have every reason to believe will provide durable immunity that will almost certainly be lifelong."