Prevention of poliomyelitis: Recommendations for use of only inactivated poliovirus vaccine for routine immunization

Since 1997, when the American Academy of Pediatrics (AAP) initially recommended expanded use of inactivated poliovirus vaccine (IPV) for routine childhood immunization against poliovirus infection, the occurrence of vaccine-associated paralytic poliomyelitis (VAPP) has decreased in the United States. However, VAPP will not be eliminated until oral poliovirus vaccine (OPV) no longer is given. As a result of continuing progress toward global eradication of poliomyelitis, the risk of imported infection has continued to decrease. Concomitantly, the use of IPV has increased substantially with the corresponding decrease in the use of OPV, indicating widespread acceptance by health care professionals and parents of the sequential or all-IPV immunization schedule previously recommended by the AAP. In addition, availability of OPV will be substantially diminished beginning in early 2000. To eliminate VAPP in the context of decreasing risk of wild-type poliovirus importation, the AAP recommends an all-IPV schedule for routine childhood immunization beginning in early 2000. The AAP further recommends that, effective immediately, OPV no longer should be purchased for routine use. Guidelines are given for utilization of remaining supplies of OPV during the transition in early 2000 to the all-IPV schedule.