Article Text

Polio vaccine: is it time for a change?
  1. D M SALISBURY
  1. Medical Secretary to the Joint Committee on Vaccination and Immunisation, Department of Health, Wellington House, 133-155 Waterloo Road
  2. London SE1 8UG, UK

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    Editor,—The arguments against and for the continued use of live attenuated oral polio vaccine (OPV) put forward by Finn and Bell1 and Heath et al in their ensuing commentary had previously been considered carefully by the Joint Committee on Vaccination and Immunisation. The committee came down on the side of Heath et al,recommending the continuing use of OPV.

    Finn and Bell suggest the introduction of Salk inactivated polio vaccine (IPV) as an opportunity to harmonise immunisation schedules in Europe and, by implication, are suggesting that we should lengthen the intervals between immunisation to two months, thereby immunising with diphtheria, tetanus, pertussis, Haemophilus influenzae type b, and IPV at 2, 4, and 6 months of age. This might lead to the prevention of one to two cases of vaccine associated paralytic poliomyelitis each year, but any such gain would be offset against the possibility of an increase in deaths from pertussis, and possibly Haemophilus influenzae type b infection, as later immunisation would leave children vulnerable to these diseases for longer than afforded with the present immunisation schedule.

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