Routine Polio Vaccination

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Infants and Children

CDC recommends that children in the United States receive inactivated poliovirus vaccine (IPV) to protect against polio, or poliomyelitis, as part of their routine immunizations. IPV is given by injection in the leg or arm, depending on the person’s age. It can be given at the same time as other vaccines.

Children get four doses of IPV, with one dose at each of these ages:

  • 2 months
  • 4 months
  • 6 through 18 months
  • 4 through 6 years

A single-antigen vaccine called IPOL is licensed in the U.S. for active immunization of infants (as young as 6 weeks of age), children, and adults for the prevention of poliomyelitis caused by poliovirus types 1, 2, and 3. Several combination vaccines licensed in the U.S. also contain IPV, including Pentacel (DTaP-IPV/Hib), Pediarix (DTaP-IPV-HepB), Kinrix (DTaP-IPV), VAXELIS (DTaP-IPV-Hib-HepB), or Quadracel (DTaP-IPV). Children getting these vaccines might get one more (fifth) dose of IPV. It is safe for children to get a fifth dose of IPV. For more information about using these combination vaccines, please refer to You Call the Shots: Vaccines Web-based Training Course | CDC.

Children who have not started their polio vaccination series or who are delayed in getting all recommended doses should start right away or finish their series by following the recommended catch-up schedule.

Accelerated Schedule for Children Traveling Outside the U.S.

Children who will be traveling to a country where the risk of getting polio is greater should complete the series before leaving for their trip. If a child cannot complete the routine series before leaving, an accelerated schedule is recommended as follows:

  • One dose at age 6 weeks or older
  • A second dose 4 or more weeks after the first dose
  • A third dose 4 or more weeks after the second dose
  • A fourth dose 6 or more months after the third dose

If the accelerated IPV schedule cannot be completed before leaving, the remaining doses should be given in the visited country, or upon returning home, at the intervals recommended. In addition, children completing the accelerated schedule should still receive a dose of IPV at 4 years old or older, as long as it has been at least 6 months after the last dose.

Children and Adults Vaccinated Outside the U.S.

CDC recommends that children and adults who may have received poliovirus vaccination outside the U.S. should meet the U.S. recommendation for poliovirus vaccination that includes protection against all three poliovirus types.

Notes about OPV doses

In April 2016, all countries that were still using OPV stopped using trivalent OPV (tOPV) and switched to using bivalent OPV (bOPV) in routine immunization. If a person only received bOPV, they are not vaccinated against type 2 poliovirus, and they need to complete an IPV 3- or 4- dose series depending on their age to be fully protected. OPV doses administered after April 1, 2016 should not be counted as tOPV doses unless written documentation specifies that the dose was tOPV.

Notes about fractional IPV doses

For people who received fractional (1/5 full dose) IPV administered intradermally outside of the U.S., 2 fractional doses of IPV (fIPV) should be considered valid and counted as 1 full intramuscular dose of IPV towards the U.S. vaccination schedule. If a person received only 1 dose of fIPV, this dose should not be considered valid or counted towards the U.S. vaccination schedule. The following countries include 2 fractional doses of IPV as part of their routine immunization schedule:

  • Bangladesh
  • Cuba
  • Ecuador
  • India
  • Nepal
  • Sri Lanka

IPV doses administered in these countries and recorded as “IPV” should be assumed to be fractional IPV doses, not full IPV doses.

Children and adolescents

If documentation is available and shows administration of age-appropriate vaccination with either IPV or trivalent OPV (tOPV), then the person is considered fully vaccinated. Children with no or questionable documentation of poliovirus vaccination should be revaccinated according to the U.S. schedule with the age appropriate IPV. For more information see Catch-up Vaccination here: Birth-18 Years Immunization Schedule | CDC.

Adults

For people age 18 years and older, verbal reports of previous polio vaccination administered outside the U.S. can be accepted unless the clinician has specific reasons to believe the patient was not vaccinated such as they did not receive consistent medical care as an infant, parents were against vaccination, or the person has other reason to doubt their vaccination status. For more information see Adult Immunization Schedule by Age | CDC

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