Poliomyelitis vaccine (IPV and OPV) !
Two types: inactivated injectable vaccine (IPV) and live oral vaccine (OPV). OPV gives gut immunity; IPV cannot cause vaccine-derived polio.
Updated 2026-11-01
Also called: IPV (inactivated poliovirus vaccine), OPV, bOPV (oral poliovirus vaccine, Sabin), Hexavalent (combination)
The figure shows the capsid of poliovirus type 1 (Mahoney strain), the type 1 strain used in inactivated vaccine; antibodies against the capsid neutralise the virus.
Mechanism of action
There are three poliovirus types and immunity to one barely protects against the others. IPV contains killed virus of the three types: it raises blood antibodies that prevent paralysis but gives less gut immunity. OPV contains live attenuated (Sabin) strains: it replicates in the gut, induces local immunity that cuts shedding and transmission, and spreads to contacts. Rarely, OPV causes vaccine-associated paralytic polio, or its strains revert and circulate in poorly vaccinated communities (cVDPV).
- IPV: killed virus induces blood antibodies against all three types
- OPV: live Sabin strains multiply in the gut and induce mucosal IgA
- Gut immunity reduces shedding and transmission of wild virus
- Rarely, OPV strains revert to neurovirulence (VAPP, cVDPV)
Pharmacokinetics
- Elimination
- OPV vaccine virus is shed in stool for weeks, which can expose contacts
Indications
- Routine childhood prevention of poliomyelitis (IPV alone or in combination, with or without bOPV depending on the national schedule)
- Outbreak response and eradication campaigns (OPV)
Adverse effects
Common
- IPV: mild local pain, redness and induration
- OPV: usually none
Contraindications
- Severe allergic reaction to a previous dose or a component (IPV carries traces of neomycin, streptomycin and polymyxin B)
- OPV: immunodeficiency in the child or household contacts (IPV is used)
Key interactions
- Immunosuppressive therapy or B-cell immunodeficiency
- Much higher risk of paralysis from live OPV: only IPV is used
What is monitored
- Series complete for age
- Acute flaccid paralysis in any child is reported to surveillance
Administration and safety
- IPV: intramuscular or subcutaneous injection, often within a hexavalent vaccine
- OPV: oral drops; do not confuse with injectable products
- Check which product the national schedule calls for at each contact
- Record the batch and product
Nursing care
- Ask about immunodeficiency in the child and in household contacts before OPV
- Teach hand washing after nappy changes for weeks after OPV
- Check the card for the full series
- Report any acute flaccid paralysis
Pregnancy and breastfeeding
Vaccination is generally avoided in pregnancy on theoretical grounds, but a pregnant woman at high risk who needs immediate protection may receive IPV.
Test yourself
Think of the answer, then tap the question to see it.
Which polio vaccine gives intestinal immunity, and why does it matter?
OPV: it replicates in the gut and induces mucosal immunity, which reduces shedding and transmission of the wild virus.
What is a cVDPV?
An OPV strain that has reverted to neurovirulence and circulates in a community with low vaccination coverage.
Why is OPV not given to an immunodeficient child?
The live vaccine virus can cause paralytic polio; inactivated IPV is used.
Related drugs
← Back to the class: Viral vaccines
Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.
Sources: Chapter 18: Poliomyelitis | Pink Book | CDC (Centers for Disease Control and Prevention, 2021); ATCDDD - ATC/DDD Index (WHO Collaborating Centre for Drug Statistics Methodology, 2026).
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Representative model, for educational purposes only.