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# 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

- Class: [Viral vaccines](https://durgical.com/en/pharmacology/classes/viral-vaccines/)
- Target: Poliovirus capsid
- ATC code: J07BF
- WHO Model List of Essential Medicines

Also called: IPV (inactivated poliovirus vaccine), OPV, bOPV (oral poliovirus vaccine, Sabin), Hexavalent (combination)

◆**Poliovirus capsid**Poliomyelitis vaccine (IPV and OPV)

ⓘ 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.

**Target in 3D:** Poliovirus capsid. PDB structure 1HXS (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/1HXS) · Drag to rotate · pinch to zoom

## 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

### Serious (rare, important)

- OPV: vaccine-associated paralytic polio (very rare; higher after the first dose and in B-cell immunodeficiency)
- Anaphylaxis (rare)

## 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.

## Memory aid

"Salk Shot, Sabin Sugar": Salk is the injected killed vaccine; Sabin is the live oral drops. Only Sabin protects the gut, and only Sabin can rarely paralyse.

## 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.

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## Related drugs

- [Rotavirus vaccine](https://durgical.com/en/pharmacology/rotavirus-vaccine/)
- [Hepatitis B vaccine](https://durgical.com/en/pharmacology/hepatitis-b-vaccine/)

[← Back to the class: Viral vaccines](https://durgical.com/en/pharmacology/classes/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](https://www.cdc.gov/pinkbook/hcp/table-of-contents/chapter-18-poliomyelitis.html) (Centers for Disease Control and Prevention, 2021); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=J07B&showdescription=no) (WHO Collaborating Centre for Drug Statistics Methodology, 2026).

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Representative model, for educational purposes only.

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