Poliovirus Vaccine, Inactivated (IPV)

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 Action Induces protective antipoliovirus antibodies, reducing pharyngeal excretion of poliovirus types 1, 2 and 3.

 Indications Routine use in infants and children is not recommended; OPV is generally preferred. Prophylaxis for individuals traveling to regions where poliomyelitis is endemic or epidemic (eg, developing countries), who routinely are exposed to patients who may be excreting polioviruses or to laboratory specimens that may contain polioviruses, and for members of communities with disease caused by wild polioviruses. Offer IPV to individuals who decline OPV or in whom OPV is contraindicated. In household with immunocompromised member or close contacts, or in household with unimmunized adult, use only IPV for all those requiring poliovirus immunization. Previous clinical poliomyelitis (usually due to single poliovirus type) or incomplete immunization with OPV are not contraindications to completing primary series of immunization with IPV.

 Contraindications History of hypersensitivity to any component of vaccine, including neomycin, streptomycin, and polymyxin B. Patients with acute febrile illness should not receive IPV until after recovery.

 Route/Dosage

CHILDREN: SC 0.5 ml in deltoid region. In infants and small children, preferred site is anterolateral thigh muscle. CHILDREN: Primary series consists of 3 doses of 0.5 ml. Separate first 2 doses by ³ 4 wk, but preferably 8 wk; commonly given at 2 and 4 mo of age. Give third dose at least 6 mo, but preferably 12 mo, after second dose, commonly given at 15 to 18 mo of age. Give all children who received primary series of IPV or combination of IPV and OPV booster dose of OPV or IPV before entering school, unless third dose of primary series was administered on or after fourth birthday. ADULTS: For unvaccinated adults at increased risk of exposure to poliovirus, give primary series of IPV: 2 doses at 1 to 2-mo interval, with third dose 6 to 12 mo later. If < 3 mo, but > 2 mo remain before protection is needed (eg, planned international travel), give 3 doses of IPV ³ 1 mo apart. Likewise, if only 1 or 2 mo remain, give 2 doses of IPV 1 mo apart. If < 4 wk remain, give single dose of either OPV or IPV. Give adults at increased risk of exposure who have had ³ 1 dose of OPV, < 3 doses of conventional IPV (available before 1988) or combination of conventional IPV and OPV totaling < 3 doses, ³ 1 dose of OPV or IPV. Give any additional doses needed to complete primary series if time permits. Give adults who have completed primary series with any poliovirus vaccine and who are at increased risk of exposure to poliovirus single dose of either OPV or IPV.

 Interactions Several routine pediatric vaccines may safely and effectively be administered simultaneously at separate injection sites (eg, DTP, MMR, OPV, Hib, hepatitis B, influenza). National authorities recommend simultaneous immunization at separate sites as indicated by age or health risk.

 Lab Test Interferences None well documented.

 Adverse Reactions IPV administration may result in erythema, induration and pain at injection site. Temperatures 39°C (102°F) or higher reported in 38% of IPV vaccinees.

 Precautions

Pregnancy: Category C. Vaccinate if risk of disease outweighs risk to patients. Lactation: Undetermined.

 Administration/Storage

• Give 0.5 ml SC in deltoid for adults; preferred site for infants is vastus lateralis.
• If blood appears in syringe after aspiration, do not inject. Withdraw needle and discard syringe. Use new dose injected at different site.
• Document manufacturer and lot number of vaccine, date of administration and name, address and title of person administering vaccine in permanent record according to federal regulations.
• Store under refrigeration.

 Assessment/Interventions

• Obtain patient history, including drug history and any known allergies.
• Advise adult patients to be vaccinated before traveling to developing country.
• Note if patient is immunocompromised or in household with unimmunized adult.
• If patient has acute febrile illness, notify physician and do not administer until after recovery.
• Assess patient for any adverse reactions and document properly in patient record. Report as required by Vaccine Adverse Event Reporting System (800–822-7967).

 Patient/Family Education

• Advise patient to observe for fever, erythema, induration, or pain at injection site, and to report to physician immediately.
• Explain risks and benefits of vaccination.
• Advise patient and family about vaccine schedule. Explain that the series must be completed to offer full protection.

Books@Ovid
Copyright © 2003 Facts and Comparisons
David S. Tatro
A to Z Drug Facts