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March 18, 1988

What Should Polio Immunization Policy Be? Public Health Service Expects Advice Soon

JAMA. 1988;259(11):1608-1609. doi:10.1001/jama.1988.03720110002002

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IN A FEW WEEKS, the Public Health Service will receive the advice it sought last year when it commissioned the Institute of Medicine to reevaluate poliomyelitis immunization policy in the United States (JAMA 1987;258:2633).

The problem centers on the very few cases of paralysis that occur with the use of the live-virus oral vaccine and whether they can be avoided by switching to the inactivated vaccine that carries no such risk.

On the average, there are eight cases of paralytic poliomyelitis a year in the United States, directly or indirectly caused by the oral vaccine. So far society has been willing to pay this price to prevent the disease.

But changing circumstances are forcing those involved in public health, immunization, and the virology of poliomyelitis to take another look. At a recent two-day meeting, they discussed the issues raised by this situation. In dealing with the problem the essential questions