Sir.—In the unending debate between the proponents of oral polio virus vaccine (OPV) and those favoring the addition or substitution of the now enhanced-potency inactivated polio vaccine (E-IPV), the 1988 Israel poliomyelitis outbreak1 was cited by Katz2 in support of continuing, for the time being, the routine use of OPV in the United States.
The 15 cases in the Israel outbreak occurred mainly in young adults immunized in the distant past with OPV, in a subdistrict where E-IPV had been used exclusively for several years. We agree with Dr Katz that the spread of wild poliovirus to susceptible people via the under-protected gastrointestinal tracts of E-IPV–vaccinated children was a major factor in the development of the epidemic. Nevertheless, despite wide circulation of wild virus, only a single case of paralytic disease was observed among some 27 000 children who had received E-IPV demonstrating the excellent individual protection
SLATER PE. Postoutbreak Polio Vaccination Policy in Israel. Am J Dis Child. 1990;144(8):850. doi:10.1001/archpedi.1990.02150320012005