http://www.canoe.ca/Health0001/20_polio.html

Thursday, January 20, 2000

Government urges use of polio shots rather than oral vaccine

By JUSTIN BACHMAN -- The Associated Press

ATLANTA -- The government Thursday endorsed polio shots for children instead of the oral vaccine because of the very small chance that the oral dose can lead to a polio infection.

 The federal Centers for Disease Control and Prevention followed the advice of an advisory panel that decided last summer the benefits of the oral polio vaccine no longer outweigh the risks.

 The agency publishes its recommended immunization schedule each January as a guide for state and local health departments and pediatricians.

 This year's guide also added a recommendation that children get a hepatitis A vaccine in Western states with historically high rates of the virus: Alaska, Arizona, California, Idaho, Nevada, New Mexico, Oklahoma, Oregon, South Dakota, Utah and Washington. Hepatitis A is a relatively mild form of the virus; most patients require no medical care.

 The CDC also removed a diarrhea vaccine because it can cause bowel obstruction.

 The oral polio vaccine, developed by Dr. Albert Sabin, has been used for nearly four decades and played a major role in the elimination of polio. But because it is made with a live virus, it causes about eight people in the United States each year to become infected with polio.

 The injectable vaccine developed by the medical pioneer Dr. Jonas Salk in the 1950s relies on a killed virus. Salk had long insisted his vaccine was safer, but other scientists said it was not as effective at providing lifelong immunity.

 According to the new CDC recommendations, the oral vaccine should be used only in cases of widespread outbreaks, for children traveling to areas where polio is endemic or epidemic and for children whose parents stop short of pursuing all four shots in the polio regimen.

 The oral vaccine's U.S. manufacturer, Wyeth-Lederle, stopped making it last year and has agreed to refund any unused supplies doctors return.

 The American Academy of Pediatrics said last month its members can continue using their remaining supplies of the oral vaccine if given as the third and fourth doses. The first and second doses should be the injectable vaccine, the academy said.

 Dr. Melinda Wharton, the CDC's chief of childhood vaccines and preventable diseases, said the agency is investigating one report from 1998 of a child that got polio after being given the half-oral, half-injectable schedule. She said the case had not been confirmed.

 Dr. Michael Gerber, a pediatrician in Bethesda, Md., and member of the pediatrics academy's infectious diseases committee, said any such risk is miniscule.

 But to Informed Parents Against VAAP, a group of parents whose children contracted vaccine-associated paralytic polio, even a miniscule chance of infection is too much.

 "While the risk is small, why should we have any cases?" said John Salamone, a member of the group whose 9-year-old son contracted polio from the oral vaccine in 1991.

 ALL INFORMATION, DATA, AND MATERIAL CONTAINED, PRESENTED, OR PROVIDED HERE IS FOR GENERAL INFORMATION PURPOSES ONLY AND IS NOT TO BE CONSTRUED AS REFLECTING THE KNOWLEDGE OR OPINIONS OF THE PUBLISHER, AND IS NOT TO BE CONSTRUED OR INTENDED AS PROVIDING MEDICAL OR LEGAL ADVICE.  THE DECISION WHETHER OR NOT TO VACCINATE IS AN IMPORTANT AND COMPLEX ISSUE AND SHOULD BE MADE BY YOU, AND YOU ALONE, IN CONSULTATION WITH YOUR HEALTH CARE PROVIDER.