(b) Polio. Currently, there are two types of preventive measures for
polio: inactivated poliovirus vaccine (IPV) and live oral poliovirus vaccine (OPV). The
preferred vaccine in the United States is the oral poliovirus vaccine which consists of a
mixture of attenuated or weakened strains of types 1, 2, and 3 poliomyelitis viruses
produced in cultures of monkey kidney cells.
1 This vaccine should be kept frozen until used, and then used
within seven days after the bottle is entered and not refrozen. An unentered container
of vaccine may be used after as many as ten freeze-thaw cycles, provided the
temperature does not exceed 8C (46F), and that the cumulative thaw time does not
exceed 24 hours. If the 24 hour period is exceeded, the vaccine must be used within 30
2 The vaccine is only given by mouth. The vaccine may be added
to a sugar cube, simple syrup, distilled water, or it may be given with a sterile medicine
dropper. It should not be given in tap water or a beverage containing free chlorine.
Advise all persons not to eat for 30 minutes after swallowing the vaccine.
3 In a few instances, a neurological disease similar to paralytic
poliomyelitis has been reported, occurring 4 to 30 days after vaccination. Do not give
the vaccine during an illness accompanied by a fever (a febrile illness). Although
usually live viral vaccines cannot be given during pregnancy, the polio vaccine can be
given during pregnancy.
4 The dose for polio is usually two drops and may come in
containers as individual doses or multiple dose vials. Check manufacturer's inserts for
the proper number of drops which make up a dose. Immunization is good for life
following a series of five doses. All soldiers receive one, two-drop dose upon entry on
active duty. Reimmunization is not required. Immunodeficient patients (those with an
immune response deficiency) and unimmunized adults may require a series of the Salk-
killed poliomyelitis vaccine injection. The subject of decreasing immunity over time is
currently being evaluated.
(c) Measles. Live attenuated measles-virus vaccines produce an
inapparent or mild infection which is noncommunicable and is followed by immunity for
at least ten years. The available evidence indicates that a single inoculation will
generally be followed by permanent immunity. There have been rare cases of children
having been vaccinated and then actually having measles several years later.
Experience with approximately 30 million doses administered in the United States
between 1963 and 1968 indicates that the vaccines are safe and highly effective.
Measles now occurs predominantly in communities which have failed to immunize their
children. Live measles vaccine, 0.5 ml, should be given to all infants and children over
15 months of age if they have not had measles. Vaccination of adults is rarely
necessary because nearly all are immune by age 18. NOTE: Most measle cases are
imported from overseas. An American who is traveling overseas and who has no
immunity to measles is a potential candidate for actually getting the disease.