Do Adults Need a Polio Booster? Here’s the Deal, Given the Recent Case in the U.S.
People were shocked late last week when news broke that polio, the potentially disabling and life-threatening disease, was detected in New York. According to a joint press release from the New York State Department of Health and the Rockland County Department of Health, an unvaccinated man in Rockland County contracted the virus from someone who had received the oral polio vaccine (OPV). As a result, he developed an infection with what’s known as vaccine-derived poliovirus (VDPV).
Vaccine-derived poliovirus is different from wild poliovirus, which was the virus that caused widespread panic in the U.S. in the 1940s. Vaccine-derived poliovirus is a strain of the weakened poliovirus that was originally included in the oral poliovirus vaccine, according to the Centers for Disease Control and Prevention (CDC).
People who are immunized with the oral poliovirus vaccine can excrete it in their stool or respiratory secretions (like coughs and sneezing), and can infect other people that way, the CDC explains—and that’s what happened in this case. That’s why the U.S. stopped using the oral vaccine in 2000, and now uses the inactivated poliovirus vaccine—which does not contain a live version of the virus.
“Based on what we know about this case, and polio in general, the Department of Health strongly recommends that unvaccinated individuals get vaccinated or boosted with the FDA-approved IPV vaccine as soon as possible,” State Health Commissioner Mary T. Bassett, MD, MPH, said in the press release. “The polio vaccine is safe and effective, protecting against this potentially debilitating disease, and it has been part of the backbone of required, routine childhood immunization recommended by health officials and public health agencies nationwide.”
It makes sense to get the polio vaccine if you didn’t have it as a child, but do adults need a polio booster? And do you need a polio booster if you’re traveling? Here’s what infectious disease experts have to say.
So, do you need a polio booster?
Backing up a moment here: The polio vaccine is part of routine childhood vaccinations. The CDC recommends that children get four doses of polio vaccine—at 2 months old, 4 months old, 6 through 18 months old, and 4 through 6 years old. If you had this as a child, you are fully vaccinated against polio, says William Schaffner, M.D., an infectious disease specialist and professor at the Vanderbilt University School of Medicine.
That said, polio boosters are a thing. The CDC says that adults who are “at increased risk of exposure to poliovirus” and previously completed their poliovirus vaccination series can get one lifetime booster dose of the polio vaccine.
So, who needs a booster shot? The CDC lists off the following adults as potentially needing a polio booster:
People who are traveling to a country where the risk of getting polio is greater.
People working in a laboratory and handling specimens that might contain polioviruses.
Healthcare workers who treat patients who could have polio or have close contact with a person who could be infected with poliovirus.
“Most people do not need a polio booster because they were vaccinated against polio when they were very young,” Dr. Schaffner says. “In general, there is no polio in the U.S. and no polio in most of the world, so people don’t need a booster.”
Richard Watkins, M.D., an infectious disease physician and professor of internal medicine at the Northeast Ohio Medical University, agrees. For most people, “you get the shots as a child and then that's it,” he says.
But, if you’re traveling to an area of the world where wild polio is still circulating, you may want to consider a polio booster, says Amesh A. Adalja, M.D., a senior scholar at the Johns Hopkins Center for Health Security. He lists off countries like Yemen, Israel, the Palestinian areas, Ukraine, Pakistan, and Afghanistan as ones where polio is still circulating.
How to tell if you’re vaccinated against polio
It’s probably been a minute since you received your childhood vaccinations and, if you’re not still visiting the same doctor you did as a child, you may be unsure if you were, in fact, vaccinated against polio as a child. Still, Dr. Schaffner says the odds are very high that you received your shots.
“You probably couldn’t have gone to school if you weren’t up to date,” he says. “Most schools in the U.S. have a policy of ‘no shots, no school’ when it comes to poliovirus.”
If you’re not sure where you stand, it's OK to get a booster. “There’s no danger in getting an additional shot,” Dr. Adalja says. But, he adds, “most patient’s primary care doctors would have records for polio immunizations.”
What is polio, again?
Polio is a potentially disabling and life-threatening disease caused by the poliovirus, per the CDC. In some instances, the virus can infect a person's spinal cord and cause paralysis.
Outbreaks of polio in the U.S. in the last 1940s caused more than 35,000 Americans a year to become disabled, the CDC says. However, the country has been polio-free since 1979 thanks to a successful vaccination campaign.
How is polio spread?
Poliovirus spreads from person to person through contact with an infected person's poop or droplets from a cough or sneeze, the CDC explains. Once a person is infected, they can spread the virus even before their symptoms appear.
What are the symptoms of polio?
Most who get infected with poliovirus won't have visible symptoms, the CDC says, but around 25% will develop flu-like symptoms. Those can include:
Sore throat
Fever
Fatigue
Nausea
Headache
Stomach pain
Less than 1% of people with poliovirus will develop serious complications that impact the brain and spinal cord. Those can include:
Paresthesia (a pins-and-needles feeling in the legs)
Meningitis (an infection of the covering of the spinal cord and/or brain)
Paralysis (the inability to move parts of the body)
Again, Dr. Schaffner stresses that the case of polio in New York is rare. “This is a very unusual event and restricted to a very conservative religious group where they are under-vaccinated,” he says. “There is no danger of spread to the general population.”
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