A spokesman for the Academy of Family Physicians told members of the committee Wednesday that the family physicians would prefer to have flexibility in recommending all oral vaccine, all inactivated vaccine or the sequential schedule approved Thursday.
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The risk of vaccine-derived polio will persist long after the switch to inactivated vaccine, since a small number of chronic excretors continue to produce active virus for years ( or even decades ) after their initial exposure to the oral vaccine.
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Because cVDPV2 strains continued to arise from trivalent oral vaccine that included attenuated WPV2, in April and May 2016 this vaccine was replaced with a bivalent version lacking WPV2 as well as trivalent injected inactivated vaccine that cannot lead to cVDPV cases.
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The US Centers for Disease Control and Prevention ( CDC ) recommends that household and other close contacts of persons with altered immunocompetence receive the live, attenuated vaccines ( viral or bacterial ), and may not receive the full benefit of inactivated vaccines.
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Several experts said that the inactivated vaccine was unlikely to cause paralytic polio and that giving it ahead of the oral vaccine would probably provide a level of immunity sufficient to protect the small number of children who contract the disease from the oral vaccine.
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She approves of the toxoid and inactivated vaccines _ tetanus, diphtheria, hepatitis B, influenza and pneumococcal vaccines _ although she advises that even these vaccines are best given in the second and third trimesters in case they may have some effect yet unrecognized on a young fetus.
