Polio Immunisation

Authored by , Reviewed by Dr Adrian Bonsall | Last edited | Meets Patient’s editorial guidelines

All children and adults should be immunised against polio. See your practice nurse if you think that you are not fully immunised.

Polio (poliomyelitis) is a serious illness caused by a virus called poliovirus. Polio mainly affects children under 5 years of age. Polio is very infectious. The infection usually spreads from person to person through contact with the stools (faeces) of an infected person. If even a minute amount of stool or droplets from an infected person gets on to another person's hands, or an object like a toy, which then touches their mouth then they can also become infected. The virus can then travel to the gut (bowel) to cause an infection.

The first symptoms are usually high temperature (fever), tiredness, headache, being sick (vomiting), neck stiffness, and pain in the arms and legs. In about 1 in 200 people with polio infection the virus travels to the nervous system and causes permanent paralysis, usually in the legs. This is called paralytic polio. Between 1 in 10 and 1 in 20 people with paralytic polio will die because the breathing muscles stop working properly.

In 1955, before the introduction of polio immunisation, there were nearly 4,000 reported cases of polio in England and Wales. Polio is now very rare in the UK because of the success of immunisation.

Since 1988, the World Health Organization (WHO) has organised an immunisation programme to remove polio virus from every country in the world. This programme has been very successful and poliovirus is now only a problem in a few countries, such as Pakistan and Afghanistan.

If the immunisation programme doesn't continue to be successful then polio could return to many countries, including the UK.

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  • For young children, polio vaccine is normally part of the combined DTaP/IPV(polio)/Hib/Hep B injection - this stands for 'diphtheria, tetanus, pertussis (whooping cough)/polio/Haemophilus influenzae type b and hepatitis B', which is given as part of the routine childhood immunisation programme. This called the 6-in-1 vaccine.
  • For adults and teenagers who receive polio immunisation, the combined Td/IPV(polio) vaccine is normally used - this stands for 'tetanus, diphtheria/polio'.

The vaccine stimulates your body to make chemicals called antibodies. These antibodies protect you from illness should you become infected with the polio virus.

The vaccine is safe to be given if you are pregnant or breast-feeding.

Before 2004, the polio vaccine was given as drops into the mouth. It is now always given as an injection. If you have previously started a course of polio immunisation with oral vaccine you can finish off the course with polio injections. You do not need to start again.

All children are offered polio immunisation as part of the routine immunisation programme. A full course of polio immunisation consists of five doses of vaccine as follows:

 ChildrenAdults (who have not been immunised as a child)
Primary CourseThree doses of vaccine - as DTaP/IPV(polio)/Hib at 2, 3 and 4 months of age.Three doses of vaccine - as Td/IPV(polio), each one month apart.
Fourth doseThree years after the primary course - as part of the DTaP/IPV(polio) pre-school booster at 3 years and 4 months to 5 years.Five years after the primary course - as Td/IPV(polio).
Fifth doseAged 13-18 years - the school leaver booster - as Td/IPV(polio).10 years after the fourth dose - as Td/IPV(polio).

The primary course of three injections gives good protection for a number of years. The fourth and fifth doses ('boosters') are needed in later years to maintain protection. After the fifth dose, immunity remains for life and you do not need any further boosters (apart from some travel situations - see 'Travellers', below).

  • Slight swelling and redness at the injection site are common.
  • A little area of hard skin may form at the injection site, which usually disappears in time.
  • Sometimes a high temperature occurs a few hours after the injection.
  • Serious reactions are extremely rare.

Polio is not just a childhood illness, it can affect anyone. Children in the UK have been immunised against polio since 1958. If you were born before 1958 you may not have been immunised. All adults who are not immunised against polio should start by having the primary course of three polio vaccines at monthly intervals and then have the booster doses as described above.

Polio has been practically destroyed in much of the world, due to immunisation. However, it is still a problem in some regions, particularly in Pakistan and Afghanistan. Your GP or practice nurse can advise if your travel destination is an at-risk area for polio. If you are travelling to an at-risk area:

  • Many people will already be fully immunised from their routine childhood immunisations and do not need a booster.
  • If you have not had a booster within the previous 10 years, you may be advised to have a booster dose of vaccine if you travel to certain countries. This is particularly important for health workers who intend to work in at-risk areas.
  • Adults - see notes above. If you are not immunised, you should be immunised before you travel.

Tetanus Immunisation

Further reading and references