Pediatricians Urge End
To Oral Polio Vaccine
By Michael Conlon

CHICAGO (Reuters) - The American Academy of Pediatrics recommended on Monday that doctors abandon oral polio vaccine entirely for routine childhood vaccinations and switch over to safer injections, which contain no live polio virus.
The recommendation is a change from one issued by the group a year ago when it suggested that injections be used for the first two vaccinations at two and four months and then either shots or oral doses -- the latter containing live but weakened polio virus -- for the next treatments at six to 18 months and again at four to six years of age.
There has been a long-running controversy over oral vaccine because the live virus carries the possibility of causing the very disease it is designed to prevent. The academy's new policy states that vaccine-caused cases of polio ``cannot be totally eliminated until oral polio virus vaccine no longer is given.''
The statement, published in the December issue of Pediatrics, the journal of the academy, said the all-injection schedule should be in place with the start of the new year.
``Pediatricians need to move to an all (injected) schedule in an expeditious manner,'' said Jon Abramson, chairman of the group's committee on infectious diseases. He suggested doctors could use up their remaining supplies of oral vaccine for the third and fourth doses, but not buy more.
``There has never been a case of (polio) reported when the first two doses are (injected) followed by two doses of oral polio vaccine,'' he said.
A Washington-based group called Informed Parents, families whose children developed polio after receiving oral vaccine, issued a statement saying the academy was wrong in saying that remaining supplies of oral vaccine could be used up during the transition period.
``We just discovered what looks like another case of vaccine-caused polio in upstate New York, where oral polio vaccine was given as the first dose despite the fact that the Centers for Disease Control and Prevention recommends against that,'' said John Salamone, president of the group and father of a nine-year-old polio victim.
``We are deeply troubled that the (academy) would tell its members to use up remaining supplies of oral polio vaccine when a clear decision has been made to move to an all-injectible polio vaccine schedule,'' he added. ``It's even more troubling because oral polio vaccine can be returned to the manufacturer at no cost to physicians.''
The pediatricians said oral vaccine, which provides immunity faster, should be used only when mass vaccination campaigns are needed to control polio outbreaks or when unvaccinated children will be traveling in less than four weeks to areas of the world were polio is endemic.
The World Health Organization has set the end of 2000 as its target for eliminating polio worldwide. There has not been a case of polio from a ``wild'' virus in the United States since 1979 but eight to nine vaccine-induced cases occur yearly.


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