Pediatrics

Vaccination against polio

definition

Polio, which is technically also known as poliomyeltitis or simply polio, is an infectious disease that can affect the central nervous system (CNS). In most cases, an infection remains asymptomatic, but some people may suffer from permanent paralysis. Usually the extremities are affected by this paralysis. If the respiratory muscles are also affected, mechanical ventilation must be used and the patient may die.

Polio is considered to be eradicated in Germany. The last recorded case occurred in Germany in 1990. Despite everything, the Standing Vaccination Commission (STIKO) recommends that children be vaccinated against polio. In other countries, especially in Nigeria, Afghanistan and Pakistan, the disease has not yet been eradicated, so travelers can carry the pathogen back to Germany. In order to ideally eradicate the disease worldwide, it is necessary that children and adults continue to be vaccinated in Germany so that Germans are no longer potential carriers of sick people who have entered the country. It can be assumed that the poliovirus will be the next virus to be eradicated due to a vaccination carried out worldwide.

Synonyms

Poliomyelitis, polio

English: poliomyelitis

Information about vaccination

To prevent polio, there is a dead vaccine that is administered parenterally. The oral vaccination applied earlier is no longer used because of the risk of vaccine-associated paralytic poliomyelitis. There are no contraindications to the parenteral vaccine.

When should vaccinations start?

The first vaccination against polio can be given from the age of two months. As a rule, this vaccination takes place as a six-fold vaccination as a so-called combination vaccine. The vaccination then takes place together with a vaccination against diphtheria, whooping cough, tetanus, Haemophilus influenzae and hepatitis B, so that children only have to be vaccinated once instead of six times.

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How often do you have to vaccinate?

In order to achieve a so-called primary immunization, the vaccine must be injected a total of four times. If you adhere to the vaccination calendar of the Standing Vaccination Commission, vaccinations take place between the ages of two and three, and the last vaccination between the eleventh and fourteenth months.

There should be an interval of at least four to six weeks between the individual vaccinations. The entire basic immunization for polio takes place together with five other vaccines as a six-fold vaccination. Although vaccination as a combination vaccine makes sense, the polio vaccination can also be administered as a monovalent vaccine, i.e. as a single vaccination. In this case, only two to three vaccinations are necessary for the basic immunization, which are carried out between the first and second year of life.

When do you need to refresh?

The vaccination against polio is one of the vaccinations that must be refreshed after a certain period of time after the basic immunization in order to guarantee permanent vaccination protection. The booster is usually given in a combination vaccine with the booster for tetanus, whooping cough, and diphtheria. It should be performed between the ages of nine and seventeen. Afterwards, no further booster vaccinations are usually necessary. A further booster vaccination is only recommended in individual cases. This applies to travelers to countries with a risk of polio infection whose last polio vaccination was more than ten years ago, as well as to people who have an increased risk of exposure to polioviruses in the laboratory or who are in contact with polio patients.

Vaccination costs

The polio vaccination costs around € 20 per injection. If you calculate with four vaccinations for the basic vaccination and one vaccination for the booster vaccination, the total costs for the polio vaccination are around 100 €.

Who bears the costs?

Since the polio vaccination is recommended by the Standing Vaccination Commission, the costs for the individual partial vaccinations are covered in full by the respective health insurance company. Patients up to the age of 18 are exempt from co-payments for vaccinations, after which there may be co-payments in individual cases.

Side effects of vaccination

The polio vaccination is usually administered as a six-fold vaccine as part of the primary vaccination. These are so-called dead vaccines, which no longer contain any living components of the pathogen. Inactivated vaccines are considered to be safer than live vaccines. The six-fold vaccine is usually well tolerated. If there are side effects, only slight local reactions, such as reddening of the injection site or pain when moving the vaccinated arm, are usually to be expected. There is also rarely a slight general reaction of the body with fever, fatigue, headache and body aches, swollen lymph nodes or gastrointestinal complaints. These vaccine reactions typically subside after one to three days.

The side effects of a vaccination occur through the activation of the body's immune system, which reacts to the vaccine with a defense reaction. This defense reaction is desired because the vaccination is intended to produce antibodies in the body, so that when the pathogen comes into contact again, the antibodies can be formed more quickly and the disease does not break out. In isolated cases, allergic reactions to the vaccine have been observed.

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Fever after vaccination against polio

In some cases, the vaccination can lead to a high fever that can rise to over 39 degrees. The fever should have subsided after one to three days and is to be understood as a reaction of the immune system to the vaccine. Very rarely (fewer than one vaccinated child in 10,000) can develop an uncomplicated febrile seizure as part of the rapid rise in temperature. In this case, a doctor should be consulted for clarification.

Advantages / disadvantages of vaccination against polio

The benefits of vaccination against polio far outweigh the disadvantages of vaccination. The only disadvantage of vaccination is that a few children can experience slight but harmless vaccination reactions. Since the vaccine has been switched from a live vaccine to a dead vaccine since 1998, an outbreak of the disease as a result of the vaccination is not to be expected.

The nationwide vaccination in Germany and in other countries enables the potentially life-threatening disease to be completely eradicated in the future. This goal is being pursued for many infectious diseases against which vaccination can be carried out, but at the moment it appears most realistic for polio.

Vaccination against polio in adults

The name “polio” should not lead you to believe that only children can become infected with the infectious disease: adults can also be affected if they are not vaccinated. The Standing Vaccination Commission therefore recommends that if you are not vaccinated, you should still be vaccinated as an adult. Both a basic vaccination plus a booster vaccination can be made up for in adults, as well as a missed booster vaccination if the basic vaccination course was received as a child. A vaccination should be obtained, especially when traveling to risk areas.

Prognosis of polio

The light form of the "minor illness“Often leads to complete, symptom-free healing. The lethality of the "paralytic poliomyelitis“Used to be 5-7%. The peripheral paresis go back very slowly. In order to fully restore the motor skills, physiotherapy and optimal positioning are necessary. The regression of the paralysis symptoms can take up to 1.5 years. The bublar poliomyelitis however, has a very bad prognosis.

Long-term effects of polio can include joint contractures, muscle atrophy, leg length and arm length differences, osteoporosis and scoliosis.