Here’s what to do in case of delayed polio vaccine doses

The national campaign against poliomyelitis and multi-vaccination ends this Friday (30). The Ministry of Health’s goal of vaccinating 95% of children between 1 and under 5 years of age was not achieved. Even so, immunization continues to be carried out throughout the year at health posts throughout the country.

Polio can cause different complications in infected children, such as paralysis of the arms and legs and problems with the respiratory system. The last case in Brazil was in 1989, but the country faces challenges in maintaining high vaccine coverage – a similar scenario for other vaccines.

Identifying if the vaccination schedule is correct and regularizing it is an important measure to follow the recommendations of the Ministry of Health. In addition, it is necessary to be attentive in cases of travel to countries considered at risk for the disease.

Below, see the main answers about the vaccination schedule adopted in Brazil for poliomyelitis.

What is the polio vaccination schedule in the country?

In Brazil, there are two types of drugs used to prevent polio: Salk (injectable vaccine) and Sabin (droplet model). Both are adopted by the PNI (National Immunization Program).

The first application of the vaccine should be done at two months of age. The second dose is indicated at four months and the third at six. All three of these applications are from the Salk vaccine.

Sabin is only used in the two boosters: the first at 15 months and the second at four years of age.

Although the vaccination campaign ends this Friday, children can be immunized throughout the year at health posts in order to overcome low coverage.

How do you know if polio vaccination is legal?

In the fifth edition of the Children’s Vaccination Card of the Ministry of Health, it is possible to observe a table in which all the immunizers indicated for minors are listed. In the polio column, there are five fields that must be completed in reference to the doses applied to the child. The dates of each of them must also be filled in by the health agent.

Some variations may occur depending on the model of the vaccination card. The scheme, however, tends to follow this same fill pattern.

What to do when a dose is overdue?

If any inconsistency in the vaccination schedule is found, it is necessary to go to a health post to regularize the situation. The rule is the same for other immunizers and, therefore, it is important to always be aware of the guidelines present in the vaccination card.

For irregular circumstances of the polio scheme, there are indications on how to proceed based on a normative instruction from the Ministry of Health.

The first scenario is a child aged up to four years, 11 months and 29 days without proof of vaccination. The orientation is to administer three doses of the injectable vaccine with an interval of 60 days between applications. It is also possible to apply the doses with a minimum of 30 days between them.

After that, the first booster with the droplet vaccine should be done six months after the last application of the Salk vaccine. The second booster must also be done after six months of the first application of the vaccine in drops.

Are there situations in which the vaccination regimen is different?

International trips to countries considered at risk are cases that may require changes in the vaccination schedule.

The disease is considered endemic in Pakistan and Afghanistan – these are the countries most at risk for the disease. In addition to these, other nations are considered at high risk for the disease to return by the Global Polio Eradication Initiative (Gpei). Some examples are China, Congo and Iran.

There are still countries facing an outbreak of the infection. The United Kingdom and the United States are in this category due to recent detections of the virus.

Due to these different scenarios, the Ministry of Health published a note in December 2021 with guidelines on immunization of international travelers.

For children under five, the folder states that they must be vaccinated according to the common vaccination schedule before travel.

For those over five years old, the ministry says it is necessary to be “vaccinated with at least two doses (preferably three doses) of VIP [vacina injetável]administered with a minimum interval of 30 days between them, prior to the trip”.

If the person does not have this minimum vaccination schedule, it is necessary to update it before the trip.

The ministry also explains that the regular schedule recommended for those unvaccinated over five years old consists of an interval of 30 to 60 days between the first and second dose. For the third application, the interval should be 6 to 12 months.

“If there is no time for administration of the recommended regular schedule, the intervals can be shortened, to a minimum interval of 30 days between the 3 doses”, completes the note.

Also for international travel, the oral vaccine should only be adopted in cases of travelers going to countries where the disease is endemic –Pakistan and Afghanistan– or places where the presence and circulation of the poliovirus, the pathogen that causes the disease, has been detected. .

An online Gpei page provides weekly updated data on the disease scenario in different countries.