Paralytic poliomyelitis–United States, 1980-1994

The Advisory Committee on Immunization Practices (ACIP) recently recommended a sequential vaccination schedule of two doses of inactivated poliovirus vaccine (IPV) followed by two doses of oral poliovirus vaccine (OPV) for routine vaccination of children in the United States (1). ACIP revised its recommendation for routine poliovirus vaccination for three reasons: 1) paralytic poliomyelitis attributable to indigenously acquired wild poliovirus has not occurred in the United States since 1979 (2), 2) progress toward global eradication of poliomyelitis has reduced the risk for importation of wild poliovirus into the United States (3), and 3) vaccine-associated paralytic poliomyelitis (VAPP) continues to occur. ACIP has recommended that implementation of this new vaccination schedule begin in early 1997. This report summarizes both the epidemiology of paralytic poliomyelitis in the United States reported during 1980-1994 and provisional reports for 1995-1996 and updates the estimated risk for VAPP. These findings indicate that the overall estimated risk for VAPP has remained constant.