Polio vaccine - Knowledge

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the strongest language that I have ever heard used at a scientific meeting." In response to the attacks from all sides, Brodie was reported to have stood up and stated, "It looks as though, according to Dr. Rivers, my vaccine is no good, and, according to Dr. Leake, Dr Kolmer's is dangerous." Kolmer simply responded by stating, "Gentlemen, this is one time I wish the floor would open up and swallow me." Ultimately, Kolmer's live vaccine was undoubtedly shown to be dangerous and had already been withdrawn in September 1935 prior to the Milwaukee meeting. While the consensus of the symposium was largely skeptical of the efficacy of Brodie's vaccine, its safety was not in question and the recommendation was for a much larger well-controlled trial. However, when three children became ill with paralytic polio following a dose of the vaccine, the directors of the

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In response, the Surgeon General pulled all polio vaccines made by Cutter Laboratories from the market, but not before 260 cases of paralytic illness had occurred. Eli Lilly, Parke-Davis, Pitman-Moore and Wyeth polio vaccines were also reported to have paralyzed numerous children. It was soon discovered that some lots of Salk polio vaccine made by Cutter, Wyeth, and the other labs had not been properly inactivated, allowing live poliovirus into more than 100,000 doses of vaccine. In May 1955, the National Institutes of Health and Public Health Services established a Technical Committee on Poliomyelitis Vaccine to test and review all polio vaccine lots and advise the Public Health Service as to which lots should be released for public use. These incidents reduced public confidence in polio vaccine, leading to a drop in vaccination rates.

736: 585: 1091:(the manufacturer who held the patent for his ricinoleating process) had distributed 12,000 doses of vaccine to some 700 physicians across the United States and Canada. Kolmer did not describe any monitoring of this experimental vaccination program nor did he provide these physicians with instructions in how to administer the vaccine or how to report side effects. Kolmer dedicated the bulk of his publications thereafter to explaining what he believed to be the cause of the 10+ reported cases of paralytic polio following vaccination, in many cases in towns where no polio outbreak had occurred. Six of these cases had been fatal. Kolmer had no control group but asserted that many more children would have gotten sick. 1217:

basic science and technology of the time was insufficient to understand and utilize this breakthrough. Brodie's work using formalin-inactivated virus would later become the basis for the Salk vaccine, but he would not live to see this success. Brodie was fired from his position within three months of the symposium's publication. While he was able to find another laboratory position, he died of a heart attack only three years later at age 36. By contrast, Park, who was believed in the community to be reaching senility at this point in his older age, was able to retire from his position with honors prior to his death in 1939. Kolmer, already an established and well respected researcher, returned to

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immunization coverage and low risk of importation, the WHO recommends one or two IPV doses starting at 2 months of age followed by at least two OPV doses, with the doses separated by 4–8 weeks depending on the risk of exposure. In countries with the highest levels of coverage and the lowest risks of importation and transmission, the WHO recommends a primary series of three IPV injections, with a booster dose after an interval of six months or more if the first dose was administered before 2 months of age.

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published the California results in August 1935. Through private physicians, Brodie also conducted a broader field study, including 9,000 children who received the vaccine and 4,500 age- and location-matched controls who did not receive a vaccine. Again, results were promising. Of those who received the vaccine, only a few went on to develop polio. Most had been exposed prior to vaccination and none had received the full series of vaccine doses being studied. Additionally, a polio epidemic in

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vaccine) had reached the market. Koprowski's attenuated vaccine was prepared by successive passages through the brains of Swiss albino mice. By the seventh passage, the vaccine strains could no longer infect nervous tissue or cause paralysis. After one to three further passages on rats, the vaccine was deemed safe for human use. On 27 February 1950, Koprowski's live, attenuated vaccine was tested for the first time on an 8-year-old boy living at

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individuals who had received potentially contaminated polio vaccine as late as 1957; the study again revealed no increased cancer incidence between persons who received polio vaccines containing SV40 and those who did not. The question of whether SV40 causes cancer in humans remains controversial, however, and the development of improved assays for detection of SV40 in human tissues will be needed to resolve the controversy.

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Sabin and Koprowski both eventually succeeded in developing vaccines. Because of the commitment to the Salk vaccine in America, Sabin and Koprowski both did their testing outside the United States, Sabin in Mexico and the Soviet Union, Koprowski in the Congo and Poland. In 1957, Sabin developed a trivalent vaccine containing attenuated strains of all three types of poliovirus. In 1959, ten million children in the

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immunizations led to a further dramatic decline in the number of polio cases. Between 1962 and 1965, about 100 million Americans (roughly 56% of the population at that time) received the Sabin vaccine. The result was a substantial reduction in the number of poliomyelitis cases, even from the much-reduced levels following the introduction of the Salk vaccine.

560:, cVDPV) and over time can revert to a neurovirulent form causing paralytic polio. This genetic reversal of the pathogen to a virulent form takes a considerable time and does not affect the person who was originally vaccinated. With wild polio cases at record lows, 2017 was the first year where more cases of cVDPV were recorded than the wild poliovirus. 633:. It should not be given to anyone who has an allergic reaction to these medicines. Signs and symptoms of an allergic reaction, which usually appear within minutes or a few hours after receiving the injected vaccine, include breathing difficulties, weakness, hoarseness or wheezing, heart rate fluctuations, skin rash and dizziness. 791:. By 2004, cases of poliomyelitis in Africa had been reduced to just a small number of isolated regions in the western portion of the continent, with sporadic cases elsewhere. Recent local opposition to vaccination campaigns have evolved due to lack of adequate information, often relating to fears that the vaccine might induce 1334: 1590:

Although poliovirus transmission has been interrupted in much of the world, transmission of wild poliovirus does continue and creates an ongoing risk for the importation of wild poliovirus into previously polio-free regions. If importations of poliovirus occur, outbreaks of poliomyelitis may develop,

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IPV was licensed in the United States in November 1987, and is currently the vaccine of choice there. The first dose of polio vaccine is given shortly after birth, usually between 1 and 2 months of age, and a second dose is given at 4 months of age. The timing of the third dose depends on the vaccine

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and Hilary Koprowski continued working on developing a vaccine using live virus. During a meeting in Stockholm to discuss polio vaccines in November 1955, Sabin presented results obtained on a group of 80 volunteers, while Koprowski read a paper detailing the findings of a trial enrolling 150 people.

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in 1934. He tested his vaccine upon himself, his two children, and his assistant. He gave his vaccine to just 23 more children before declaring it safe and sending it out to doctors and health departments for a larger test of efficacy. By April 1935, he was able to report having tested the vaccine on

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substitutions distinguish the attenuated Sabin 1 strain from its virulent parent (the Mahoney serotype), two nucleotide substitutions attenuate the Sabin 2 strain, and 10 substitutions are involved in attenuating the Sabin 3 strain. The primary attenuating factor common to all three Sabin vaccines is

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SV40 was found to be present in stocks of the injected form of the IPV in use between 1955 and 1963. It is not found in the OPV form. Over 98 million Americans received one or more doses of polio vaccine between 1955 and 1963 when a proportion of vaccine was contaminated with SV40; an estimated 10–30

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A novel OPV2 vaccine (nOPV2) which has been genetically modified to reduce the likelihood of disease-causing activating mutations was granted emergency licencing in 2021, and subsequently full licensure in December 2023. This has greater genetic stability than the traditional oral vaccine and is less

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2 OPV in regions where cVDPV type 2 was known to circulate. The switch to the bivalent vaccine and associated missing immunity against type 2 strains, among other factors, led to outbreaks of circulating vaccine-derived poliovirus type 2 (cVDPV2), which increased from 2 cases in 2016 to 1037 cases in

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proof of OPV or IPV vaccination (received between 4 weeks and 12 months before departure) upon arrival; children under age 15 must have received three doses of polio vaccine before travel. Travellers without proof will be vaccinated upon arrival. Travellers departing Iraq to Afghanistan and Pakistan

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of the Wistar Institute in Philadelphia, who tested the first successful polio vaccine, in 1950. His vaccine, however, being a live attenuated virus taken orally, was still in the research stage and would not be ready for use until five years after Jonas Salk's polio vaccine (a dead-virus injectable

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While Brodie had arguably made the most progress in the pursuit of a poliovirus vaccine, he suffered the most significant career repercussions due to his status as a less widely known researcher. Modern researchers recognize that Brodie may well have developed an effective polio vaccine, however the

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stood to immediately present clinical evidence that the Kolmer vaccine had caused several deaths and then allegedly accused Kolmer of being a murderer. As Rivers recalled in his oral history, "All hell broke loose, and it seemed as if everybody was trying to talk at the same time....Jimmy Leake used

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it became the first trial site for the new vaccine on very short notice. Between November 1934 - May 1935, over 1,500 doses of the vaccine were administered in Kern County. While initial results were very promising, insufficient staffing and poor protocol design left Brodie open to criticism when he

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to be the most effective. By 1 June 1934, Brodie was able to publish his first scholarly article describing his successful induction of immunity in three monkeys with inactivated polio virus. Through continued study on an additional 26 monkeys, Brodie ultimately concluded that administration of live

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created a special committee on live polio vaccines. The various vaccines were carefully evaluated for their ability to induce immunity to polio, while retaining a low incidence of neuropathogenicity in monkeys. Large-scale clinical trials performed in the Soviet Union in late 1950s to early 1960s by

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after two doses of inactivated polio vaccine (IPV), and at least 99% are immune to polio virus following three doses. The duration of immunity induced by IPV is not known with certainty, although a complete series is thought to provide protection for many years. IPV replaced the oral vaccine in many

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to encourage them to distribute the vaccine in areas they control. However, the Pakistani Taliban was not supportive. On 11 September 2016, two unidentified gunmen associated with the Pakistani Taliban, Jamaat-ul-Ahrar, shot Zakaullah Khan, a doctor who was administering polio vaccines in Pakistan.

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pharmaceutical company, with the paralysis starting in the limb the vaccine was injected into. The Cutter vaccine had been used in vaccinating 409,000 children in the western and midwestern United States. Later investigations showed that the Cutter vaccine had caused 260 cases of polio, killing 11.

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was generally believed to have been caused by polio). The Salk vaccine had been 60–70% effective against PV1 (poliovirus type 1), over 90% effective against PV2 and PV3, and 94% effective against the development of bulbar polio. Soon after Salk's vaccine was licensed in 1955, children's vaccination

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proof of OPV or IPV vaccination (received between 4 weeks and 12 months before departure) upon arrival. Regardless of immunisation status, all travellers from Afghanistan, Myanmar, Nigeria, Pakistan, Papua New Guinea, Somalia, Syria, and Yemen will be given an Oral Polio Vaccine dose upon arrival.

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Polio vaccination programs have been resisted by some people in Pakistan, Afghanistan, and Nigeria - the three countries as of 2017 with remaining polio cases. Almost all Muslim religious and political leaders have endorsed the vaccine, but a fringe minority believes that the vaccines are secretly

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One dose of trivalent OPV produces immunity to all three poliovirus serotypes in roughly 50% of recipients. Three doses of live-attenuated OPV produce protective antibodies to all three poliovirus types in more than 95% of recipients. As with other live-virus vaccines, immunity initiated by OPV is

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but are otherwise well. However, the emergence of circulating vaccine-derived poliovirus (cVDPV), a form of the vaccine virus that has reverted to causing poliomyelitis, has led to the development of novel oral polio vaccine type 2 (nOPV2) which aims to make the vaccine safer and thus stop further

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Polio was eliminated in the Americas by 1994. The disease was officially eliminated in 36 Western Pacific countries, including China and Australia, in 2000. Europe was declared polio-free in 2002. Since January 2011, no cases of the disease have been reported in India, hence in February 2012, the

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During the early 1950s, polio rates in the U.S. were above 25,000 annually; in 1952 and 1953, the U.S. experienced an outbreak of 58,000 and 35,000 polio cases, respectively, up from a typical number of some 20,000 a year, with deaths in those years numbering 3,200 and 1,400. Amid this U.S. polio

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In the 1930s, poliovirus was perceived as especially terrifying, as little was known of how the disease was transmitted or how it could be prevented. This virus was also notable for primarily impacting affluent children, making it a prime target for vaccine development, despite its relatively low

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laboratory. Brodie's progress was eagerly covered by popular press as the public hoped for a successful vaccine to become available. Such reporting did not make mention of the 12 children in a New York City Asylum who were subjected to early safety trials. As none of the subjects experienced ill

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OPV is usually provided in vials containing 10–20 doses of vaccine. A single dose of oral polio vaccine (usually two drops) contains 1,000,000 infectious units of Sabin 1 (effective against PV1), 100,000 infectious units of the Sabin 2 strain, and 600,000 infectious units of Sabin 3. The vaccine

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The inactivated polio vaccines are very safe. Mild redness or pain may occur at the site of injection. Oral polio vaccines cause about three cases of vaccine-associated paralytic poliomyelitis per million doses given. This compares with 5,000 cases per million who are paralysed following a polio

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his polio vaccine, he repeatedly passed the virus through monkeys. Using methods of production that were later described as "hair-raisingly amateurish, the therapeutic equivalent of bath-tub gin," Kolmer ground the spinal cords of his infected monkeys and soaked them in a salt solution. He then

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was essential for an efficacious vaccine. Kolmer directly questioned the killed virus approach in scholarly journals. Kolmer's studies however had raised even more concern with increasing reports of children becoming paralysed following vaccination with his live virus vaccine and notably, with

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proof of vaccination with at least one dose of bivalent OPV or IPV (received between 4 weeks and 12 months before departure). Persons obliged to undertake urgent international travel must be immunised with a single dose of polio vaccine before their departure. There is also risk of poliovirus

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proof of polio vaccination (received between 4 weeks and 12 months before departure) upon arrival. Residents and ALL travellers staying in Afghanistan longer than 4 weeks need proof of polio vaccination (received between 4 weeks and 12 months before departure) when departing from Afghanistan.

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Travellers who wish to enter or leave certain countries must be vaccinated against polio, usually at most 12 months and at least 4 weeks before crossing the border, and be able to present a vaccination record/certificate at the border checks. Most requirements apply only to travel to or from

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oral poliovirus vaccine (MOPV) was licensed, and in 1962, type 3 MOPV was licensed. In 1963, trivalent OPV (TOPV) was licensed, and became the vaccine of choice in the United States and most other countries of the world, largely replacing the inactivated polio vaccine. A second wave of mass

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undertook a large study, using cancer case information from the institute's SEER database. The published findings from the study revealed no increased incidence of cancer in persons who may have received vaccine containing SV40. Another large study in Sweden examined cancer rates of 700,000

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in individuals with normal immune function, polio viruses have no non-primate reservoir in nature, and survival of the virus in the environment for an extended period of time appears to be remote. There are two types of vaccine: inactivated polio vaccine (IPV) and oral polio vaccine (OPV).

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In countries with endemic polio or where the risk of imported cases is high, the WHO recommends OPV vaccine at birth followed by a primary series of three OPV doses and at least one IPV dose starting at 6 weeks of age, with a minimum of 4 weeks between OPV doses. In countries with >90%

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The leader of the Jamaat-ul-Ahrar claimed responsibility for the shooting and stated that the group would continue this type of attack. Such resistance to and skepticism of vaccinations has consequently slowed down the polio eradication process within the two remaining endemic countries.

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structures and reduces the ability of poliovirus to translate its RNA template within the host cell. The attenuated poliovirus in the Sabin vaccine replicates very efficiently in the gut, the primary site of infection and replication, but is unable to replicate efficiently within

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in Georgia (acting as the primary funders for the project) requested it be withdrawn in December 1935. Following its withdrawal, the previously observed moratorium on human poliomyelitis vaccine development resumed and there would not be another attempt for nearly 20 years.

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A potential adverse effect of the Sabin OPV is caused by its known potential to recombine to a form that causes neurological infection and paralysis. The Sabin OPV results in vaccine-associated paralytic poliomyelitis (VAPP) in approximately one individual per every

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Sabin AB, Ramos-Alvarez M, Alvarez-Amezquita J, Pelon W, Michaels RH, Spigland I, et al. (August 1960). "Live, orally given poliovirus vaccine. Effects of rapid mass immunization on population under conditions of massive enteric infection with other viruses".

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especially in areas with low vaccination coverage and poor sanitation. As a result, high levels of vaccination coverage must be maintained. In November 2013, the WHO announced a polio outbreak in Syria. In response, the Armenian government put out a notice asking

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Travellers from active-transmission (including wild or vaccine-derived poliovirus) and at-risk countries, as well as all travellers from Afghanistan, Congo-Kinshasa, Mozambique, Myanmar, Niger, Nigeria, Pakistan, Papua New Guinea, Somalia, Syria, and Yemen, need

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100 children without ill effect. Kolmer's first formal presentation of results would not come about until November 1935 where he presented the results of 446 children and adults he had vaccinated with his attenuated vaccine. He also reported that together the

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in Philadelphia. The rivalry between these two researchers lent itself to a race-like mentality which, combined with a lack of oversight of medical studies, was reflected in the methodology and outcomes of each of these early vaccine development ventures.

1376:, Byron Bennett, L. James Lewis, and Lorraine Friedman, which required years of subsequent testing. Salk went on CBS radio to report a successful test on a small group of adults and children on 26 March 1953; two days later, the results were published in 1530:. Routine vaccination of adults (18 years of age and older) in developed countries is neither necessary nor recommended because most adults are already immune and have a very small risk of exposure to wild poliovirus in their home countries. In 2002, a 1115:), Brodie was able to pursue development of an inactivated or "killed virus" vaccine. Brodie's process also began by grinding the spinal cords of infectious monkeys and then treating the cords with various germicides, ultimately finding a solution of 754:

During the race to develop an oral polio vaccine, several large-scale human trials were undertaken. By 1958, the National Institutes of Health had determined that OPV produced using the Sabin strains were the safest. Between 1957 and 1960, however,

531:. The oral administration does not require special medical equipment or extensive training. Attenuated poliovirus derived from the oral polio vaccine is excreted for a few days after vaccination, potentially infecting and thus indirectly inducing 1038:

mortality and morbidity. Despite this, the community of researchers in the field thus far had largely observed an informal moratorium on any vaccine development as it was perceived to present too high a risk for too little likelihood of success.

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began to raise concerns regarding the safety and efficacy of the new poliovirus vaccines. At this time there was very little oversight of medical studies, and ethical treatment of study participants largely relied upon moral pressure from

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Travellers from Afghanistan, Angola, Benin, Cameroon, the Central African Republic, China, Congo-Kinshasa, Ethiopia, Ghana, Indonesia, Kenya, Mozambique, Myanmar, Niger, Nigeria, Pakistan, Papua New Guinea, Philippines, and Somalia need

1683:). Several countries have additional precautionary polio vaccination travel requirements, for example to and from 'key at-risk countries', which as of December 2020 include China, Indonesia, Mozambique, Myanmar, and Papua New Guinea. 1526:

formulation, but should be given between 6 and 18 months of age. A booster vaccination is given at 4 to 6 years of age, for a total of four doses at or before school entry. In some countries, a fifth vaccination is given during

398:(WHO) recommends all children be fully vaccinated against polio. The two vaccines have eliminated polio from most of the world, and reduced the number of cases reported each year from an estimated 350,000 in 1988 to 33 in 2018. 6416: 535:

in unvaccinated individuals, and thus amplifying the effects of the doses delivered. Taken together, these advantages have made it the favored vaccine of many countries, and it has long been preferred by the global eradication

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In April 1955, soon after mass polio vaccination began in the US, the Surgeon General began to receive reports of patients who contracted paralytic polio about a week after being vaccinated with Salk polio vaccine from the

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cultures failed to grow, but the polio cultures were successful. This development greatly facilitated vaccine research and ultimately allowed for the development of vaccines against polio. Enders and his colleagues,

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so-called 'polio-endemic', 'polio-affected', 'polio-exporting', 'polio-transmission', or 'high-risk' countries. As of August 2020, Afghanistan and Pakistan are the only polio-endemic countries in the world (where

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Resistance to polio vaccination is a fringe position. Almost every Muslim scholar and political leader has endorsed the vaccine, and all but a few Muslim-majority countries have wiped out the disease entirely.

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likely to revert to a virulent form. Genetically stabilised vaccines targeting poliovirus types 1 and 3 are in development, with the intention that these will eventually completely replace the Sabin vaccines.

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The primary disadvantage of OPV derives from its inherent nature. As an attenuated but active virus, it can induce vaccine-associated paralytic poliomyelitis (VAPP) in approximately one individual per every

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proof of OPV or IPV vaccination (received between 4 weeks and 12 months before departure) upon arrival. Belize residents travelling countries with confirmed polio cases also need proof of vaccination.

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Oral polio vaccines were easier to administer than IPV, as it eliminated the need for sterile syringes and therefore was more suitable for mass vaccination campaigns. OPV also provided longer-lasting

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Hammon WM, Coriell LL, Wehrle PF, Stokes J (April 1953). "Evaluation of Red Cross gamma globulin as a prophylactic agent for poliomyelitis. IV. Final report of results based on clinical diagnoses".

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arranging a Symposium on Poliomyelitis to be delivered at the Annual Meeting of their Southern Branch the following month. It was during the discussion at this meeting that James Leake of the

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proof of OPV or IPV vaccination (received between 4 weeks and 12 months before departure) upon arrival. ALL Syria residents departing Syria to any country also need proof of vaccination.

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Until recent times, a trivalent OPV containing all three virus strains was used, and had nearly eradicated polio infection worldwide. With the complete eradication of wild poliovirus type

6408: 4741: 7189: 3041:"Poliomyelitis prevention: recommendations for use of inactivated poliovirus vaccine and live oral poliovirus vaccine. American Academy of Pediatrics Committee on Infectious Diseases" 1325:, an institution for physically and mentally disabled people located in New York. After the child had no side effects, Koprowski enlarged his experiment to include 19 other children. 2614: 1221:

as a professor of medicine. Kolmer had a very productive career, receiving multiple awards, and publishing countless papers, articles, and textbooks up until his retirement in 1957.

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epidemic, millions of dollars were invested in finding and marketing a polio vaccine by commercial interests, including Lederle Laboratories in New York under the direction of

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The Pasteur Institute stated that an antipoliomyelitis vaccine, developed by Professor Pierre Lepine would soon be produced in large quantities. (Times, London, 4 April 1955).

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proof of OPV or IPV vaccination (received between 4 weeks and 12 months before departure) upon arrival. Travellers without proof are offered OPV vaccination upon arrival.

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scientists. Brodie's inactivated vaccines faced scrutiny from many who felt killed virus vaccines could not be efficacious. While researchers were able to replicate the

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proof of OPV vaccination upon arrival. Residents and ALL travellers staying in Pakistan longer than 4 weeks need proof of OPV vaccination when departing from Pakistan.

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invented a key laboratory technique that enabled the mass production of the vaccine by a team she led in Toronto. Beginning 23 February 1954, the vaccine was tested at

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and his colleagues demonstrated safety and high efficacy of the vaccine. Based on these results, the Sabin strains were chosen for worldwide distribution. Fifty-seven

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ingredients and could cause impotence and infertility in male children, leading some parents not to have their children vaccinated. This belief is most common in the

1010:. The development of immunity to polio efficiently blocks person-to-person transmission of wild poliovirus, thereby protecting both individual vaccine recipients and 646:

million doses administered, with symptoms identical to wild polio. Due to its improved genetic stability, the novel OPV (nOPV) has a reduced risk of this occurring.

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proof of OPV or IPV vaccination (received between 4 weeks and 12 months before departure) upon arrival. Travellers without proof will be vaccinated upon arrival.

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continued to administer his vaccine around the world. In Africa, the vaccines were administered to roughly one million people in the Belgian territories (now the

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effects, Park, described by contemporaries as "never one to let grass grow under his feet," declared the vaccine safe. When a severe polio outbreak overwhelmed

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Sabin AB (1987). "Role of my cooperation with Soviet scientists in the elimination of polio: possible lessons for relations between the U.S.A. and the USSR".

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where they worked together on poliovirus. With the aid of grant funding from the President's Birthday Ball Commission (a predecessor to what would become the

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paralysis beginning at the arm rather than the foot in many cases. Both Kolmer and Brodie were called to present their research at the Annual Meeting of the

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Enders JF, Weller TH, Robbins FC (January 1949). "Cultivation of the Lansing Strain of Poliomyelitis Virus in Cultures of Various Human Embryonic Tissues".

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virus in embryonic lung tissue. He had inoculated the planned number of tubes when he noticed that there were a few unused tubes. He retrieved a sample of

1021:. The last cases of paralytic poliomyelitis caused by endemic transmission of wild virus in the United States occurred in 1979, with an outbreak among the 3806:

Olin P, Giesecke J (1998). "Potential exposure to SV40 in polio vaccines used in Sweden during 1957: no impact on cancer incidence rates 1960 to 1993".

3384: 7429: 5169: 4599: 1066:. Inspired by the success of vaccines for rabies and yellow fever, he hoped to use a similar process to denature the polio virus. In order to go about 358: 6113: 1445: 8479: 3182:"Guidance for Assessment of Poliovirus Vaccination Status and Vaccination of Children Who Have Received Poliovirus Vaccine Outside the United States" 1673: 920:

temperature, which produces spontaneous mutations in the viral genome. Oral polio vaccines were developed by several groups, one of which was led by

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region. Attacks on polio vaccination teams have also occurred, thereby hampering international efforts to eradicate polio in Pakistan and globally.

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Yamazaki S, Toraya H (2001). "General News. Major Milestone reached in Global Polio Eradication: Western Pacific Region is certified Polio-Free".

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Once Sabin's oral vaccine became widely available, it supplanted Salk's injected vaccine, which had been tarnished in the public's opinion by the

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Nathanson N, Martin JR (December 1979). "The epidemiology of poliomyelitis: enigmas surrounding its appearance, epidemicity, and disappearance".

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The inactivated polio vaccines are very safe. Mild redness or pain may occur at the site of injection. They are generally safe to be given to

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The selection and use of essential medicines 2023: web annex A: World Health Organization model list of essential medicines: 23rd list (2023)

2238: 1425:, and 1.2 million children received no vaccination and served as a control group, who would then be observed to see if any contracted polio. 95: 7047: 5896: 3240: 2604: 1405:, the largest medical experiment in history at that time. The test began with about 4,000 children at Franklin Sherman Elementary School in 704:

million Americans may have received a dose of vaccine contaminated with SV40. Later analysis suggested that vaccines produced by the former

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transmission inside Ukraine itself, and travellers to Ukraine are recommended to be up to date with their polio vaccination before entry.

6269: 5238: 2653: 1441:, the annual number of polio cases fell from 35,000 in 1953 to 5,600 by 1957. By 1961 only 161 cases were recorded in the United States. 1075:, and refrigerated the product for 14 days to ultimately create what would later be prominently critiqued as a "veritable witches brew". 6567: 5467: 5428: 7375: 7342: 7311: 3607: 3551:

Eddy BE, Borman GS, Berkeley WH, Young RD (May 1961). "Tumors induced in hamsters by injection of rhesus monkey kidney cell extracts".

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Schonberger LB, Kaplan J, Kim-Farley R, Moore M, Eddins DL, Hatch M (1984). "Control of paralytic poliomyelitis in the United States".

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Diphtheria and Tetanus Toxoids and Acellular Pertussis Adsorbed, Hepatitis B (Recombinant) and Inactivated Poliovirus Vaccine Combined

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reference strains, Mahoney (type 1 poliovirus), MEF-1 (type 2 poliovirus), and Saukett (type 3 poliovirus), grown in a type of monkey

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which people drank. The vaccine was not approved for use in the United States, but was used successfully elsewhere. The success of an

5842: 5533: 3735: 2086:, the government recommends all others travellers to consider getting a polio vaccine or booster dose, depending on their situation. 6037: 5367: 1417:. By the conclusion of the study, roughly 440,000 received one or more injections of the vaccine, about 210,000 children received a 7315: 7278: 7077: 6368: 3150: 6987: 6507: 4204: 2741:"Transmissibility and persistence of oral polio vaccine viruses: implications for the global poliomyelitis eradication initiative" 1506:, described as the Soviet Union's highest civilian honor. Sabin's oral vaccine using live virus came into commercial use in 1961. 8059: 7107: 3406: 2547: 1391: 993: 567:

2 this was phased out in 2016 and replaced with bivalent vaccine containing just types 1 and 3, supplemented with monovalent type

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was asked to discuss each of the presented papers as a prominent critic of the vaccine development effort. This resulted in the

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of 1955, in which Salk vaccines improperly prepared by one company resulted in several children dying or becoming paralyzed.

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In keeping with the norms of the time, Kolmer completed a relatively small animal trial with 42 monkeys before proceeding to

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under age 15 to get the polio vaccine. As of 2014, polio virus had spread to 10 countries, mainly in Africa, Asia, and the

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Travellers from polio-exporting countries (identified by Qatar as: Afghanistan, Nigeria, Pakistan and Philippines) need

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Long-term visitors departing to states with wild or circulating vaccine-derived poliovirus transmission should present

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country was taken off the WHO list of polio-endemic countries. In March 2014, India was declared a polio-free country.

1200: 1188: 527:, the primary site of wild poliovirus entry, which helps prevent infection with wild virus in areas where the virus is 5933: 5042: 4719: 1274:. Other important advances that led to the development of polio vaccines were: the identification of three poliovirus 7918: 2843: 1237:

successfully cultivated the poliovirus in human tissue in the laboratory. This group had recently successfully grown

617:

Inactivated polio vaccine can cause an allergic reaction in a few people since the vaccine contains trace amounts of

1257:

infected with poliovirus and added it to the remaining test tubes, on the off chance that the virus might grow. The

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Benison S (1982). "International medical cooperation: Dr. Albert Sabin, live poliovirus vaccine and the Soviets".

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million doses administered. The live virus can persist circulate in under-vaccinated populations (termed either

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believe is due to refusals by certain local populations to allow their children to receive the polio vaccine.

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developed countries in the 1990s mainly due to the (small) risk of vaccine-derived polio in the oral vaccine.

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Brodie M (1935). "Active immunization in monkeys against poliomyelitis with germicidally inactivated virus".

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The results of the field trial were announced 12 April 1955 (the tenth anniversary of the death of President

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Vilchez RA, Kozinetz CA, Arrington AS, Madden CR, Butel JS (June 2003). "Simian virus 40 in human cancers".

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to conduct a highly structured trial of the Brodie vaccine using funding from the Birthday Ball Commission.

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Kolmer began his vaccine development project in 1932 and ultimately focused on producing an attenuated or

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Travellers from Afghanistan, Congo-Kinshasa, Ethiopia, Kenya, Nigeria, Pakistan, Somalia, and Syria need

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