16 Poliomyelitis

16.4 Vaccines

New Zealand switched from oral polio vaccine (OPV) to inactivated polio vaccine (IPV) in 2002 (see Appendix 1).

16.4.1 Available vaccines

Funded polio vaccines

The polio-containing vaccines funded as part of the Schedule are:
  • DTaP-IPV-HepB/Hib (Infanrix-hexa, GSK): diphtheria, tetanus, acellular pertussis, inactivated polio, hepatitis B and Haemophilus influenzae type b vaccine (see section 5.4.1 for more information)
  • DTaP-IPV (Infanrix-IPV, GSK): diphtheria, tetanus, acellular pertussis and inactivated polio vaccine (see section 5.4.1 for more information)
  • IPV (IPOL, Sanofi-aventis NZ Ltd): contains three strains of poliovirus (40D antigen units of the Mahoney, 8D units of the MEF-1, and 32D antigen units of the Saukett strains), inactivated by formaldehyde and containing phenoxyethanol as a preservative; trace amounts of neomycin, streptomycin, polymyxin B, polysorbate 80 and bovine serum albumin may be present.

Other vaccines

Other polio-containing vaccines registered (approved for use) and available (marketed) in New Zealand are:

Oral poliomyelitis vaccine (OPV)

OPV is no longer used in New Zealand. OPV continues to be used in many countries because it remains the vaccine for the WHO Expanded Programme on Immunization, but the WHO plans to withdraw this vaccine worldwide by 2019/201 (see section 16.3.2).

16.4.2 Efficacy and effectivenessTop

See also section 14.4.2 for information about DTaP-IPV-HepB/Hib vaccine.

Immunogenicity and efficacy

Virtually all infants will seroconvert after three doses of IPV vaccine, and more than 85 percent will seroconvert after two doses. The efficacy of IPV is greater than 90 percent.6

The combined IPV-containing vaccines induce immune responses against polioviruses superior to IPV stand-alone vaccines. This is due to the effect of the aluminium adjuvant present in these combination vaccines.6

Duration of protection

Available data indicates the persistence of antibodies up to school age, following two or three doses of IPV-containing vaccine in the first year of life and a booster in the second year. There is no data beyond this because a preschool booster is given at this time. There is a strong anamnestic response to this preschool booster and it is expected to confer long-term protection, possibly lifelong.6

16.4.3 Transport, storage and handlingTop

Transport according to the National Guidelines for Vaccine Storage and Distribution.7 Store at +2oC to +8oC. Do not freeze.

DTaP-IPV-HepB/Hib vaccine should be stored in the dark.

DTaP-IPV-HepB/Hib (Infanrix-hexa) must be reconstituted by adding the entire contents of the supplied container of the DTaP IPV-HepB vaccine to the vial containing the Hib pellet. After adding the vaccine to the pellet, the mixture should be shaken until the pellet is completely dissolved. Use the reconstituted vaccine as soon as possible. If storage is necessary, it may be kept at room temperature for up to eight hours but discarded after that time.

16.4.4 Dosage and administrationTop

The dose of DTaP-IPV-HepB/Hib (Infanrix-hexa) and DTaP-IPV (Infanrix-IPV) is 0.5 mL, administered by intramuscular injection (see section 2.3).

The dose of monovalent IPV (IPOL) is 0.5 mL, administered by subcutaneous injection (see section 2.3).

Co-administration with other vaccines

DTaP-IPV-HepB/Hib, DTaP-IPV and IPV may be given at the same time as inactivated or live attenuated vaccines, at separate sites and in separate syringes. (See also section 14.4.4 for information about co-administration of DTaP-IPV-HepB/Hib and PCV13.)