Mike- Correct me if I'm wrong but the chances of getting polio from an OPV is 1 out of a million in previously unvaccinated individuals (4-6 babies a year) and one out of 30 million in immune competent individuals who have been previously vaccinated with 2 IPVs. Many immunocompromised babies might not be identified during their first months of life but would probably be diagnosed by 12 months of age. So, if no live virus vaccines were given during the first 12 months of life fewer babies would run the albeit small risk of getting infected with the diseases we're trying to protect them against. As far as immunocompromised caregivers, if I can identify their existence at the time of the vaccination I stick to the full IPV schedule. Regards- Kim Burlingham MD ---------- > From: Michael Sachs <> > To: > Subject: Re: IPV Vs OPV > Date: Sunday, June 28, 1998 2:17 AM > > At 09:30 PM 6/23/98 -0500, Dogwood Ridge wrote: > > >The first generation of babies that I started on IPV at their 2 and 4 month > >visits are now 18 months old and due for boosters. My thoughts were to > >give OPV as a booster and this has been very well received by the parents- > >has this been your experience? > >Regards Kim Burlingham, Md > > > The question to ask, is what are your reasons for using IPV at 2 and 4 > months? If it's only to prevent VAPP in infants who might have an > as-yet-to-be-diagnosed immune deficiency (or 1/1,000,000 bad luck), then > the sequential schedule and a change to OPV makes sense. But if you're > also hoping to prevent VAPP in adult contacts, then you'd want to continue > with IPV since the previous IPV doses won't prevent shedding of the OPV in > the feces or saliva. So if you switch to OPV you'll need to remember to > ask about possible immunodeficient or unimmunized contacts. > > > > Michael Sachs, M.D. > General Pediatrician > group. >