Okay, this non-MD has a question on this topic. If a 6mo is getting IPV but is at childcare w/older children getting OPV, isn't the 6mo being exposed to the live virus anyway. From my [possibly misinformed] readings, it sounds like a 6mo in childcare might as well save the shot and get OPV. Any comments? Thanks, Danny >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. >> > > > > **************************************************************************** Daniel Frieling mailto: Pediatric Software Intl., Inc. http://www.compukid.com CompuKID, The Pediatric Toolkit Computer software for primary care pediatrics (800) WELL-CHILD (800-935-5244) Outside the USA: (802) 651-0809 ****************************************************************************