Israeli Public's Fears Over Polio Vaccination Unfounded, Say Doctors

Children with weakened immune systems can attend school if they’ve had the dead-virus vaccine and pay special attention to hygiene.

Ilan Lior
Ilan Lior
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Health-care professionals sought Monday to ease growing public fears that people with weakened immune systems could contract polio as a result of the current vaccination campaign.

According to Prof. Eli Somekh, head of the Israel Pediatric Association and chairman of the Health Ministry’s advisory council on the vaccination campaign, very few people are actually at high risk – mainly those who have had bone marrow transplants or those with congenital problems producing antibodies.

People in those two categories could significantly reduce their risk, he added. People with bone-marrow transplants should be inoculated with the dead-virus vaccine (the current campaign uses a live-attenuated vaccine), while those with antibody production problems should ingest a special solution containing antibodies every month.

Other people with weakened immune systems face a lower risk. These include cancer and AIDS patients, people taking biological drugs and anyone on treatment that suppresses the immune system, such as radiation, chemotherapy or high dosages of steroids. People in this group, as well as those around them, should be extra careful about hygiene, including washing their hands frequently, to prevent contracting polio.

“You have to remember that most people have been vaccinated against polio,” Somekh said. “They received the vaccine in the past.”

The decision not to give children the live-attenuated vaccine if they or their relatives have weakened immune systems is strictly an additional precaution, he explained.

Somekh stressed that aside from the precautions listed above, people with weakened immune systems can continue leading normal lives. “If, for instance, a grandfather is undergoing chemotherapy and his grandson was vaccinated, we don’t recommend refraining from seeing him or hosting him. We merely ask them to be strict about hygiene ... The virus isn’t transmitted through the air; it’s transmitted by secretions, mainly in feces. Therefore, be careful of hygiene, and make sure that relative doesn’t handle secretions or diapers, and after contact, he should wash his hands well.”

Somekh was responding to fears voiced by parents whose children have weakened immune systems, such as Yael Eliyahu, whose 9-year-old daughter has leukemia. Eliyahu posted an anguished note on Facebook on Sunday, in which she described how her daughter, having just finished chemotherapy, was supposed to go back to school this year after two-and-a-half years at home, while another daughter was slated to start first grade. Her Facebook post was shared widely.

“Now, all that can’t happen, because of the live-attenuated polio vaccine, which every child in the country up to age nine is receiving these days,” she wrote. “My daughter can’t be around children who were vaccinated, or people who came into contact with them within two weeks [afterward]. Because the Health Ministry decided to vaccinate everyone with the live-attenuated virus, rather than the dead one, and also didn’t trouble to squeeze all the vaccinations into a defined time period ... I and all other oncology families in Israel are in an unreasonable situation.”

“My doctor told me explicitly that even if my daughter received the dead-virus vaccine today, she still can’t be around children who received the live-attenuated vaccine, at least during the first two weeks,” Eliyahu explained. But since the campaign is slated to continue through November, rather than lasting only two or three weeks, there’s no way of knowing when other children, or their siblings, were vaccinated, and therefore no way of knowing whether they’re still in the first two weeks.

Somekh countered that, in most cases, children with weakened immune systems can go to school safely, as long as they’ve received the dead-virus vaccine and are careful about hygiene. But he said parents should consult their child’s physician first.

Prof. Shai Ashkenazi, an infectious diseases expert at Schneider Children’s Medical Center, also said children vaccinated with the dead virus needn’t fear going to school. The risk they face from ordinary viruses, like flu or dysentery, is “thousands of times greater than that from a virus that’s already been attenuated,” he said.

An infant being given the polio vaccine in Rahat. Credit: Eliyahu Hershkovitz