So Who Does the Polio Vaccine Actually Protect?

Parents have been asking questions since the current campaign to revaccinate children against polio began, and the Israeli Health Ministry does not always provide acceptable answers.

Natasha Dornberg
Natasha Dornberg
Natasha Dornberg
Natasha Dornberg

I am the poster child for the Health Ministry’s current campaign to revaccinate children aged 9 and under against polio. If I am not the poster child, I am the mom of two poster children. But I’ll introduce them to you in a moment.

The Health Ministry - through well-baby clinics nationwide – includes poliomyelitis in its regular vaccination schedule for all children. Since 2004, Israel’s children have received four doses of inactivated polio vaccine - the injected vaccine known as IPV. Prior to 2004, all children whose parents brought them for vaccinations got two kinds of polio vaccine: IPV, and a weakened live-virus vaccine administered orally and known as OPV.

OPV was taken out of circulation in 2004 in Israel and the rest of the developed world due to its undesirable side effect: it has been linked to actually causing paralytic polio. The attenuated vaccine is administered orally and is shed, still live, into sewers (among other places). The Health Ministry has released strict hygiene guidelines for anyone in contact with or changing diapers of kids who are given OPV.

Now – in the face of the wild polio virus in our sewers – the ministry is opting to bring OPV back into the mix. And by “mix” I do mean that literally. Because the ministry only suggests OPV vaccines for children who have already received IPV – after all, in unvaccinated kids it has been associated with actual polio, including in Israel in the years 1984-1988. Israel’s sewers are regularly tested for polio and it was found in 2004 and 2007. At that time, no one launched a massive campaign to revaccinate all of Israel’s children.

OPV will not be administered to any children who have not already received IPV. The ministry isn’t interested in the portions of the population who have opted out of vaccine programs to date: the ultra-Orthodox are skeptical, the Bedouin are uninterested, and a growing portion of educated, urban parents are opting out of the vaccine schedule.

Parents have been asking questions since the campaign began, and the ministry is not always providing acceptable answers.

OPV will not be administered to children who have an immediate family member who is immunocompromised. The ministry itself is concerned it could endanger parents who are also cancer patients. Having protected these cancer patients by not administering OPV to their children, how do they protect cancer patients from the kid next door? How is the shedding limited to the household?

The ministry assures the public it is safe and well-tested to administer OPV to children who have already received IPV. Centrally, the ministry says the version of OPV associated with actual cases of polio had three strains of polio, the most aggressive of which was removed from the current version in 2009.

A grassroots parents’ campaign is seeking information about this new two-strain live polio vaccine. First and foremost, parents are asking to see the results of clinical trials showing the efficacy and safety of this new OPV. The Health Ministry has a Facebook page where it has been diligently interacting with parents, responding to concerns. But it has systematically evaded any questions about research on this version. Sometimes it says this vaccine has been in use for decades; sometimes it says this is a new, two-strain vaccine. The ministry has contacted some of the parents asking questions on Facebook in private and asked for their patience. They are still waiting, more or less patiently.

The ministry has posted a number of documents on that Facebook page. None of them seem to actually be the results of clinical trials, and some of them seem to relate to a different two-strain OPV, manufactured by a different company, than the one being administered here. Shlemielism.

This entire campaign to vaccinate against polio is geared solely to children who – according to the ministry – are all immune to polio because they got four doses of IPV.

Remember my poster children? A 9-year-old and a 3-year-old. The ministry says 9 year olds did not receive OPV back in the day. But I thought I remembered her getting it, so I looked in her vaccination card. She did get it. Does the ministry know when they stopped giving it? Or did each individual well-baby clinic do as it pleased? Shlemielism.

This campaign is not geared to those populations that have refused to vaccinate until now. They say already-IPV-immune kids should get the vaccine to protect those people who aren’t vaccinated.

Well, we know it doesn’t protect – but in fact endangers – populations who can’t get the vaccine, like cancer patients, otherwise they would administer OPV to kids whose moms are in chemotherapy. So who does it protect who doesn’t actually get the vaccine?

Remember my vaccinated poster children? I’m easy. I vaccinate. My children have a cousin. She’s not vaccinated. Her mom isn’t easy and doesn’t vaccinate. But remember that shedding? Is this how we protect unvaccinated populations? We shed OPV in their vicinity and inoculate them without dragging their skeptical parents into a clinic? My kids inoculate their cousin? Or is this more shlemielism?

Parents have asked if giving OPV to kids who already got IPV endangers them in any way - a sort of toxic vaccine overload. The ministry says it is now common practice to administer a cocktail of four doses of polio vaccine in any combination of IPV and OPV, as long as the first is IPV. “IPV first” eliminates, according to the ministry’s Facebook page, any danger of actual polio infection from OPV.

My poster child 9-year-old? She got seven - count them - doses of polio vaccine: a full run of four IPV and a full run of three OPV. Who decided on that protocol, and why doesn’t the ministry mention that they did that? Shlemielism.

Parents asking these questions - on Facebook, in television appearances, in playgrounds and at the pool - don’t seem to be those who’ve already decided not to vaccinate for anything. They seem to be just the parents the Health Ministry wants to see Sunday morning at well-baby clinics: parents who played by the book, brought their kids to the clinics and got IPV. These are the parents the Health Ministry must convince, and it must do so by transparently revealing research, answering questions and explaining its motives.

An Israeli child receives a polio vaccine in Be'er Sheva on August 5, 2013.Credit: Reuters

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