A: Routine polio vaccination of U.S. residents 18 years of age and older—including those working in healthcare or in healthcare-related training—is not recommended. Polio vaccination is recommended for all travelers to countries with wild poliovirus (WPV) or vaccine-derived poliovirus (VDPV) circulation. Countries are considered to have WPV or VDPV circulation if they have evidence during the previous 12 months of ongoing endemic circulation (WPV only), a polio outbreak, or environmental evidence (through sewage sampling) of WPV or VDPV circulation. For additional information on countries with WPV or VDPV circulation and vaccine recommendations, consult the travel notices on the CDC Travelers’ Health website (www.cdc.gov/travel) or the weekly update of reported WPV and VDPV cases at the Global Polio Eradication Initiative website (www.polioeradication.org/Dataandmonitoring/Poliothisweek.aspx).
Adults who are traveling to areas where WPV or VDPV is actively circulating and who are unvaccinated, incompletely vaccinated, or whose vaccination status is unknown should receive a series of 3 doses: 2 doses of IPV administered at an interval of 4–8 weeks; a third dose should be administered 6–12 months after the second. If 3 doses of IPV cannot be administered within the recommended intervals before protection is needed, the following alternatives are recommended:
- If more than 8 weeks is available before protection is needed, 3 doses of IPV should be administered at least 4 weeks apart.
- If less than 8 weeks but more than 4 weeks is available before protection is needed, 2 doses of IPV should be administered at least 4 weeks apart.
- If less than 4 weeks is available before protection is needed, a single dose of IPV is recommended.
If less than 3 doses are administered, the remaining IPV doses to complete a 3-dose series should be administered when feasible, at the intervals recommended above, if the person remains at increased risk for poliovirus exposure.
If an adult at risk previously received only one or two documented doses of polio vaccine (either OPV or IPV), he or she should receive the remaining dose(s) of IPV, regardless of the interval since the last dose. It is not necessary to restart the vaccination series.
Adults who have completed a routine series of polio vaccine are considered to have lifelong immunity to poliomyelitis, but data on duration of immunity are lacking. As a precaution, adults 18 years of age or older who are traveling to areas where WPV or VDPV is actively circulating and who have received a routine series with either IPV or OPV in childhood should receive another dose of IPV before departure. For adults, available data do not indicate the need for more than a single lifetime booster dose with IPV.