CHAPTER I INTRODUCTION

1.1

Background of the Study Polio is the common name for poliomyelitis, which comes from the

Greek words for grey and marrow, referring to the spinal cord, and the suffix itis, meaning inflammation. Poliomyelitis, shortened, became polio. For a time, polio was called infantile paralysis, though it did not affect only the young Polio is an infectious disease caused by a virus that lives in the throat and intestinal tract. It is most often spread through person-to-person contact with the stool of an infected person and may also be spread through oral/nasal secretions. Polio used to be very common in the Indonesia and caused severe illness in thousands of people each year before polio vaccine was introduced. Most people infected with the polio virus have no symptoms; however, for the less than 1% who develop paralysis it may result in permanent disability and even death. Polio can be prevented with immunisation. All children and adults should receive the vaccine. If you are not immunised, you could contract polio if your food, water or hands are contaminated with the faeces (poo) of an infected person. Serious side effects or allergic reactions to the vaccine are rare. If you are concerned about your reaction or your childs reacti on to any vaccine, see your doctor immediately.

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1.2

Statement of the Problems Based on the background above, the problems of this research are: 1. What is polio vaccine? 2. What are the types of polio vaccine? 3. When Polio Immunisation Timetable? 4. Are there any side-effects and Reducing side-effects from the polio vaccine? 5. Who should not get IPV or should wait?

1.3

Objectives of the Study 1. To know the definiton of polio vaccine 2. To know the types of polio vaccine 3. To know Polio Immunisation Timetable 4. To know side-effects and Reducing side-effects from the polio vaccine 5. To know people should not get IPV or should wait

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CHAPTER II THEORY REVIEW

2.1

Definition Of The Polio Vaccine Polio immunization protects against poliomyelitis, a severe disease

that leads to the loss of movement. The vaccine contains an inactive (dead) form of the polio virus. It is called an inactivated polio vaccine, or IPV. It cannot cause polio. Polio vaccination is one of the recommended childhood immunizations and vaccination should begin during infancy. In most parts of the Indonesia, polio immunization is required before a child can start school

2.2

Types Of Polio Vaccine There are two types of vaccine that protect against polio: inactivated

polio vaccine (IPV) and oral polio vaccine (OPV). Polio vaccine may be given at the same time as other vaccines. Most people should get polio vaccine when they are children. Children get 4 doses of IPV, at these ages: 2 months, 4 months, 6-18 months, and booster dose at 4-6 years. OPV has not been used in the United States since 2000 but is still used in many parts of the world. Two polio vaccines are used throughout the world to combat poliomyelitis (or polio). The first was developed by Jonas Salk and first tested in 1952. Announced to the world by Dr Thomas Francis Junior on April 12 1955, it consists of an injected dose of inactivated (dead)

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poliovirus. An oral vaccine was developed by Albert Sabin using attenuated poliovirus.

2.2.1

Oral Polio Vaccine (OPV) Oral polio vaccine (OPV) is a live-attenuated vaccine, produced by

the passage of the virus through non-human cells at a sub-physiological temperature, which produces spontaneous mutations in the viral genome. Oral polio vaccines were developed by several groups, one of which was led by Albert Sabin. Other groups, led by Hilary Koprowski and H.R. Cox, developed their own attenuated vaccine strains. In 1958, the National Institutes of Health created a special committee on live polio vaccines. The various vaccines were carefully evaluated for their ability to induce immunity to polio, while retaining a low incidence of neuropathogenicity in monkeys. Large-scale clinical trials performed in the Soviet Union in late 1950s early 1960s by Mikhail Chumakov and his colleagues demonstrated safety and high efficacy of the vaccine. Based on these results, the Sabin strains were chosen for worldwide distribution. There are 57 nucleotide substitutions which distinguish the attenuated Sabin 1 strain from its virulent parent (the Mahoney serotype), two nucleotide substitutions attenuate the Sabin 2 strain, and 10 substitutions are involved in attenuating the Sabin 3 strain. The primary attenuating factor common to all three Sabin vaccines is a mutation located in the virus's internal ribosome entry site (IRES) which alters stem-loop structures, and reduces the ability of poliovirus to translate its RNA template within the host cell. The attenuated poliovirus in the Sabin vaccine replicates very efficiently in the gut, the primary site of infection and replication, but is

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unable to replicate efficiently within nervous system tissue. OPV also proved to be superior in administration, eliminating the need for sterile syringes and making the vaccine more suitable for mass vaccination campaigns. OPV also provided longer lasting immunity than the Salk vaccine. OPV is usually provided in vials containing 10-20 doses of vaccine. A single dose of oral polio vaccine (usually two drops) contains 1,000,000 infectious units of Sabin 1 (effective against PV1), 100,000 infectious units of the Sabin 2 strain, and 600,000 infectious units of Sabin 3. The vaccine contains small traces of antibiotics neomycin and streptomycinbut does not contain preservatives. One dose of OPV produces immunity to all three poliovirus serotypes in approximately 50% of recipients. Three doses of live-attenuated OPV produce protective antibody to all three poliovirus types in more than 95% of recipients. OPV produces excellent immunity in the intestine, the primary site of wild poliovirus entry, which helps prevent infection with wild virus in areas where the virus is endemic. The live virus used in the vaccine is shed in the stool and can be spread to others within a community 2.2.2 Inactivated Polio Vaccine (IPV) IPV is produced from wild-type poliovirus strains of each serotype that have been inactivated (killed) with formalin. As an injectable vaccine, it can be administered alone or in combination with other vaccines (e.g., diphtheria, tetanus, pertussis, hepatitis B, and haemophilus influenza). Generally three spaced doses are administered to generate adequate levels of seroconversion, and most countries, a booster dose is added during late childhood. IPV has been used successfully in the polio eradication programs in a few countries, notably in Scandinavia and the Netherlands, but until recently most countries have used the oral polio vaccine. IPV provides serum immunity to all three types of poliovirus, resulting in protection against paralytic poliomyelitis. Most studies indicate

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that the degree of mucosal immunity in the intestine is significantly less than that provided by OPV, although this difference may be less pronounced in the pharyngeal mucosal lining. Adverse events following administration of IPV are very mild and transient. Due to the risks associated with the large quantities of poliovirus needed for IPV production, following the global cessation of poliovirus transmission high level (BSL-3/polio) containment of all manufacturing and quality control areas where live virus is handled must be implemented. IPV produces less gastrointestinal immunity than does OPV, and primarily acts by preventing the virus from entering the nervous system. The IPV is available alone, or combined with: DTaP-HepB, DTap Hib, DTaP only. IPV is a shot, given in the leg or arm, depending on age. It may be given at the same time as other vaccines. 2.3

Polio Immunisation Timetable For young children, polio vaccine is normally part of the combined DTaP/IPV(polio)/Hib injection - this stands for 'diphtheria, tetanus, pertussis (whooping cough)/polio/Haemophilus influenzae type b', which is given as part of the routine childhood immunisation programme.

For adults and teenagers who receive polio immunisation, the combined Td/IPV(polio) vaccine is normally used - this stands for 'tetanus, diphtheria/polio' All children are offered polio immunisation as part of the routine

immunisation programme. A full course of polio immunisation consists of five doses of vaccine as follows:

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Adults Children (who have not been immunised as a child) Primary Course Three doses of vaccine - as DTaP/IPV(polio)/Hib at two, three and four months of age. Three years after the primary course - as part of the 4th dose DTaP/IPV(polio) pre-school booster at 3 years and four months to 5 years. Aged 13-18 years - the school 5th dose leaver booster - as Td/IPV(polio). 10 years after 4th dose - as Td/IPV(polio). Three doses of vaccine - as Td/IPV(polio), each one month apart. 5 years after the primary course - as Td/IPV(polio).

2.4

Side-Effects From The Polio Vaccine All vaccines and medicines can have side effects. However, these

are usually not serious. Severe reactions to the polio vaccine are rare they are much less common than the effects that occur with the disease itself. Some people may experience a mild adverse reaction to the vaccine. These tend to happen soon after immunisation and continue for a couple of days. a. Minor side effects may include: Muscle aches Mild temperature Soreness, redness and swelling at the injection site Unsettled and grizzly behaviour Sleepiness.

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There is a very small risk of a serious allergic reaction to any vaccine. It is important to stay at the clinic where the immunisation was given for 15 minutes after the immunisation. b. Reducing the side effects of the polio vaccine Side effects of the vaccine can be reduced: Give paracetamol to reduce any fever check the label for the correct dose (especially for children) Hold a cold, wet cloth against the injection site Drink extra fluids Make sure to avoid overheating dont overdress your child. If you are concerned about any reaction to the vaccine, contact your doctor or hospital

2.5 a.

People Should Not Get IPV Or Should Wait These people should not get IPV Anyone with a life-threatening allergy to any component of IPV, including the antibiotics neomycin, streptomycin or polymyxin B, should not get polio vaccine. Tell your doctor if you have any severe allergies.

Anyone who had a severe allergic reaction to a previous polio shot should not get another one.

b. These people should wait

Anyone who is moderately or severely ill at the time the shot is scheduled should usually wait until they recover before getting polio vaccine. People with minor illnesses, such as a cold, may be vaccinated.

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CHAPTER II RESUME

1.

Polio immunization protects against poliomyelitis, a severe disease that leads to the loss of movement

2.

There are two types of vaccine that protect against polio: inactivated polio vaccine (IPV) and oral polio vaccine (OPV)

3.

Minor side effects may include: Muscle aches Mild temperature Soreness, redness and swelling at the injection site Unsettled and grizzly behaviour Sleepiness.

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