Vaccinations counter polio threat in Israel
Facing evidence that poliovirus has spread through the sewer system in several communities, Israel has begun an emergency vaccination program to reach 500,000 children.
The Health Ministry will initially inoculate 200,000 children, age four months to nine years, at the country’s Tipat Chalav (“drop of milk”) well-baby clinics.
The push follows the discovery by doctors of hundreds of people carrying the disease, although none, b’ezrat Hashem (with G-d’s help) were suffering with symptoms of polio or paralysis. The poliovirus was found in sewage from the Bedouin city of Rahat in May, and later in sewage in Beer Sheva, Ashdod, Tel Aviv and other nearby towns. The virus reportedly came to Israel from Egypt.
The clinics will be using the attenuated (weakened but live) oral poliovirus vaccine (OPV), pioneered by Albert Sabin in the 1950s. Although Israeli children — along with ninety-eight percent of all people in Israel — have been vaccinated with the IPV killed poliovirus vaccine (inactivated poliovirus vaccine) pioneered by Jonas Salk, the current vaccinations should prevent transmission of the poliovirus, according to news reports in Israel.
IPV has been used exclusively in the United States since 2000, usually in combination with other vaccines. It is administered as part of the child vaccine protocol in four doses at age two months, four months, six to 18 months and a booster shot at four to six years of age.
“Different polio vaccines are indicated for different scenarios,” said Rabbi Dr. Aaron Glatt, Chief Administrative Officer at Mercy Medical Center in Rockville Centre and a spokesperson for the Infectious Disease Society of America.
“I am sure they know which one to give and why,” he told The Jewish Star. “In the U.S., all get the same type as routine kids’ vaccinations. No cause for concern if you are vaccinated in the U.S. All the more reason to get vaccinated.”
According to the Centers for Disease Control and Prevention (CDC), polio, or poliomyelitis, is an infectious disease caused by a virus and is spread from feces and other body secretions. It was the scourge of the first half of the 20th century when children were most affected by the virus, with less than one-percent of those infected contracting paralytic poliomyelitis that affected their central nervous system and resulting in paralysis and sometimes death.
Thousands became ill from polio every year in the U.S. until the vaccine came into use in 1955. The World Health Organization declared naturally occurring poliovirus eradicated from the Western Hemisphere in 1994 as a result of mass immunization efforts.
After receiving three doses of IPV or OPV or four doses of a combination of the two, a person is considered fully immunized, states the CDC. The benefits of OPV use were until recently considered to outweigh the risk: generally the OPV, according to the World Health Organization, is a mixture of the three strains of live but weakened poliovirus. After three or more spaced doses of the oral vaccine the person has antibodies to the virus in the blood protecting against polio paralysis by preventing the spread of the virus to the nervous system. It also triggers an immune response in the lining or mucous membrane of the intestines a main place where the poliovirus grows, inhibiting growth of other naturally occurring poliovirus. This immunity is thought to prevent the transfer of polio to other people. The risk associated with OPV is that of vaccine associated paralytic poliomyelitis (VAPP), noted the CDC site, or paralysis resulting from the vaccine, that was found in one child out of every 2.4 million doses given. That’s why OPV was not used in the U.S. after 2000. But OPV is still used where polio is endemic or likely to spread. It is used to eradicate polio globally, rather than IPV, because of OPV’s triggering immunity in the gut and its ability to spread the vaccine to others who are unvaccinated and come into physical contact with those who have been immunized with OPV.
