Polio Vaccine: A Travel Essential?

The World Health Organization (WHO) has declared the international spread of poliovirus a public health emergency of international concern (PHEIC). As a result, some countries may require travellers to show proof of polio vaccination before entering or leaving the country. This is to prevent the further spread of the disease. The vaccination record is typically documented on the International Certificate of Vaccination or Prophylaxis, which is the only document accepted as proof of vaccination. It is recommended that travellers consult a healthcare professional or visit a travel health clinic to discuss their travel plans and determine if they need any additional vaccinations or medications.

Countries may require proof of polio vaccination

Countries may require travellers to provide proof of polio vaccination upon entry or exit. This is to prevent the spread of the poliovirus and potential epidemics. The most widely used vaccination record is the International Certificate of Vaccination or Prophylaxis (ICVP or Carte Jaune/Yellow Card).

The World Health Organization (WHO) recommends that all travellers to polio-affected areas be fully vaccinated against polio. Travellers to countries with an increased risk of exposure to poliovirus may need to show proof of polio vaccination on their yellow ICVP when departing the country. As of August 2020, Afghanistan and Pakistan are the only polio-endemic countries in the world, but outbreaks can occur in other countries where people may not be fully vaccinated. Several countries have additional precautionary polio vaccination requirements, including China, Indonesia, Mozambique, Myanmar, and Papua New Guinea.

The recommended primary vaccination series for unvaccinated adults consists of three doses: the first dose at any time, the second dose one to two months later, and the third dose six to twelve months after the second dose. If the accelerated schedule cannot be completed before travel, the remaining doses should be administered in the visited country or upon returning home.

Children should also be vaccinated against polio before international travel. The routine series of four doses is recommended for infants and children in the United States. If a child cannot complete the routine series before departure, an accelerated schedule can be followed, with the final dose administered at least six months after the previous dose.

The polio vaccine is available at pharmacies

The World Health Organization (WHO) recommends that all travellers to polio-affected regions be fully vaccinated against the virus. For residents and visitors staying for more than four weeks in these areas, an additional dose of OPV or IPV is advised within four weeks to 12 months of travel. It is crucial to review the vaccination requirements for your destination country and consult a travel health advisor if needed.

The polio vaccine is typically administered in several doses, with children receiving four doses at specific ages. In some cases, an accelerated schedule may be recommended for children who cannot complete the routine series before travelling. Adults who have never been vaccinated or have incomplete vaccination histories should receive three doses of IPV.

Pharmacies play a vital role in providing convenient access to the polio vaccine. However, it is always advisable to consult with a healthcare professional or your doctor's office to determine the best course of action for your specific situation. They can provide personalized advice and address any concerns or questions you may have regarding the polio vaccine or any other recommended vaccinations for your travel plans.

Polio is endemic in Afghanistan and Pakistan

Poliomyelitis, commonly known as polio, is a highly infectious disease that can cause permanent disability and even death. While most infected individuals exhibit mild or no symptoms, they can still unknowingly pass on the infection to others. In a small number of cases, the poliovirus may attack the nerves of the spine and brain, resulting in more severe symptoms. Although there is no cure for polio, the disease can be prevented through vaccination.

Afghanistan and Pakistan are the only two remaining polio-endemic countries globally. In recent years, significant progress has been made in these countries to eradicate polio. In 2018, only eight cases were reported from a handful of districts in Pakistan, and Afghanistan registered 56 cases in 2019, down from 190 cases in 2011. However, due to the highly infectious nature of the poliovirus, failure to eliminate it from these last strongholds could result in a resurgence, with an estimated 200,000 new cases worldwide annually within a decade.

Several factors contribute to the continued endemicity of polio in Afghanistan and Pakistan. Political instability, inadequate health infrastructure, and government negligence are among the primary reasons. However, the most significant challenge is the opposition from religious militant groups, particularly the Taliban. These groups have resisted polio-prevention campaigns, claiming that vaccinations are "un-Islamic" and part of a Western plot to sterilize Muslim populations. Militants have resorted to violence, kidnapping, beating, and assassinating vaccinators to stop antipolio initiatives.

Despite these challenges, efforts to eradicate polio in Afghanistan and Pakistan remain steadfast. The World Health Organization (WHO) and partners in the Global Polio Eradication Initiative are committed to supporting both governments in tackling polio. National Immunization Days (NIDs) in Afghanistan aim to reach nearly 10 million children through house-to-house and health facility-based approaches. In Pakistan, polio vaccination teams cross the Indus River to reach remote communities. Community awareness about the importance of polio vaccination is increasing, but more work is needed to dispel myths and convince hesitant families.

The WHO recommends polio vaccination for travellers

The World Health Organization (WHO) recommends that all travellers to polio-affected areas be fully vaccinated against polio. This is because polio is a highly infectious disease that can spread easily from person to person through contaminated food and water. It can enter the body through the mouth, mainly from food or water contaminated with faeces.

The WHO advises that residents and visitors staying for more than four weeks in infected areas should receive an additional dose of oral polio vaccine (OPV) or inactivated polio vaccine (IPV) within four weeks to 12 months of travel. This includes those who have previously received three or more doses of OPV or IPV and should be given another one-time booster dose of the polio vaccine. If it is not possible to get vaccinated before last-minute travel, it is recommended to get at least one dose of OPV or IPV before departure if the previous dose was more than 12 months ago.

The specific requirements and schedules for polio vaccination may vary depending on the country, so it is essential to check with the national health authorities of the destination country. Some countries may require long-term travellers to show proof of polio vaccination upon departure. This documentation is typically recorded on the International Certificate of Vaccination or Prophylaxis (ICVP), also known as the "yellow booklet."

It is worth noting that polio is part of the routine childhood immunization schedule in many countries, and children are typically vaccinated with four doses of IPV at ages 2 months, 4 months, 6-18 months, and 4-6 years. However, infants and children travelling to high-risk areas should complete the routine series before departure to ensure they are fully protected. Similarly, adults who are unvaccinated or incompletely vaccinated should complete the primary vaccination series or receive the remaining doses before travelling to polio-affected areas.

Polio vaccination is documented on the ICVP

The International Certificate of Vaccination or Prophylaxis (ICVP), also known as the "yellow card", is an official, internationally recognised document that travellers use to provide proof of vaccination. The ICVP is a type of medical passport that may be required for entry to certain countries with increased health risks. The certificate is issued by yellow fever vaccination (travel) clinics and must be validated with the Uniform Stamp of the centre where the vaccine was given. The ICVP is not an immunity passport, but rather incentivises individuals to obtain vaccination against a disease.

The ICVP was established by the International Sanitary Convention for Aerial Navigation in 1933 and came into force in 1935. It was amended in 1944 to include the following certificates:

• International Certificate of Inoculation Against Cholera
• International Certificate of Inoculation Against Yellow Fever
• International Certificate of Immunity Against Yellow Fever
• International Certificate of Inoculation Against Typhus Fever
• International Certificate of Vaccination Against Smallpox

The ICVP is only valid for vaccines approved by the World Health Organization (WHO). The form must be completed in English or French by a medical practitioner or authorised health worker and must include the official stamp of the administering centre. The main portion of the ICVP is a form for physicians to fill out when administering a vaccine. This section includes the traveller's name, date of birth, sex, nationality, national identification document, and signature. For each vaccine administered, the physician must include the prophylaxis or vaccine administered, date, signature, manufacturer and batch number, dates valid, and an official stamp from the administering centre.

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