Mother in Israel’s Guide to the Polio Vaccine Campaign

Israel lives with constant military threats. Lately we are dealing with an invisible threat, the polio virus, which has crossed our borders via Egypt. Polio was supposed to have been eliminated by now, through aggressive vaccination. One of the most dangerous strains is already extinct. But partly because of conspiracy theories (in Pakistan, health workers were killed because vaccines are considered a Western attempt at fertility control), polio is still active in a handful of countries. The Global Polio Eradication project lists polio as endemic in Afghanistan and Pakistan. (Update August 2016: Nigeria was taken off the list since this blog post was first published.) Importation countries, where the virus commonly erupts, include about ten countries throughout Africa like Chad, Niger, and Somalia. Israel may well join this infamous list.

Before I address parents’ concerns, let’s start with the definitions:

IPV= Inactivated Polio Vaccine.  This vaccine is made from 3 strains of the wild virus that are killed with a form of formaldehyde and is usually given through intramuscular injection. According to polioeradication.org:

The inactivated polio vaccine produces antibodies in the blood to all three types of poliovirus. In the event of infection, these antibodies prevent the spread of the virus to the central nervous system and protect against paralysis.

All children in Israel receive a series of IPV injections beginning at 2 months of age. After the regular schedule of 3 doses, individuals gain 99% immunity.

OPV= Oral Polio Vaccine. This vaccine is made from live weakened forms of the virus and is given orally in drops. Also from polioeradication.org:

OPV produces antibodies in the blood to all three types of poliovirus. In the event of infection, these antibodies protect against paralysis by preventing the spread of wild poliovirus to the nervous system. OPV also produces a local, mucosal immune response in the mucous membrane of the intestines.

In the event of infection, these mucosal antibodies limit the replication of the wild poliovirus inside the intestine. This intestinal immune response to OPV is thought to be the main reason why mass campaigns with OPV can rapidly stop person-to-person transmission of wild poliovirus.

All children in Israel born between 1990 and 2004 received several doses of OPV. In the US, it was used until 2000. Because of the slight risk of contracting Vaccine Associated Polio Paralysis, it is not used in countries where this is no active threat of wild polio. This has been the case here from 2004 until recently.

WPV= Wild Polio Virus, the active form of the virus that has been found in the sewage in the south and center of the country, as far north as Baka al-Jarbiya.

VAPP= Vaccine Associated Polio Paralysis. This is the reason for not using the OPV in countries without a polio threat. In a tiny number of cases in particular conditions, the OPV has led to a child getting a full-blown case of polio. According to the CDC:

Until recently, the benefits of OPV use (i.e. intestinal immunity, secondary spread) outweighed the risk for vaccine-associated paralytic poliomyelitis (VAPP) which occurred in one child out of every 2.4 million OPV doses distributed. To eliminate the risk of vaccine-associated paralytic poliomyelitis (VAPP), as of January 1, 2000, OPV was no longer recommended for routine immunization in the United States. [Ed.: Israel stopped giving OPV as part of routine immunizations in January 2004].

First a little history. The last two polio outbreaks occurred in Israel in the 1980’s. From 1983-1987, 8 people came down with polio. Half of the cases were associated with the OPV, but the situation was different then: The OPV was given to children who did not have the IPV first. In 1988, 15 people became seriously ill. These people contracted the disease not from the vaccine, but from the WPV–the wild virus that was circulating throughout the country. Those patients had either been unvaccinated or had only received the IPV. The country held a massive campaign to give the OPV to everyone under 40, thus ending the outbreak.

The situation today is nearly identical to the situation in 1988: A lot of children protected only by the IPV, the WPV circulating and spreading, and a fear of polio for those who cannot be vaccinated because of immunological issues. The 1988 outbreak led to the reintroduction of the OPV for all children. From 1990-2004, all children received both the IPV and the OPV. On page 10 of my 9-year-old’s vaccination folder, reproduced above, it clearly shows that she received the oral drops.

In 2004, after years of monitoring, it was felt that it would be safe to stop the OPV because the WPV was no longer a threat. But the health ministry has been monitoring the sewage. Earlier this year, the virus was found in Egypt, which quickly stepped up with its vaccination campaign. An article in Yediot Acharonot claimed that at that point, Israel should have already begun to act. But only once the virus was found in sewage in Rahat, a Beduin town in the south, did the ministry began filling the holes and making sure that all children were up to date with the IPV. Later still, after consultation with the World Health Organization, it decided that the OPV was also warranted for all children in Israel who have not received it. This generally means children born in 2004 and later. If you are not sure if your child received it, you can check your vaccination book or ask at Tipat Halav (well-baby clinic).

Since there has been so much talk about the risk of the OPV, let’s review the risk of contracting polio:

Symptoms
Most infected people (90%) have no symptoms or very mild symptoms and usually go unrecognized. In others, initial symptoms include fever, fatigue, headache, vomiting, stiffness in the neck and pain in the limbs.

Acute flaccid paralysis (AFP)
One in 200 infections leads to irreversible paralysis, usually in the legs. This is caused by the virus entering the blood stream and invading the central nervous system. As it multiplies, the virus destroys the nerve cells that activate muscles. The affected muscles are no longer functional and the limb becomes floppy and lifeless – a condition known as acute flaccid paralysis (AFP).

All cases of acute flaccid paralysis (AFP) among children under fifteen years of age are reported and tested for poliovirus within 48 hours of onset.

Bulbar polio
More extensive paralysis, involving the trunk and muscles of the thorax and abdomen, can result in quadriplegia. In the most severe cases (bulbar polio), poliovirus attacks the nerve cells of the brain stem, reducing breathing capacity and causing difficulty in swallowing and speaking. Among those paralysed, 5% to 10% die when their breathing muscles become immobilized.

Post-polio syndrome
Around 40% of people who survive paralytic polio may develop additional symptoms 15–40 years after the original illness. These symptoms – called post-polio syndrome – include new progressive muscle weakness, severe fatigue and pain in the muscles and joints.

I can’t possibly answer all of the questions that have been raised about the vaccine. Most have been pulled out of the air and have no basis in reality.  They come from the agenda of the anti-vaccination movement, and they waste the time of medical professionals who must spend additional time convincing parents of what should be obvious. Anti-vaccination groups have succeeded in sowing doubt among educated and rational parents, leading them to consider not vaccinating at all and in this case, refusing to participate in the current campaign that is meant to prevent a full-blown epidemic.

This is the most salient fact and it cannot be emphasized enough: The risk of a polio epidemic is real. Forty-two children have been found to be carrying the virus in their gut. So far the IPV has prevented any children from getting the disease, and carriers are symptom-free. But only the OPV can prevent them from becoming carriers of the wild virus. Unfortunately, the ministry at first only related to the risk of the unvaccinated population- which mainly includes immunosuppressed cancer/autoimmune disease patients.

Children are protected fairly well by the IPV injections they received at their regular Tipat Chalav appointments. Why get the OPV for our kids just so they won’t become carriers? Most of us don’t have loved ones who are undergoing chemotherapy or are otherwise immuno-suppressed.  But the OPV helps prevent the virus from spreading, and apparently people feel that as long as their children aren’t at risk, a polio epidemic isn’t such a bad thing.

The Health Ministry has since changed its tune about the benefits to the children getting the OPV:

“Question: My young children have been vaccinated against polio. Why do they need to be vaccinated again? Answer: The vaccine is intended to provide additional protection to your children and to the entire extended family.”

While the ministry maintained that the vaccine was not necessary for the children who have received the IPV, parents thought they could avoid the small risk of the OPV by refusing to participate in the current vaccine campaign. Why take a risk to help prevent spread the vaccine among the unvaccinated, whether they don’t vaccinate for medical or ideological reasons? Haaretz even claimed that there was an ethical issue with vaccinating people who are immune, purely for the sake of public health. But the fact is that children are better protected from polio with the IPV and the OPV than with the IPV alone. Children who have only had the IPV are also at risk in case of an epidemic. The IPV will generally protect children, but only as long as their immune system is strong. The IPV won’t help children exposed to the WPV when they are being treated with steroids (not uncommon) or undergoing chemotherapy. Your children might be healthy now, but would you want to take a risk that they will stay that way? Also, the vaccine is about 99% effective. That sounds great, but not if your child is the one in 100 for whom the IPV doesn’t take.

Let’s address a couple of arguments against the vaccine.

  • We have good hygiene in Israel. Polio is spread via contact with feces, so washing your hands will help a lot. However, the virus has still spread to 42 people (as carriers, but it counts). Are you willing to rely on everyone else’s good hygiene to prevent such a serious disease? Do you trust the store assistant who handles your produce, or the child playing with yours in the park?
  • The vaccine has not been tested. It’s true that there was no clinical trial of the Glaxo-Smith-Kline version of the bivalent OPV. But that is not a reason to panic. The WHO relied on trials done by the previous manufacturer. The GSK version of the vaccine has been used on millions of children since 2009, with no unexpected effects. That is much more significant than a clinical trial on a small number of people.  Are the parents concerned about “lack of testing” so careful about every medicine and food they put in their children’s mouths? For a detailed response from the WHO to the accusation of lack of clinical testing, see the letter from Suzanne Pfeiffer to Uri Goren (English excerpt below).
  • The risk of spreading the virus via shedding from the OPV is higher than from the WPV. This is absolutely false, yet people state it with absolute certainty. It is based on the fact that the weakened virus is shed in the feces of children who  have had the OPV recently. That is why children with a first-degree relative who is immuno-compromised will not get the OPV. Nearly every child in Israel got the OPV several times between 1990 and 2004. At the time we were warned to be careful to wash hands and double-wrap diapers, just like now. Yet not one person came down with polio via the OPV. There is no reason to think that today’s OPV is going to spread polio, when it didn’t then. In fact the risk of VAPP is significantly lower, since the most dangerous strain of the weakened virus has been removed.
  • I’ll just wait and see what happens. Parents feel that it pays to take a middle ground. However, this places them firmly on the side of contributing to a polio epidemic. The virus is here now and it is spreading. Parents who wait are increasing the chances that their child will become a carrier or possibly become ill with polio. In a few weeks or months, the tide will have turned one way or the other. Maybe you (and the excellent health system we all rely on) will be lucky. Or maybe not.
  • Why should I vaccinate to protect those crazy people who don’t vaccinate? It’s their problem. I see this point, except that you are doing the same as they are by relying on others to protect your child and loved ones. It’s also not the fault of the children that their parents chose not to vaccinate them. But there are many people at risk because the vaccine would be too dangerous for them, and it is the right thing to do to help protect them. The OPV also protects your own children, as I explained above.
  • Even if the risk is small, why should I take it? People are upset that the health ministry has said that the risk of getting polio (VAPP) from the OPV is zero.  That is not right, but it is pretty close. OPV after the IPV will prevent VAPP. In the modern era there has been only a single case of VAPP associated with the OPV, in which the child had received IPV. The cases of VAPP in India recently and in Israel (1988) and elsewhere occurred when the child received OPV without having received the IPV first. The chances are listed by the health ministry as 1 in 2.7 million, but many times that number have received the OPV throughout the world. So if your child has received the IPV and now gets the OPV, the chance of contracting VAPP are infinitely smaller than virtually every other everyday hazard you can imagine: Getting hit by a car on the sidewalk, choking on food, getting hit by a falling tree, and so on. The danger of getting sick from a full-blown wild polio epidemic with just the IPV  is much greater than any risk from the OPV.

Here is an excerpt from the WHO about the “lack of testing”:

First clinical trials are required to answer well defined questions of product effectiveness, dosage and safety. The size of clinical trial matters when it comes to ability identifying post-vaccination reactions. Clinical trials will identify very common, common and uncommon reactions, i.e. those occurring up to one case in 1.000 vaccinated. Some vaccine trials have been designed to identify rare reactions, i.e. occurring app 1/10.000 vaccinated recent examples include HPV, rota virus vaccines. To identify rare events, at least 30.000 or more individuals need to be enrolled in a clinical trial. However, for very rare events these cannot be identified by a clinical trial, but by using postlicensure monitoring systems which are regular systems that monitor safety and effectiveness of products over decades and for millions of doses administered. These can trace signals for very rare events which then lead into more targeted search and specific studies. Simply, there are limits what clinical trials can produce.

Many parents are concerned about a fetus and newborns. According to the Health Ministry:

  • Can children living in a household with pregnant women receive the vaccine? Children who are candidates for the live-attenuated vaccine (OPV) can receive the vaccine when there are pregnant women in the household both at the time of the vaccination and afterwards. Immunizing the older siblings will prevent their becoming infected with the wild polio virus, and therefore the infants will be protected as well.
  • Can children with a sibling/siblings under the age of two months receive the vaccine? There is no need to avoid the vaccine if there are children under the age of two months in the household. Immunizing the older siblings will prevent their becoming infected with the wild polio virus, and therefore the infants will be protected as well. It is advised to maintain the personal hygiene of all the individuals living in the household by washing hands with water and soap for at least 20 seconds, in particular in the following situations: after visiting the toilet, before any contact with food, and also after changing diapers.

According to Human Virology, by L.H. Collier (2000), newborns are protected from polio by maternal antibodies until about six months. Vaccines given before then are to ensure that immunity is in place by that point.

Still not convinced? Check out these links:

Thanks to reader Abbi Adest for comments, corrections, and additions, including many useful links. 

More from A Mother in Israel:

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The Burka Wedding Pictures

Should Orthodox Girls Get Vaccinated against HPV? 

Comments

  1. Rachel Ann Anolick-hindarochel says

    When I was a child my doctor insisted on giving us the IPV first, followed by the OPV because he had concerns about the OPV. Smart man.

    I understand people’s fears about the vaccine, however I feel they are misplaced. Everything in life entails risk; understanding the true risks helps lead to making intelligent decisions. In this case, the risk factor of the disease is greater than the risk in the inoculation. But IPV first.

  2. David Strausberg says

    Hi Hanna,

    You wrote: that “the WPV [is] circulating and spreading”. Do you have any proof of that? I’ve read that finding the virus in the sewers is the result of administering the IPV – not WPV, and that there aren’t any actual in the wild cases in Israel now or in the past dozen years.

    Regards,

    David

    • David: The spread of the wild virus (WPV) is the entire reason for the new campaign. I’m not sure what you read, but it’s simply not true. It’s not connected to the IPV or the OPV, and the people who test know the difference. In the Yedioth article I linked to there are many, many details about how the virus has been detected.

    • David,
      The IPV is an inactivated vaccine, the viruses are dead. Their genetic material will cause the human body to build up immunity against it, but the dead viruses can not spread the disease. The viruses from the OPV, a live-attenuated vaccine, can spread through feces of the vaccinated person. But since the viruses are weakened, they can not reproduced and should not cause disease.

  3. EXCELLENT post – you summarized and explained the data in a user friendly way. WOW

  4. Great post, I’ve learnt many things I did not know. Here in Brazil, we have universal vaccination against polio. When I was a child – I was born in 1976 – it was really mandatory and most of the country is free from the virus now. The problem is as people do not see polio survivors anymore, they are relaxing. In my childhood, we used to have two campaign a year. Just one day to take the oral vaccine. The last campaigns were extended for weeks because parents, most of them very young, are not worried about their children health, they grew up in a country freed from polio, but the most scariest thing is christian fundamentalists are spreading the idea that vaccination is a menace (*OPV causes cancer or an attempt at fertility control*). Just imagine that? It’s really horrible and I fear for the future. During the rubella (German measles) campaign they tried the same thing, and in fact most people did not get the vaccine for many motives, being religious propaganda the most wretched of all of them.

  5. Excellent post! Thank you for a detailed, level-headed analysis of the situation.

    Regarding David’s post- Pro-med posted a detailed explanation of the source of the WPV and it’s genetic identity:

    “On [3 Jun 2013] wild poliovirus type 1 (WPV1) was detected in 2 sewage samples taken in Beer Sheba, one on [9 Apr 2013] and the other on [13 May 2013]. Beer Sheba is a city with a population of about 200 000, 20 km [12.4 mi] south of Rahat, the town where the virus was first detected from a sample taken on [9 Apr 2013]. Beer Sheba is the nearest commercial center to Rahat, and there is considerable communication between these towns.

    The samples collected in Rahat yielded an exceptionally large number of plaques on L20B cells while the samples from Beer Sheba yielded only a few plaques. Representative isolates from Rahat and all isolates from Beer Sheba were then analyzed and identified as non-Sabin poliovirus type 1. Further analysis by PCR and sequencing revealed that these isolates belong to the SOAS [South Asia] lineage of wild poliovirus type 1 which circulates in Pakistan and Afghanistan, and which was also isolated from sewage in Egypt in December 2012.

    As the WPV1 isolate was identified as similar to the WPV1 identified in environmental (sewage) samples in Egypt earlier this year (2012) (see ProMED-mail Poliomyelitis – worldwide (01): Egypt ex Pakistan, Niger 20130122.1509210) one suspects that the virus’ itinerary was most likely Afghanistan/Pakistan to Egypt, to Israel.”

    I can’t post the link but you can search by date: 2013-06-05 15:19:05

  6. Hannah,
    Nice and important post. One small correction on your comments about IPV. The vaccine is not injected into the bloodstream but should be administered SC or IM. The reaction of the body happens of course in the bloodstream.

  7. Well done Hannah. This is very thorough and I can see you’ve done your homework!

  8. Tamar Oren says

    Thank you Hannah for a very informative post. I do have one question which maybe you can answer. Do you know after how many doses of the IPV it is safe to give the OPV? My two month old has had only one dose of IPV so far (with the next dose scheduled when he’ll be four months old) and I am not sure if it is safe to give him (or the other children in my house, for that matter) the OPV….

    • Hi Tamar,
      Here is the question according to the Health Ministry Q&A:
      “Who must not be vaccinated against polio?
      It should not be given to a baby or a premature infant who has not previously received at least one dose of IPV. It must not be given to infants or children who have not received any dose of IPV in the past. In case of illness with fever. The vaccine should also not be given to a child who has a first degree relative with an impaired immune system.”
      When the OPV was part of the routine vaccine schedule, it was given at 4 months along with the second dose of the IPV. The ministry is also saying now that it should be given to babies over 4 months of age.

  9. Sara Bonchek says

    Thanks so much for taking the time to research and write such a detailed and informative post. I don’t know if you will be able to answer this question, but is it safe to vaccinate children who have a newborn sibling or are about to (please G-d) have a newborn sibling?

  10. Sara Bonchek says

    Thanks so much, Hannah, for the update about pregnant women. Ketivah v’chatimah tovah to you and your family.

  11. On the other hand, the CDC recommends two IPV doses before OPV is given, with at least a 4-week interval in between doses: “For accelerated sequential IPV-OPV vaccination of infants and children, the first three doses (IPV, IPV, OPV) should be administered at 4-week intervals. The second dose of OPV should be administered at 4-6 years of age.”(www.cdc.gov/mmwr/preview/mmwrhtml/00046568.htm)
    This is from 1997, and if the recommendation has changed since then, I would be happy to hear about it. But in the meantime, although I’m religious about vaccinating in general, I remain reluctant to rush to get the oral vaccine for any of my kids right now because my youngest is 4 months old and just had her second IPV dose this week. I know the Health Ministry says the older ones could protect the baby if they got the OPV – but since as far as I can understand they could also potentially spread vaccine-associated polio within the household (particularly given that no matter how hard I try I just can’t guarantee that a 2- and 4-year-old will maintain good hygiene), I remain unconvinced about the benefits of getting the oral vaccine within the next four weeks.
    I think you did a good job of portraying the complexity of the issue here, but the Health Ministry’s misleading responses (such as not even mentioning vaccine-associated polio) leave me doubting whether I can trust them.

    • The CDC recommendation you quote is for countries where wild polio is not present. For situations like ours, where wild polio is definitively present in the population (42 people have been found to be carriers so far), the CDC and WHO recommend mass vaccination with OPV for everyone from ages 2 months and up, regardless of previous IPV vaccines. I have heard from people who work with WHO reps on polio eradication that they feel Israel is being extremely conservative with who is being vaccinated with OPV at this point.

      “In most countries, OPV remains the vaccine of choice in routine immunization schedules and supplementary immunization activities.

      Where more than one type of wild poliovirus is circulating, OPV is epidemiologically and operationally the best vaccine to use because protection develops to each of the three types of polio virus. – See more at: http://www.polioeradication.org/Polioandprevention/Thevaccines/Oralpoliovaccine(OPV).aspx#sthash.bcjOOxws.dpuf”

      In terms of weighing the risks, the chances of OPV turning into the full blown virus is 1 in 2.5 million without previous IPV vaxing. The chances with IPV are infinitesimal (even one shot). Misrad Habriut hasn’t hidden any dangerous information because the simple fact is that at this point, a full blown polio epidemic is a MUCH more dangerous risk then the infinitesimal chance of contracting VAPP from OPV.

      Again, on top of the fact that OPV was given as part of the regular Tipat Chalav schedule between 1990 and 2004 without one child being harmed.

      My takeaway from looking at all of the sources for this article is that we are facing the real risk of a polio outbreak and OPV is the best way to stop it in its tracks before it seriously harms children or adults. This method has been used in other countries (the Netherlands, Somalia) to great success. Misrad Habriut is not pulling this out of the air. But in order for it work , we all need to participate.

      If you haven’t seen this article from Scientific American, please take a look. It just confirms everything we have said above: http://www.scientificamerican.com/article.cfm?id=does-israels-new-polio

  12. very interesting article, well written. my qustion is, what would you recommend to do for infants who have not yet recieved the full course of the IPV? you mentioned that the OPV was to be taken after the IPV…?thanks

    • Thank you, Tova. According to the health ministry, the OPV should be given at 4 months with the second dose of the IPV. That used to be the routine until 2004.

  13. The Health Ministry site says that children born after January 1st, 2004 need to get the OPV drops, but my son was born at the end of May 2004 and his vaccination booklet shows that he received three doses of the IPV as well as three doses of the OPV (so his OPV page resembles your daughter’s OPV page in the photo). Can I take that to mean that he doesn’t need to get the OPV drops now, even though he was born after January 1st?

  14. Hannah, were you using cloth diapers when your children received the OPV? Did you have any special washing instructions?

  15. Excellent post. It is hard to believe polio is even entering the vocabulary again. I hope your post is convincing to the anti-vaxers.

  16. Please see Gary Nulls documentary on how the FDA tests the safety of drugs and vaccines at
    youtube.com/watch?v=h0CQrL5nzwo
    and then get back to me.

  17. Julie Rosenzweig says

    Thank you for this informative and helpful post.

  18. Overheard a conversation that many people in the ma’arechet = health system are not giving the vaccination to their kids

  19. Don’t hesitate to vaccinate, against all forms of polio. I had polio in the early 50’s, the last major epidemic in North America. To this day many of us deal with post-polio syndrome, and we are the lucky ones. We lived.
    Polio is systemic and creates life-long disabilities, minor and major. For those countries who have limited vaccinations as some sort of hold out against the west, I can only imagine the response from the people who get the disease and are fortunate enough to survive.
    I have a great grandchild about to be born in Israel. I will ask that the baby be vaccinated. I was not aware that polio was any kind of issue in Israel. Thank you for this information.

  20. Hannah, this is the best backgrounder on the polio outbreak that I have read. You’ve answered all the myriad questions that I and my children had about the vaccinations. I’ve sent your article to all my family and friends. Kol hakavod.

    My only concern is that my married kids, both of whom live in yishuvim in the Shomron, haven’t heard yet from their clinics or local councils when the vaccinations will take place. Is there any danger in this long wait?

    • I imagine they are just very busy. As I pointed out, there is value in taking care of it quickly. I hope other readers from the Shomron can help answer. I’ll also post on the FB page.

  21. Thank you Mother In Israel, for such a clear and thorough report. Shockingly, I was asked by an acquaintance in the US what action should be taken by her young-adult son studying in Israel, since for ideological reasons she did not vaccinate him as a child! Do you have any information to share for non-vaccinated adults currently in Israel? Thanks in advance.

    • Nurse Noa writes: He should go to the Lishkat Habriut (there’s one in Jaffa Rd) and get the IPV. The kupah will not give it to adults. And I love how “ideological” non-vaccinators change their tune when they think real risk is involved. You should see how nasty the non-vaccinators parents are getting with me – demanding to be seen immediately to get the IPV when just a few months ago they told me they believe in the body’s innate strength and/or Hashem’s loving kindness.
      Hannah: When I went to South America I got vaccines at the travel clinic at Beilinson; I imagine other hospitals have them too.

  22. Thank you so much! I felt I had halve answers from the ministry of health and you synthetized everything in one great article. I’m going next week to Tipat Halav

  23. There is actually plenty to worry about an untested medicine of any kind whatsoever.
    And you cannot trust the Israeli Ministry of Health to be honest.

    Cast in point: Eltroxin. Eltroxin was the only thyroid medicine available in Israel until 2011. In 2011, it changed manufacturer. The new medicine came from Germany, and was also untested but caused plenty of health problems in the general population in Norway, and since 2011 in Israel. I begged and pleaded to be taken off this medicine for years. In 2012 I suffered a 16 week second trimester miscarriage because of it, after I had asked doctor after doctor to take me off of it. Eltroxin caused thousands of miscarriages in Israel between 2011 and 2012, yet the Ministry of Health refuses to take any responsibility.

    If you want to give untested OPV to your child, then your choice. But don’t our children deserve better?

    • Anon, I’m so sorry to hear about your miscarriage.
      OPV is among the most tested medicines/vaccines on the planet. This manufacturer’s vaccine has been given to a billion children since 2009. It’s not correct to say it’s untested.

  24. Says in the article above that the GSK that is currently being distributed in Israel was NOT clinically tried. Furthermore, it caused 47,000 children in India to die or be maimed.

  25. I know they like to play down the absence of clinical trials, but I learned the hard way that even the slightest alteration of even an “inactive” ingredient can wreck havoc and misery. I think the children of Israel deserve better.

    • As I explained in the article it’s not a question of “playing down” the absence of clinical trials. Real-life use among a billion children tells us much more than a trial on a small number of people. The children who have been damaged by OPV (don’t know if your number is accurate) did not get the IPV first. Leaving out that fact is disingenuous.

  26. I don’t think any of the parents were given a choice in the situation. It was in India.

    If GSK made an OPV vaccine, it doesn’t matter if OPV has been used before if this version of the vaccine has not been tested. People get harmed. and even if the chance of being harmed is 1 in 100, if you’re that 1 then it’s 100% for you.

  27. Thanks for the thorough explanations! I just wanted to point out that although the Israeli Health Ministry claims that “Children who are candidates for the live-attenuated vaccine (OPV) can receive the vaccine when there are pregnant women in the household…”, it is written on the vaccine pamphlet to be cautious after getting the vaccine when you are in close contact with pregnant or lactating women. This is copied directly from the oral bivalent vaccine pamphlet which can be found on the WHO website: “Take special care with [the oral vaccine]… vaccine viruses can be excreted… and reach contact persons, including pregnant and lactating women. However the safety of [the vaccine] in pregnant or lactating women is unknown.”

  28. Hi
    My daughter 3.5 years old , before 12 days , gave her oral polio vaccine , accidentally they gave her 8-10 drops!! instead of 2 drops as one shot !! I want to know whats the risk of this overdose , my daughter take her all previous polio vaccines according to ministry of health program (3 separate doses) ,, please answer me & if there’s any test can I do to exclude problems or to test her immunization against polio please tell me about it
    Regards & hope to answer me as soon as you can …..

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