Your Guide To Adult Vaccines
Polio has practically been relegated to history books since 1979, when the virus that can sometimes cause permanent paralysis and death was wiped out from the U.S., thanks to highly successful vaccines.
But the poliovirus has reared its head again. Most recently, health officials noticed it in wastewater in New York City and several nearby counties, suggesting that it’s likely circulating in the area. And in July, the first case of polio in nearly a decade, and one that caused paralysis, was identified in an unvaccinated man in a community just north of the city, along the Hudson River.
New York State Health Commissioner Mary T. Bassett, M.D, called the findings “alarming,” since “for every one case of paralytic polio identified, hundreds more may be undetected.”
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That’s because most people who get infected with poliovirus do not have visible symptoms; about 1 in 4 experience flu-like illness. A much smaller proportion of people with a poliovirus infection develop more serious symptoms that affect the brain and spinal cord and can lead to paralysis and death, the Centers for Disease Control and Prevention (CDC) says.
The good news is, if you’ve been vaccinated — even if it was decades ago — you don’t have much to fear when it comes to these latest discoveries, says Svea Closser, an associate professor in international health at the Johns Hopkins Bloomberg School of Public Health. The vaccine is highly effective in fully vaccinated people, providing at least 99 percent protection against polio. And experts expect the effects to be long-lasting.
“We have not had a case in an adult vaccinated person in the United States for many decades,” Closser says. “If you were fully vaccinated as a kid, there’s not really any reason to worry about it at this point.”
The CDC says most adults in the U.S. were vaccinated as children (the vaccine first became available in 1955), and that continues to be the case. Federal data shows that nearly 93 percent of kids are vaccinated against polio by the age of 2. Still, a share of the population remains vulnerable to a viral illness that at one point paralyzed more than 15,000 Americans each year.
How do you know if you’re protected?
People who are fully vaccinated have received four doses of the vaccine, which was once given orally; now it’s a shot. If you are partially vaccinated, meaning you’ve only had one or two doses, health officials say you should get the remaining doses, no matter how much time has elapsed.
And if you haven’t been immunized, go get the polio vaccine, experts urge. You need only three shots if you are starting the series as an adult.
Unsure of your vaccination status? Unfortunately, there isn’t a national organization that maintains these records. The CDC suggests asking family members for your vaccine history or checking baby books or other saved documents. Some doctor’s offices hold on to this information if you know where you were taken as a child — same with some state health departments.
If you still can’t track down your vaccine records and are concerned, the CDC says it’s safe to repeat vaccines, and the one for polio comes with minimal side effects, such as soreness and redness at the injection site. There is a polio booster, but only fully vaccinated adults at increased risk of encountering the poliovirus need the onetime shot. Eligible individuals include:
- People who are traveling to a country where the risk of getting polio is greater
- Laboratory workers who may be exposed to samples of polioviruses
- Health care workers treating patients who have or could have polio
Talk to your primary care physician if you fall into one of these categories and are interested in getting boosted.
Older adults have an important role to play
While there’s no need for most older adults to stress over the latest news involving polio, Closser says they’re not fully off the hook. Knowing firsthand the dangers of polio, “they have a really important role to play in terms of making sure that grandchildren are vaccinated” so that more widespread circulation doesn’t come back.
“I don’t remember polio from my childhood. I don’t have an emotional connection to it. But you know, older people in our country remember it and grew up with it. They remember how terrifying it can be and how awful it can be. And so, they have a unique role in terms of talking to other people about how important it is to be vaccinated against polio,” Closser says.
According to the CDC, children should start the polio vaccine series when they are 2 months old and go back for the other three shots when they are 4 months, 6 through 18 months, and 4 through 6 years old.
The virus — which takes hold in the throat and intestines and can also invade the nervous system — is highly contagious and is “really good at finding pockets of unvaccinated people,” Closser says. Evidence of the virus circulating in some New York neighborhoods means the vaccination rates in that area aren’t quite high enough to stop transmission, she says.
Roughly 86 percent of children between the ages of 6 months and 5 years in New York City have received three doses of the polio vaccines, though that number is lower in certain neighborhoods. And in the New York county where the one case was identified, the polio vaccination rate hovers around 60 percent, according to New York City’s health department.
Poliovirus still circulates in two countries, Afghanistan and Pakistan, though cases have been popping up in other areas of the world. There is no cure for polio and no specific treatment.
“Polio is entirely preventable and its reappearance should be a call to action for all of us,” said New York City Health Commissioner Ashwin Vasan, M.D.
Rachel Nania writes about health care and health policy for AARP. Previously she was a reporter and editor for WTOP Radio in Washington, D.C. A recipient of a Gracie Award and a regional Edward R. Murrow Award, she also participated in a dementia fellowship with the National Press Foundation.
Editor's Note: This story, originally published Aug. 19, 2022, has been updated to reflect new information.