A federal advisory panel has recommended the first major changes in the way polio vaccine is administered since baby boomers began getting their dose on a sugar cube in 1961.
The panel decided Thursday that infants should get two shots of a weaker version of the vaccine before being given the more potent oral dose. The goal is to reduce the risk that the vaccine itself will give children polio.
The recommendation is subject to final approval from the Centers for Disease Control and Prevention, and doctors would not be advised to follow it until 1997.
"This is a major change. We have not made any changes like this since the 1960s," said Dr. Walter Orenstein, director of the CDC's National Immunization Program.
The oral vaccine, which is made from live but weakened polio virus, causes an average of eight cases of the paralyzing disease a year, out of 4-million doses given.
Giving infants shots before administering the oral vaccine could boost their immunity to the virus.
Last fall, the panel tentatively decided to adopt the new recommendation. But lobbying by patients, vaccine manufacturers and medical associations led the committee to delay a final decision and hear more public comment.
Opponents of the change say parents wary of giving infants shots may skip the vaccine, causing a resurgence of polio in the United States.
"It's not clear that the (change) is going to stop many of the cases that still occur, but it could make a mess of the immunization program," said Dr. Peter Paradiso, scientific director for vaccine-maker Wyeth-Lederle.
Paradiso is concerned that infants would still be vulnerable to contracting polio from the oral doses. Those who support the change say eight cases of polio a year is still too many.
Under the new guidelines, infants would be injected with a vaccine made from killed polio virus twice within their first four months. The shots would replace two doses of the more potent oral vaccine. Two oral doses between ages 1 and 6 would still be recommended.
A Centers for Disease Control advisory committee voted Thursday to change its recommendation for childhood polio vaccination:
Four doses of oral vaccine, one at 2 months of age, 4 months, 18 months and 4 to 6 years.
Two injections of a weaker vaccine to boost immunity, then two doses of the oral vaccine.
Reason for change
To lessen chance children may contract polio from vaccine; about one child per 2.4-million doses gets the disease.
Source: Centers for Disease Control