Polio

Status: Required for all students

Valid for: Does not expire once the series is complete or immunity is confirmed.

Why this is required

Placement sites require proof that you are immune to the vaccine-preventable diseases you could encounter — or pass on — during patient care, and polio is one of them. Vaccination protects both you and the people around you:

• Protects you. A completed polio series gives lasting protection against a virus that can cause permanent paralysis in a small share of infections.
• Protects your patients. Documented immunity across the health workforce lowers the chance that an undiagnosed, imported case reaches a vulnerable patient.
• It is usually already done. Polio vaccine is part of routine childhood immunization in Canada, so most students simply need to locate their existing records rather than book anything new.

Canada was certified polio-free in 1994, and wild type 2 and type 3 poliovirus have been eradicated worldwide (in 2015 and 2019). But the virus has not been eliminated everywhere: Health Canada notes that the risk of importing wild poliovirus from countries where it still circulates remains, which is why documented immunity is still expected of the health workforce.

About polio

Polio (poliomyelitis) is a highly infectious, vaccine-preventable disease caused by the poliovirus. It spreads mainly through the fecal–oral route — and rarely through respiratory droplets — and the virus can remain in an infected person's stool for three to six weeks. About 75% of infections cause no symptoms at all.

• Symptoms, when they occur, are usually mild and last 2 to 10 days: fever, sore throat, headache, abdominal pain, nausea, vomiting, tiredness, loss of appetite, aching muscles, and a stiff neck or back.
• Paralysis: in less than 1% of infections the virus damages the nervous system, which can cause weakness or permanent paralysis. The case-fatality ratio for paralytic polio is 2–5% in children and 15–30% in adults.
• Post-polio syndrome: an estimated 25–40% of adults who had paralytic polio in childhood may develop this non-infectious condition 15 to 40 years after the original infection.

How the vaccine works

Canada uses the inactivated poliovirus vaccine (IPV); the oral polio vaccine (OPV) is not used here. IPV contains killed poliovirus that cannot cause disease — it teaches your immune system to recognise all three types of poliovirus so your body is protected if you are ever exposed. It is almost always given as a combination vaccine (for example DTaP-IPV-Hib in childhood or Tdap-IPV as an adult booster), which is why a single shot can protect against several diseases at once.

How well it works

• IPV produces immunity to all three types of poliovirus in over 95% of people after three doses, and in close to 100% after a booster dose.
• Protection from a completed series is long-lasting, which is why a documented childhood series is normally accepted without further doses.

Safety and side effects

Reactions are usually limited to mild injection-site reactions such as pain, redness or swelling. Serious adverse events after an IPV-containing vaccine are rare.

Staying protected

A completed IPV series gives lasting protection and does not need routine boosters for most people. Health Canada recommends a single lifetime booster dose for adults at increased risk of exposure — for example, if you travel to or plan to work in an area with wild or vaccine-derived poliovirus. Adults who were never immunized and need only polio protection receive two doses 4 to 8 weeks apart, followed by a third dose 6 to 12 months later. Confirm what applies to you with your program or a health care provider.

What to submit

• A record of your completed polio vaccine series, or
• A lab report showing a positive polio antibody titre
• Your full legal name and date of birth on every document

Accepted proof

• Childhood immunization record (e.g. the yellow immunization card)
• Provincial or public health immunization record
• Lab report of a polio serology/titre with the result clearly stated
• International immunization card with an English translation

Good to know

• Most students were vaccinated as children — check your childhood records or ask your public health unit before booking anything new.
• Combination vaccines count: doses listed as DTaP-IPV, Tdap-IPV or similar include polio.
• If your records are lost, ask your program whether they accept a titre or require a booster dose — policies differ.

Validity

Does not expire once the series is complete or immunity is confirmed by a titre.

Source & references

The medical information on this page is adapted from Health Canada and the Public Health Agency of Canada:

• Health Canada
• Poliomyelitis (polio) vaccines: Canadian Immunization Guide
• Poliomyelitis (polio)
• Immunization of workers: Canadian Immunization Guide
• Polio eradication (Canada Communicable Disease Report)