# Polio

Canonical page: https://carecard.ca/knowledge/immunizations-serology/polio



**Status:** Required for all students

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

<Callout type="info">
  This page explains why proof of polio immunity is required and how the vaccine works, using
  guidance from Health Canada and the Public Health Agency of Canada. It is educational and does not
  replace advice from your own health care provider or the specific rules of your program and
  placement site. See the [Source & references](#source--references) at the bottom.
</Callout>

## Why this is required [#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 [#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 [#how-the-vaccine-works]

Canada uses the &#x2A;*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 [#how-well-it-works]

* IPV produces immunity to all three types of poliovirus in &#x2A;*over 95%** of
  people after three doses, and in &#x2A;*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 [#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 [#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 [#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 [#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 [#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 [#validity]

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

## Source & references [#source--references]

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

* [Health Canada](https://www.canada.ca/en/health-canada.html)
* [Poliomyelitis (polio) vaccines: Canadian Immunization Guide](https://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-part-4-active-vaccines/page-17-poliomyelitis-vaccine.html)
* [Poliomyelitis (polio)](https://www.canada.ca/en/public-health/services/diseases/poliomyelitis-polio.html)
* [Immunization of workers: Canadian Immunization Guide](https://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-part-3-vaccination-specific-populations/page-11-immunization-workers.html)
* [Polio eradication (Canada Communicable Disease Report)](https://www.canada.ca/en/public-health/services/reports-publications/canada-communicable-disease-report-ccdr/monthly-issue/2015-41/ccdr-volume-41-10-october-1-2015-vaccines/ccdr-volume-41-10-october-1-2015-vaccines-2.html)
