Bacterial Vaginosis (BV): Causes, Symptoms, and Treatment
Nasal Vaccine
An interesting and also annoying aspect about the human immune system is that it is not a neat, centralized system where you input an antigen pattern in one spot and suddenly every T and B lymphocyte in the body knows how to target an intruder. Generally, immunity stays confined to specific areas, such as the vascular and lymph system, as well as the intestinal and mucosal (nasal) parts of the body.
The result of this is that specific types of vaccines have a different effect, as is demonstrated quite succinctly with the polio vaccines. The main difference between the oral polio vaccine (OPV) and inactivated vaccine (injected polio vaccine, or IPV) is that the former uses a weakened virus that induces strong immunity in the intestines, something that the latter does not. The effect of this is that while both protect the individual, it does not affect the fecal-oral infection route of the polio virus and thus the community spread.
The best outcome for a vaccine is when it both protects the individual, while also preventing further infections as part of so-called sterilizing immunity. This latter property is what makes the OPV vaccine so attractive, as it prevents community spread, while IPV is sufficient later on, as part of routine vaccinations. The decision to use a vaccine like the OPV versus the IPV is one of the ways doctors can tune a population's protection against a disease.
This is where the current batch of commonly used SARS-CoV-2 vaccines are showing a major issue, as they do not provide significant immunity in the nasal passage's mucosal tissues, even though this is where the virus initially infects a host, as well as where it replicates and infects others from. Here intranasal vaccines may achieve what OPV did for polio.
Continue reading "Intranasal Vaccines: A Potential Off-Ramp For Coronavirus Pandemics" →
Polio Is On The Brink Of Eradication. Here's How To Keep It From Coming Back
A child in Tanzania has his finger marked to show that he has received a polio vaccine during a door-to-door campaign in 2022.Credit: Ericky Boniphace/AFP via Getty
Nobody expected polio to be back.
It's 2040, a decade since the disease was eradicated. The global health campaign that vanquished the virus has disbanded; immunization efforts have slackened. Then, one day, a sick child in a conflict-wracked country develops paralysis; the cause turns out to be polio. Scientists trace the origin of the virus to a laboratory on the other side of the world. A technician at the lab had handled a forgotten batch of polio-infected material — and then visited their family abroad.
As cases multiply, the World Health Organization (WHO) appeals for help to conduct emergency immunization campaigns, but stocks of vaccines are low and few members of staff have direct experience of polio outbreaks. Soon there are tens of thousands of cases: millions more people around the world who haven't had the vaccine are at risk.
This is just one of many possible scenarios that could follow polio eradication. Although the world has not yet eliminated poliovirus, many observers think it could be gone within three years. The polio-eradication campaign has increased its intensity and funding in the past year in the hope of finally meeting a deadline that's been postponed many times since efforts were launched in 1988.
The front lines are Afghanistan and Pakistan, where pockets of wild polio persist but are shrinking (see 'Wild polio tamed'), and a swathe of Africa, where a polio vaccine that includes live virus has itself seeded outbreaks. There are signs that health campaigns are now bringing these vaccine-derived episodes under control.
Source: Global Polio Eradication Initiative
The final steps towards eradication are formidable, and it's not clear when — or whether — nations will reach this goal. Nonetheless, with the demise of the virus in sight, health authorities are planning what happens next.
That's because eradication is not extinction. Polio could lurk in testing labs and manufacturing facilities — from which it has leaked in the past — and even in some people. Mistakes years after eradication could let polio into an unprotected population where it could "wreak havoc", says virologist Konstantin Chumakov, former associate director of vaccine research at the FDA Office of Vaccines Research and Review in Silver Spring, Maryland.
The end of polio is only the beginning of another effort: developing the resilience to keep it away, says Liam Donaldson, a public-health specialist at the London School of Hygiene & Tropical Medicine, UK, and the lead author of a series of independent reports on the campaign's progress (see go.Nature.Com/49hho4a). "People have signed up to polio eradication, but they've not signed up to the longer journey."
Stamping it outOnly one human disease has so far been declared eradicated: smallpox, in 1980. Polio has been more complex, says David Heymann, who heads the WHO's Containment Advisory Group. That's because of a key difference: every smallpox infection produces symptoms, but polio can silently infect up to 1,000 people before causing a case of paralysis. The other snag is that polio can be caused not only by the wild virus, but also, in very rare cases, by the vaccines deployed to prevent it. Eradication means getting rid of both forms for good.
The main tool is vaccination. Industrialized, polio-free countries use an inactivated poliovirus vaccine (IPV), which doesn't prevent the virus infecting the body and being shed in stools, but does protect against paralysis. Provided that immunization levels with IPV remain high and sanitation is good, a rogue poliovirus will probably peter out, according to Concepcion Estivariz, a polio researcher at the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia.
But because the inactivated vaccine can't block transmission, children in at-risk countries still receive another type: an oral poliovirus vaccine (OPV) that contains an attenuated form of the live virus, and can stop polio's spread — which is crucial for eradication. It's also cheaper and easier to deliver than IPV, which is administered by injection. The oral campaign has been hugely successful. Since 1988, the Global Polio Eradication Initiative (GPEI) estimates it has prevented 20 million cases of polio paralysis.
A chemist processes samples at the National Polio and Measles Laboratory in Bangladesh.Credit: G.M.B. Akash/Panos
But OPV has some important downsides. There is a low risk that the vaccine itself can cause paralysis. And, on rare occasions, the weakened virus used in the vaccine can mutate sufficiently to regain virulence. This can lead to outbreaks of cases known as vaccine-derived polio among people who have not been vaccinated fully or at all. "If we continue OPV," says Estivariz, "we never stop the circle." Most countries are now using IPV in their routine immunization programmes alongside OPV, and the WHO recommends that IPV administration should continue for a decade after disease transmission has been stopped, to protect against any accidental releases or hidden pockets of the virus.
Polio will be certified as eradicated when no case has been observed for three years, and when there is no sign of it in environmental surveillance data — that is, in samples of waste water. A year after that, OPV must be withdrawn to prevent vaccine-derived polio. The problem, however, is that removing it will be an extraordinarily delicate manoeuvre. Done messily, this process could trigger the return of the virus.
In 2016, for instance, the withdrawal of an OPV across 150 countries went disastrously wrong. "The results were sobering", says Kimberly Thompson, an epidemiologist at the research non-profit organization Kid Risk, in Orlando, Florida.
There are three strains of wild polio — types 1, 2 and 3. Type 2 was declared eradicated in 2015, and type 3 followed in 2019. The oral vaccine contained attenuated versions of all three strains, but after type 2 was eradicated, the aim was to withdraw vaccines containing that strain to minimize the risk of seeding vaccine-derived type 2 polio. So the GPEI orchestrated a two-week period in April 2016 in which all three-strain oral vaccines were switched for versions containing just types 1 and 3.
Swiftly, however, cases of vaccine-derived type 2 polio began to build — in two countries in 2016, spreading to 24 countries by 2020, with countries in Africa worst affected. A case popped up in the United States in 2022, and the United Kingdom found the virus in wastewater samples. The cumulative number of paralysis cases so far is just over 3,200; the yearly total peaked at more than 1,000 in 2020 and now seems to be declining, with 238 recorded so far this year (see 'Rare and receding: vaccine-derived polio'). African countries are still running multiple emergency campaigns delivering oral type 2 vaccines to stamp these outbreaks out.
Source: Global Polio Eradication Initiative
Why the rebound? First, populations in the regions affected weren't sufficiently vaccinated beforehand with IPV, which would have protected them until any outbreaks could be controlled. This was partly owing to a gap in vaccine supply, says Ondrej Mach, who co-chairs a new GPEI group that will oversee future withdrawals of the oral vaccine.
What's more, says Mach, just before the switch, vaccine-derived type 2 polio was detected in Nigeria. Transmission was probably already under way in Nigeria and other countries, adds Mach, and the emergency type 2 vaccine seeded further outbreaks.
Since 2021, however, this seeding has become much less likely: vaccination campaigns are controlling the outbreaks using a genetically engineered oral vaccine, which has an even lower chance of becoming virulent than the OPVs used previously.
What risks does the post-polio world face if full oral withdrawal goes wrong? An analysis by Kid Risk and the CDC gave one answer (D. A. Kalkowska et al. Risk Anal. Https://doi.Org/k428; 2023). Their model considers what might happen if all OPV use stopped in 2027 but vaccine-derived polio was not completely eliminated beforehand and outbreak responses were weak. In one scenario, the model predicts that there could be as many as 40,000 cases of paralysis caused by vaccine-derived polio 8 years after OPV administration is discontinued. To avoid this, the authors suggest that population immunity in areas with polio cases today needs to be very high — about 90% — just before withdrawal. Thompson says that most countries have achieved this in the past, at least for short periods of time.
Keeping a lookoutEven after OPVs are successfully withdrawn, therefore, countries can't let their guard down. They must put in place surveillance "to detect any poliovirus, no matter where in the world it appears and however fleetingly", says a report by the Transition Independent Monitoring Board, an independent group of scientists that reports periodically on the polio endgame and is chaired by Donaldson.
Polio surveillance takes two main forms: searching for cases of paralysis that might be caused by polio; and monitoring waste water for any virus shed by carriers.
Both will be crucial for years, as an example from Malawi shows. The country had been free from wild polio for three decades when, in 2021, a stool sample from a three-year-old with paralysis arrived at the national laboratory to be sent abroad for testing. The sample sat for two months before it was shipped with others, says Jamal Ahmed, who coordinates polio eradication for the WHO in its African region, which comprises 47 countries. The result came back a month later: it was wild polio type 1, not seen in the continent since 2016.
Sequencing traced its origin to Pakistan, but also revealed that the virus had been circulating for two years undetected — possibly in Malawi, and possibly elsewhere. Because Malawi had no wastewater surveillance at the time, it was impossible to know.
A health worker gives an oral polio vaccine to a child in Karachi, Pakistan, in 2022.Credit: Asif Hassan/AFP via Getty
Within 30 days of receiving the result, emergency immunizations began. Six campaign rounds later, says Ahmed, Malawi has seen no more cases of wild polio. And, with the WHO's help, the country swiftly installed environmental surveillance sites.
The episode also showed that the emergency vaccination programme wasn't up to the job, says Jay Wenger, who leads the polio programme at the Bill & Melinda Gates Foundation in Seattle, Washington. "We had to rebuild the polio infrastructure we had before" to get rid of the virus, he says.
Global wastewater surveillance has become a bigger priority since the COVID-19 pandemic, says Donaldson, because politicians are paying more attention to trends in disease. Ahmed says that 41 of the 47 member states of WHO Africa now have environmental polio surveillance, and that the rest will soon catch up.
Innovations are helping to speed up a process in which timeliness is crucial. One breakthrough is direct detection, a method that leapfrogs several of the conventional stages of the testing process; for example, by extracting RNA directly from samples without the need to culture them.
The threat of escapeNo matter how successful the eradication effort is, the virus will remain in research institutes and vaccine-manufacturing facilities — and in an unknown number of routine diagnostic labs.
Escapes happen. Last year, a lab worker at a manufacturing facility in Utrecht, the Netherlands, picked up type 3 virus at the facility, and this was then detected in wastewater surveillance outside the plant. No cases of paralysis resulted. Vaccine manufacturing is "a huge containment nightmare", says Mach.
The WHO has a plan for poliovirus containment that urges nations to minimize the number of facilities retaining poliovirus materials and to destroy any unnecessary stocks. At the moment, the WHO knows of 74 facilities that hold polio, in 22 countries.
Can the world really stop wild polio by the end of 2023?
The first step was for each country to set up a national authority for containment by 2018, to ensure that facilities comply with biosafety requirements. China and Romania have not yet done this, and other countries have missed subsequent deadlines.
Even for compliant facilities, forgotten samples remain a threat, says Andy Macadam at the National Institute for Biological Standards and Control in Potters Bar, UK. "All you have to do is mislabel the tube." And polio might lurk in some facilities that are not even subject to the containment plan, says Heymann. This could include frozen stool samples taken for other reasons at a time when polio was circulating.
Since 2000, there have been 21 reported incidents of poliovirus release from laboratories and vaccine-production facilities in 8 countries, with 16 cases of polio as a result, according to Derek Ehrhardt, who heads the WHO's poliovirus containment unit. Most cases have been in vaccine-manufacturing facilities, but five of them were in research labs in which workers discovered that vials containing poliovirus were mislabelled (none of those cross-contamination incidents led to paralysis). The solution, says Heymann, is better biosecurity in all labs.
To reduce the need for live virus, scientists are developing ways to produce the inactivated vaccine without it — for example, by using a non-infectious, genetically engineered starting material, or by designing vaccines from virus-like particles or messenger RNA.
A surprising sourceThere is yet another source of poliovirus, unforeseen 35 years ago when eradication efforts began.
In most people who receive the oral vaccine, the immune system generates antibodies that protect them against the virus. But in a small number of people born with particular immune deficiency disorders, the immune system allows the attenuated virus from the vaccine to live on, evolving as time goes by and emerging in their stools. No drugs have been proved to cure an ongoing polio infection.
Only some of the several hundred types of immunodeficiency lead to chronic retention of poliovirus. No one knows how many people are affected, and no such shedding is known to have triggered a polio outbreak, although it might have contributed to one in the Philippines in 2019–21.
But, says Mach, even one person retaining and shedding poliovirus is incompatible with eradication. "We have to do something." An international — if patchy — search for people with these immune disorders who have chronic polio has produced a register of 200 individuals.
New polio vaccine poised to get emergency WHO approval
One person with the condition lives in the United Kingdom and was vaccinated with OPV as a child. For more than 20 years, he asymptomatically carried — and shed — the attenuated virus, which evolved to its disease-causing form. His gut was "essentially a culture vessel", says David Boyle at PATH, a non-profit medical-research organization based in Seattle, Washington.
That's why scientists were surprised to learn that the person's infection had gone.
It disappeared after he received the antiviral drug remdesivir for severe COVID-19 in August 2021. This could be coincidence, says Macadam, but it bolsters the case that antivirals could be used to treat polio infection (two such drugs are being explored as polio treatments). Monoclonal antibodies are also under development.
Complacency and responsibilityKeeping vaccination rates high for at least a decade after eradication will be the best protection — but there are fears that commitment to IPVs might wane once eradication has been declared. Routine immunization campaigns struggle to reach every child, especially during conflict, disasters or pandemics. COVID-19 drove the number of unvaccinated or undervaccinated children up to 23 million in 2020.
Added to this is the growing problem in some regions of vaccine scepticism and complacency, which grew worse because of activism against COVID-19 vaccines, says Peter Hotez, a vaccine specialist and public advocate at Baylor College of Medicine in Houston, Texas.
Spate of polio outbreaks worldwide puts scientists on alert
With so much to be done to maintain a polio-free world, Donaldson is asking who will be accountable once the GPEI disbands a year after eradication, handing its responsibilities to WHO departments, partners and national health programmes.
A transition has already begun in some countries, but many have struggled to find their own funding amid changing government priorities. Slackening efforts now could bring bigger problems in the future, says Aidan O'Leary, who directs polio eradication at the WHO. "If we collectively take our eye off the ball and don't build the resilience of health systems going forward, then we face further problems down the line."
But done well, says O'Leary, the post-polio world could bring wider health benefits for everyone: better surveillance and immunization measures, and more joined-up health services. "The last mile of the polio eradication programme", he says, "is the first mile for global public-health security."
Adacel Polio
Consumer Medicine Information (CMI) summary
The full CMI on the next page has more details. If you are worried about using this medicine, speak to your doctor or pharmacist.Why am I using Adacel Polio? Adacel Polio contains the active ingredients diphtheria toxoid, tetanus toxoid, pertussis toxoid, pertussis filamentous haemagglutinin, pertussis fimbriae 2+3, pertactin and poliovirus types 1,2 and 3 (Vero). Adacel Polio is used to help to protect you or your child against whooping cough (pertussis), tetanus, diphtheria and polio. For more information, see Section 1. Why am I using Adacel Polio? In the full CMI.
What should I know before I use Adacel Polio? Do not use if you or your child has ever had an allergic reaction to Adacel Polio or any of the ingredients listed at the end of the CMI, or if you or your child ever had a disease of brain without an apparent cause within 7 days of a previous pertussis, tetanus or diphtheria vaccination. Talk to your doctor if you have any other medical conditions, take any other medicines, or are pregnant or plan to become pregnant or are breastfeeding. For more information, see Section 2. What should I know before I use Adacel Polio? In the full CMI.
What if I am taking other medicines?
How do I use Adacel Polio? Adacel Polio is given by your doctor, nurse or pharmacist. More instructions can be found in Section 4. How do I use Adacel Polio? In the full CMI.
What should I know while using Adacel Polio?
Things you should do
Tell your doctor, nurse or pharmacist before you receive the vaccine if you or your child
is allergic to the active ingredients or any of the other ingredients in this vaccine.
is suffering from an illness
has a bleeding problem or bruise easily.
ever fainted from an injection
has not previously received the complete course of tetanus and diphtheria vaccination
had a disease of brain without an apparent cause within 7 days of a previous pertussis, tetanus or diphtheria vaccination.
Driving or using machines
Adacel Polio should not normally interfere with your ability to drive or operate machinery. However, it may cause light-headedness, tiredness, drowsiness in some people.
Looking after your medicine
Adacel Polio is usually stored in the surgery or clinic, or at the pharmacy. However, if you need to store Adacel Polio, keep in the fridge between 2-8°C. Do not freeze.
Are there any side effects? Common side effects include a local reaction around the injection site such as bruising, redness, itchiness, tenderness, pain or discomfort, warmth, burning or stinging, swelling or the formation of hard lumps or scars, rash, headaches, tiredness, weakness or fatigue, fever, rigors, soreness, aching muscles, muscle tenderness or weakness (not caused by exercise), joint pain or swelling, irritability, nausea and vomiting, diarrhoea.Serious side effects can include red, itchy rash or hives, swelling of the face, lips, tongue or other parts of the body, shortness of breath, wheezing or trouble breathing, a temporary inflammation of the nerves, causing pain, weakness, and paralysis in the extremities and often progressing to the chest and face, severe pain and decreased mobility of arm and shoulder, fits or convulsion, fainting, tingling or numbness of the hands or decreased feeling or sensitivity of the vaccinated arm, a paralysed nerve in the face, dizziness, generally feeling unwell, pale skin, stomach pain . See your doctor immediately if you notice this.For more information, including what to do if you or your child have any side effects, see Section 6. Are there any side effects? In the full CMI.
Active ingredient(s): Pertussis Vaccine - Acellular and Diphtheria and Tetanus Toxoids (Adsorbed) Combined with Inactivated Poliovirus Type 1, 2 and 3 (Vero cell)
Consumer Medicine Information (CMI)
This leaflet provides important information about using Adacel Polio. You should also speak to your doctor or pharmacist if you would like further information or if you have any concerns or questions about using Adacel Polio.
Where to find information in this leaflet:
Why am I using Adacel Polio?
Adacel Polio contains the active ingredients diphtheria toxoid, tetanus toxoid, pertussis toxoid, pertussis filamentous haemagglutinin, pertussis fimbriae 2+3, pertactin and poliovirus types 1,2 and 3 (Vero).
Adacel Polio is a vaccine used to help to protect you or your child against whooping cough (pertussis), tetanus, diphtheria and polio.
Adacel Polio works by causing the body to produce its own protection against whooping cough, tetanus, diphtheria, and polio. It does this by making substances called antibodies in the blood, which fight the bacteria and toxins that cause these diseases. If a vaccinated person comes into contact with these bacteria and toxins, the body is usually ready to destroy them.
It usually takes several weeks after vaccination to develop protection against these diseases.
Use of Adacel Polio during pregnancy allows antibodies to be passed to the baby in the womb from the pregnant woman to protect the baby from whooping cough during the first few months of life.
Most people will produce enough antibodies against these diseases. However, as with all vaccines, 100% protection cannot be guaranteed.
The vaccine will not give you or your child any of these diseases.
The chance of a severe reaction from Adacel Polio is very small, but the risks from not being vaccinated against these diseases may be very serious. Polio, whooping cough, tetanus and diphtheria cause significant sickness and sometimes death in unvaccinated infants, children, and adults.
This vaccine is for use as a booster in adults, adolescents and children aged four years and older who have previously received childhood immunisation. Children from four to six years of age should have already received four doses of whooping cough, tetanus, diphtheria and polio vaccine. Adacel Polio is not intended for primary immunisation.
What should I know before I use Adacel Polio?
Warnings Do not use Adacel Polio if your or your child:
had an allergic reaction to Adacel Polio or any of the ingredients listed at the end of this leaflet.
had an allergic reaction to another vaccine designed to protect against pertussis, tetanus, diphtheria or polio.
had serious encephalopathy (disease of brain) without an apparent cause within 7 days of a previous pertussis, tetanus or diphtheria vaccination.
Always check the ingredients to make sure you or your child can receive this vaccine.
Adacel Polio is not recommended for use in children under 4 years.
Check with your doctor if you or your child: Has or ever had any other medical conditions, such as:a poor or reduced immune system due to medication (e.G. Steroid or medicines used to treat cancer (including radiation therapy) diseases such as some blood disorders, malaria, kidney disease requiring dialysis, HIV/AIDS or cancer
a progressive illness affecting the brain/nerves or uncontrolled fits
takes any medicines for any other condition
has reacted to previous vaccination with any of the following: life-threatening allergic reaction, fainting or collapse, shock-like state or being unresponsive for a long period of time, fits or convulsions, high temperature (greater than 40°C), crying or screaming lasting for more than 3 hours, severe skin reaction at the injection site, including severe bruising.
had a Guillain-Barré syndrome (temporary loss of movement and feeling in all or part of the body) within 6 weeks of a previous dose of a tetanus containing vaccine.
has not previously received the complete course of tetanus and diphtheria vaccination.
has an infection or high temperature. Your doctor may decide to delay vaccination until the illness has passed. A mild illness, such as a cold, is not usually a reason to delay vaccination.
Has any allergies to any vaccines, any other medicines or any other substance such as foods, preservatives or dyes.
After vaccination, you or your child may be at risk of developing certain side effects. It is important you understand these risks and how to monitor for them. See additional information under Section 6. Are there any side effects? Pregnancy and breastfeedingTell your doctor or nurse if you are pregnant or breast-feeding, think you might be pregnant or are planning to have a baby. Your doctor will help you decide if you should receive Adacel Polio during pregnancy.
Adacel Polio may be administered during pregnancy for prevention of pertussis in young infants.
What if I am taking other medicines?
Tell your doctor or pharmacist if you are taking any other medicines, including any medicines, vitamins or supplements that you buy without a prescription from your pharmacy, supermarket or health food shop.
Having other vaccinesTell your doctor if you or your child has had any vaccines in the last 4 weeks.
Your doctor will advise you if Adacel Polio is to be given with another vaccine.
Your doctor and pharmacist may have more information on medicines and vaccines to be careful with or avoid during vaccination with Adacel Polio.
Check with your doctor or pharmacist if you are not sure about what medicines, vitamins or supplements you are taking and if these affect Adacel Polio.
How do I use Adacel Polio?
Adacel Polio is given as an injection, usually into your
upper arm muscle by a doctor or nurse.
How much is givenThe dose of Adacel Polio is a single dose of 0.5mL.
When to receive Adacel PolioAdacel Polio is generally given whenever a booster dose of tetanus and diphtheria is required and where a booster dose of whooping cough and polio is considered necessary.
What should I know while using Adacel Polio? Things you should do
Keep an updated record of your vaccinations.
Call your doctor straight away if you or your child:does not feel well after having Adacel Polio
has any signs of allergic reaction which may include difficulty breathing, shortness of breath, swelling of the face, lips, throat or tongue, cold, clammy skin, palpitations, dizziness, weakness, fainting, rash or itching.
Driving or using machinesAdacel Polio should not normally interfere with your ability to drive or operate machinery. However, it may cause light-headedness, tiredness, drowsiness in some people.
Looking after your medicineAdacel Polio is usually stored in the doctor's surgery or clinic, or at the pharmacy. However, if you need to store Adacel Polio:
keep Adacel Polio in the original pack until it is time for it to be given.
keep it in the refrigerator, store at 2°C to 8°C. Do not freeze Adacel Polio.
Do not use Adacel Polio after the expiry date which is stated on the carton after EXP.
Do not use Adacel Polio if the packaging is torn or shows signs of tampering.
Keep it where young children cannot reach it.
Getting rid of any unwanted medicineIf you no longer need to use this medicine or it is out of date, take it to any pharmacy for safe disposal.
Are there any side effects?
All medicines can have side effects. If you do experience any side effects, most of them are minor and temporary. However, some side effects may need medical attention.
See the information below and, if you need to, ask your doctor or pharmacist if you have any further questions about side effects.
Less serious side effects Serious side effectsTell your doctor or pharmacist if you notice anything else that may be making you feel unwell.
Other side effects not listed here may occur in some people.
Reporting side effects After you have received medical advice for any side effects you experience, you can report side effects to the Therapeutic Goods Administration online at www.Tga.Gov.Au/reporting-problems . By reporting side effects, you can help provide more information on the safety of this medicine.Product details
This medicine is only available with a doctor's prescription.
What Adacel Polio containsActive ingredients
(main ingredient)
not less than 2 IU (2 LF) diptheria toxoid
not less than 20 IU (5 LF) tetanus toxoid
2.5 micrograms pertussis toxoid
5 micrograms pertussis filamentous haemagglutinin
3 micrograms pertussis pertactin
5 micrograms pertussis fimbriae 2 + 3
40 DAgU Poliovirus inactivated type 1
8 DAgU Poliovirus inactivated type 2
32 DAgU Poliovirus inactivated type 3
Other ingredients
(inactive ingredients)
aluminium phosphate
phenoxyethanol
polymyxin B sulfate
neomycin
streptomycin sulfate
formaldehyde
glutaral
polysorbate 80
water for injections
Medium Hanks 199 without phenol red (including phenylalanine)
The manufacture of this product includes exposure to bovine materials. No evidence exists that any case of vCJD (considered to be the human form of bovine spongiform encephalopathy) has resulted from the administration of any vaccine product
Do not take this medicine if you are allergic to any of these ingredients.
What Adacel Polio looks likeAdacel Polio is a sterile, uniform cloudy, white suspension for injection.
Aust R 106576 - Syringe
Who distributes Adacel PolioAustralia:
sanofi-aventis australia pty ltd
12 - 24 Talavera Road
Macquarie Park
NSW 2113, Australia
Tel: 1800 816 806
New Zealand:
sanofi-aventis new zealand limited
Level 8,
56 Cawley St
Ellerslie
Auckland
New Zealand
Tel: 0800 727 838
This leaflet was prepared in June 2021.
Ada-pol-ccdsv12-cmiv3-21jun21
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