14 Diseases You Almost Forgot About (Thanks to Vaccines)

Should You Get A Polio Vaccine Booster? Here's How To Decide

With a polio case reported in Rockland County, New York, adults may be wondering whether they should ... [+] get a polio vaccine booster after getting vaccinated as a child.

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Didn't think you'd have "Decide whether to get the polio vaccine booster as an adult" on your 2022 List of Things to Do, did you? After all, wasn't the U.S. Declared polio-free back in 1979 years after the polio vaccine had become part of routine childhood vaccinations? But then again, you probably didn't expect to have "Read about how the poliovirus has re-appeared again in U.S." on your 2022 list either.

Well, the re-appearance of the poliovirus in the U.S. Has many people now double-checking whether they got vaccinated against polio as a child and wondering whether they need a booster as an adult. As I covered for Forbes on August 6, an unvaccinated adult in New York has come down with paralytic polio, the first confirmed polio case in the U.S. Since 2013. Plus, wastewater samples from the state have revealed presence of the virus, meaning that others, potentially hundreds of others, have already been infected with the virus. Obviously, anything that can cause paralysis is not a good thing to have. Neither is something that can cause death, because death would kind of ruin your day. So the return of the poliovirus, which used to leave an average of over 35,000 more people each year in the U.S. Disabled, is clearly bad news.

Upon closer reflection, is this return really that much of a surprise? There's a thing called cause-and-effect in nature. The World Health Organization (WHO) declared measles eliminated from the U.S. In 2000 due to successful vaccination efforts. But then after years of some personalities, politicians, and purposely anonymous social media accounts peppering people with unscientific anti-vaccination messages, what did you think would happen? Measles vaccination rates dropped and then, guess what, the U.S. Started having measles outbreaks again over the past decade. Over the same time, polio vaccination rates have been dropping, as well, despite the vaccine having an excellent safety record and three doses of the inactivated polio vaccine (IPV) being 99% effective at preventing paralytic polio, according to the Centers for Disease Control and Prevention (CDC). Lower vaccination rates has meant that the poliovirus would have more bodies to infect, sort of like offering the virus more cheap motel rooms to occupy and reproduce in, which is why the polio situation in New York is occurring now.

Adults who didn't get vaccinated against polio as a child can now get the inactivated polio vaccine ... [+] (IPV) in three doses, with the second dose coming one to two months after the first and the third dose coming six to 12 months after the second. (Photo by ED JONES/AFP via Getty Images)

AFP via Getty Images

So what should you do? If you are an infant, congratulations on you ability to read. If you can write too, you may want to leave notes to your parents in between your burping to remind them to get you your recommended vaccines, including four doses of the IPV at 2 months, 4 months, 6 through 18 months, and 4 through 6 years of age. If you are older, check with your parents to see if they got you vaccinated. If they start talking about the "Deep State" and not wanting you to become a gigantic magnet where keys and anvils stick to you forehead, you may want to track down your old vaccination records from your school or doctor to verify for yourself whether you were indeed vaccinated as a young child.

If you either can't verify this or know for sure that you didn't get vaccinated against polio, you can always get three doses of the IPV as an adult. Once you've gotten the first dose, you have to wait one to two months to get the second dose, and then another six to 12 months to get the third dose. As an adult, the IPV is as easy as one, two, three.

If you indeed got the four-dose series as child, that in theory should give you lifetime protection. It's in theory because while studies have suggested that protection can last for decades, they haven't yet specifically determined whether such protection will last lifelong for everyone. So, yes, it is possible that your protection after getting vaccinated as a child may wane a bit at some point as an adult.

That's the rationale behind the CDC's current recommendation that as an adult who was vaccinated as a child you don't need a adult booster unless you are "at increased risk of exposure to poliovirus." Now, you may ask what exactly would put you at increased risk of exposure to the poliovirus? Certainly, if you plan on going snorkeling in New York's wastewater where they recently found the poliovirus, you could be at increased risk. The same would apply if you have close contact with anyone who may be infected with the poliovirus or handle the poliovirus in any way. Therefore, it's a good idea to get boosted if you work in healthcare or a laboratory where any jar, test tube, or other container happens to have the word "polio" on it.

The polio vaccine has been licensed in the U.S. Since 1955. Here Carol Ciminelli holds a photo of ... [+] herself as a young child in one hand, and a copy of her Covid-19 vaccine card in the other hand, at her home in Amityville, New York on August 10, 2021. In 1954, Ciminelli was a "Polio Pioneer", one of a group of 6-to-8 year-olds across the nation who received a polio vaccine in a clinical trial to test the safety and efficacy of the Salk vaccine. (Photo by J. Conrad Williams, Jr./Newsday RM via Getty Images)

Newsday via Getty Images

The CDC also recommends getting a booster if "You are traveling to a country where the risk of getting polio is greater." This includes Afghanistan and Pakistan, where polio remains endemic. Of course, nowadays you may ask whether New York or other parts of the U.S. Represent a place "where the risk of getting polio is greater." This may seem tricky since the actual number and distribution of currently infected people are not known. Health departments just don't have the resources track such numbers. That's what happens when the country invests so little in public health infrastructure.

Nonetheless, right now, there's probably no need to get an adult booster unless you are a healthcare worker, a laboratory worker handling polio specimens, traveling to a country where polio is still more widespread than it is in the U.S., or otherwise may be around someone who has a good chance of being infected. At the same time, there's no real harm in getting an adult booster. Billions of people have received the IPV since it was first licensed in the U.S. On April 12, 1955. If you are on the fence about what your risk of exposure may actually be, talk to your doctor. Your doctor may tell you to go ahead and get the adult booster. This should then have you set for life against polio and offer you peace of mind. It would certainly only you to cross "decide whether to get the polio vaccine booster as an adult" off your 2022 list of things to do. And your 2023 one, your 2024 one, and so forth.

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.

1. 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.

2. 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.

3. What if I am taking other medicines?

4. 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.

5. 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.

6. 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)

Full 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:

1. 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.

2. What should I know before I use Adacel Polio?

Warnings Do not use Adacel Polio if you 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

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 breastfeeding

Tell 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.

3. 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 vaccines

Tell 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.

4. 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 given

The dose of Adacel Polio is a single dose of 0.5mL.

When to receive Adacel Polio

Adacel 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.

5. 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 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 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 medicine

If you no longer need to use this medicine or it is out of date, take it to any pharmacy for safe disposal.

6. 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

Less serious side effects

What to do

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 joint swelling

irritability

nausea and vomiting

diarrhoea

These are the more common side effects of Adacel Polio. Mostly these are mild and short-lived. If however, these symptoms persist for more than 1 week, then you should tell your doctor.

Speak to your doctor if you have any of these less serious side effects and they worry you.

Serious side effects

Serious side effects

What to do

dizziness

generally feeling unwell

pale skin

stomach pain

pain in the vaccinated arm

swollen glands in the neck, armpit or groin

large reactions at the injection site (larger than 5 cm), including extensive limb swelling from the injection site beyond one or both joints. These reactions start within 48 hours after vaccination, may be associated with redness, warmth, tenderness or pain at the injection site, and get better within 3-5 days without the need for treatment.

The following side effects are very serious. You or your child may need urgent medical attention or hospitalisation:

sudden signs of allergy such as 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

inflammation of spinal column

tingling or numbness of the hands or decreased feeling or sensitivity of the vaccinated arm

a paralysed nerve in the face

All of these side effects are rare.

Call your doctor straight away, or go straight to the Emergency Department at your nearest hospital if you notice any of these serious side effects.

Tell 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.

7. Product details

This medicine is only available with a doctor's prescription.

What Adacel Polio contains

Active ingredients

(main ingredients)

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

29 DAgU Poliovirus inactivated type 1*

7 DAgU Poliovirus inactivated type 2*

26 DAgU Poliovirus inactivated type 3*

Other ingredients

(inactive ingredients)

aluminium phosphate

ethanol

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

*These quantities are the same as those previously expressed when measured by a suitable method.

Do not take this medicine if you are allergic to any of these ingredients.

What Adacel Polio looks like

Adacel Polio is a sterile, uniform cloudy, white suspension for injection.

Aust R 106576 - Syringe

Who distributes Adacel Polio

Australia:

sanofi-aventis australia pty ltd

12 - 24 Talavera Road

Macquarie Park

NSW 2113, Australia

Tel: 1800 816 806

This leaflet was prepared in November 2023.

ada-pol-ccdsv15-cmiv5-21nov23

As Polio Reemerges In New York, Here's What To Know About Polio And Its Risk In Florida

"Even a single case of polio is a threat," opined New York State Health Commissioner Mary T. Bassette in an op-ed essay in The New York Times on Aug. 21.

"The case of a young adult paralyzed by polio in New York is not simply unexpected. It's shocking," she wrote exactly one month after a 20-year-old unvaccinated man contracted the disease.

Polio may have been circulating in New York even longer, given that it was present in New York's wastewater in April, according to a new report from the Centers for Disease Control and Prevention.

"Sustained poliovirus transmission has been eliminated from the United States for approximately 40 years," according to the CDC. "The last time polio was diagnosed in New York State was in 1990," Bassette wrote.

"We will learn more, but what we know already is enough. We have circulating poliovirus that can cause paralysis in these communities. Polio in New York today is an imminent threat," she wrote.

But if polio is a worry in New York City is it a worry in Miami? We are, after all, sister cities. "Changes in the genome of the virus suggest that this version has been circulating, somewhere in the world, for up to a year," New York Times reported in August.

Are we in Florida in the "somewhere?" category?

The Miami Herald reached out to Dr. Mary Jo Trepka, a professor and chair of Florida International University's Department of Epidemiology at the Robert Stempel College of Public Health & Social Work. We asked her to help answer some questions you may have concerning polio and whether we ought to be concerned in the Sunshine State.

Dr. Mary Jo Trepka, Professor and Chair, Department of Epidemiology at Florida International University's Robert Stempel College of Public Health & Social Work.

Is polio in Florida?

As of Sept. 3, there are no reported cases in Florida this year, according to the state health department's reportable diseases frequency report. There have only been two in Florida since polio was declared eradicated in the U.S. In 1979 — in Hillsborough in 1996 and Orange County in 1997, according to the chart.

Is there a particular risk of polio in Florida?

What would make us susceptible, we wondered?

"The risk of polio, as with other vaccine-preventable diseases such as measles, mumps, rubella, diphtheria and pertussis, principally depends on the underlying level of vaccination in the community," Trepka said.

Trepka said that Florida's vaccination rate among kindergarten students at 93.3% in 2020-2021 is slightly lower than that of the U.S. As a whole, which was at 93.9%.

There was a slight downturn from 2019-20 — 93.5% — coinciding with the spread of the novel coronavirus and the introduction of COVID-19 vaccines, which for some have become politicized and polarizing.

"The pandemic has led to lower vaccination rates in many people," Trepka said. "Some states are doing better and others worse."

The SchoolVaxView Interactive School Vaccination Coverage chart from the CDC finds that New York's level of vaccinated kindergarten children is higher than Florida's rate — 97.8% compared to 93.4%.

"But the person with the case of polio, who was unvaccinated, lives in a county (Rockland) with a very low vaccination rate. That can happen here, too. By that I mean there may be small communities within Florida with lower vaccination rates than the overall state rate. In such groups of people, we see outbreaks," Trepka said.

Polio affects children younger than 5 more than other age groups, according to the Mayo Clinic.

Is Florida's wastewater a risk factor?

Sewage overflows through a manhole due to heavy rainfall in the Little Havana neighborhood of Miami, Florida, on Saturday, June 4, 2022. Heavy rainfall caused by a tropical disturbance overwhelmed Miami-Dades sewage treatment system, which exceeded capacity and causes wastewater to overflow in several locations in the center of the county.

Polio was seen in wastewater in New York, much like COVID is detected in wastewater around the country, including in Florida. After a good rainstorm, and it doesn't have to be a tropical system or hurricane, some of our streets as in downtown Miami and Brickell Avenue flood. You may be wondering, hmmm?

"In order to get polio from flooding, there would have to be contamination of the water by sewage from people who were infected with polio and you would have to ingest that virus," Trepka said. "One way that could happen would be to contaminate your hands and subsequently contaminate food you eat. Given that we have not had a case of polio reported in Florida for more than 10 years, exposure to polio would be unlikely at this time. In Pakistan, where there is a much larger problem with polio and where there are massive floods now, the risk is clearly higher."

Miami-Dade County is doing surveillance for the SARS CoV2 virus, the virus that causes COVID-19, in its wastewater. "Surveillance for poliovirus could potentially be added as is happening in New York," Trepka said.

"The Miami-Dade Water and Sewer Department is investigating opportunities to add the monitoring of the polio virus to our wastewater surveillance program, where it makes sense, in the effort to continue the documentation of information for the benefit of the public health," said Jennifer Messemer-Skold, public affairs administrator for the department.

What is polio?

An emergency polio ward in Boston in 1955 equipped with iron lungs, pressurized respirators that acted as breathing muscles for polio victims, who often were paralyzed.

Polio, or poliomyelitis, is a disabling and life-threatening disease caused by the poliovirus. The polio virus spreads from person to person and can infect a person's spinal cord, causing paralysis, according to the Centers for Disease Control and Prevention.

Polio was once a terror in the 1940s and '50s in the United States, Canada and elsewhere before virologist Jonas Salk's polio vaccine was first administered in 1955. Some famous people who contracted polio before there was a vaccine include U.S. President Franklin Delano Roosevelt, musicians Joni Mitchell and Neil Young and actors Alan Alda, Mia Farrow and Donald Sutherland.

In the early 1950s, before Salk's vaccine, polio outbreaks caused more than 15,000 cases of paralysis each year, the CDC said. After the vaccines — there are two: trivalent inactivated poliovirus vaccine (IPV), introduced in 1955, and trivalent oral poliovirus vaccine (OPV) in 1963 — the number of polio cases plummeted to fewer than 100 in the 1960s and fewer than 10 in the 1970s.

In this Oct. 7, 1954, file photo, Dr. Jonas Salk, developer of the polio vaccine, holds a rack of test tubes in his lab in Pittsburgh.

I thought polio was a devastating disease of the past. Unfortunately, it's notOpinion

How contagious is polio?

"Polio is transmitted person to person through the fecal oral route, by contact with stool from an infected person or by droplets such as after an infected person coughs," Trepka said.

"For example, an infected person's hands can get contaminated with stool after using the toilet and remain contaminated if there is poor hand washing. That person can then contaminate food that another person consumes and thus expose the person to the polio virus," she said.

What are polio's symptoms?

Symptoms can include sore throat, fever, fatigue, nausea, headache and stomach pain, according to the CDC. These symptoms mirror many other ailments. A healthcare provider can take swabs from the throat and collect stool samples to send to a lab for testing.

According to the CDC, a large majority of people who are infected with polio may have no symptoms, about 72%; about 25% have a flu-like illness. A small percentage, about one in 200, of individuals who contract the polio virus suffer paralysis. A few could contract meningitis if the polio virus attacks the covering of the spinal cord or brain. Polio is fatal for 2%-10% of those paralyzed or between 1 in 2,000 to 1 in 10,000 of those infected.

READ NEXT: 'Florida is in midst of a meningococcal outbreak.' What to know now about meningitis

Why are polio, monkeypox and meningitis reemerging?

This 2014 illustration made available by the U.S. Centers for Disease Control and Prevention depicts a polio virus particle.

"Monkeypox is a different issue from the situation with polio. Polio is a disease that we normally successfully prevent when we have high rates of children vaccinated," Trepka explains.

READ NEXT: As monkeypox spreads in South Florida, experts have advice on prevention, risk, vaccines

"Small outbreaks of vaccine-preventable childhood diseases are not new because we do not have universally high rates of childhood vaccination. We continue to have outbreaks, albeit relatively small ones, of vaccine-preventable disease such as measles and pertussis. These happen whenever you get a pocket of people who are not fully vaccinated. It has been challenging to keep vaccination rates high," she said.

Lack of first-hand experience can be a factor.

"One of my mother's classmates died of polio while she was in middle school; thus, she had first-hand knowledge of the devastating consequences of polio and fully supported having her own children vaccinated. However, because of the success of the U.S. Childhood vaccination program, few parents of young children have personally experienced the devastating consequences of previously common childhood diseases, such as measles, pertussis, polio and diphtheria, that we now prevent with vaccines. Thus, some people don't understand the full benefit of these vaccines and how they have made childhood a much less dangerous time than it used to be," Trepka said.

"At the same time, the internet has provided a forum for widely disseminating inaccurate information about vaccines. I think it is challenging for many people to differentiate accurate from inaccurate information. Thus, while vaccine hesitancy is not new, the challenge to keep childhood vaccination rates high is greater than it has been in the past," Trepka said.

We're facing a triple threat of COVID, monkeypox and polio. Let's take them seriously.

Is there a vaccine for polio?

The polio vaccine became widely available starting in 1955. Doctors say anyone who received a polio vaccine even decades ago likely still has immunity.

Polio remains one of the standard childhood vaccines.

Since 2000, only the inactivated polio vaccine (IPV) has been used in the United States, which is an injection, usually to the arm or leg, according to the CDC.

"The oral polio vaccine is not used in the U.S. Because it is live attenuated vaccine, meaning that it exposes the body to a weakened version of the virus leading to an immune response and not infection in people with healthy immune systems. However, there is a risk of infection among people with weakened immune systems. The IPV does not have this risk," Trepka explained.

The IPV vaccine is four doses -- at 2 months of age, 4 months, 6-18 months and 4-6 years.

I've never been vaccinated for polio. Should I now?

Yes. People who have never been vaccinated for polio should definitely get vaccinated regardless of their age, Trepka said. For adults who have never been vaccinated, three doses are needed with the second dose one to two months after the first and the third dose six to 12 months after the second, according to the CDC.

I was vaccinated for polio. Do I need a booster?

"At this point, there is not a recommendation for a booster for the general population," Trepka said. "However, there is a one-time lifetime booster recommendation for a select group of people, namely travelers to a country where there is a high risk of polio, laboratory workers or healthcare workers who may handle specimens with polio, or for people who have been in close contact with a person with polio virus."

"There has been a global effort to eliminate polio for many years. Unfortunately, it has been unsuccessful because unlike smallpox, which we did eradicate, a high percentage of people infected with polio have no symptoms. Also the problem of vaccine hesitancy is a global one and has thwarted polio eradication in some countries. Until polio is eradicated from the world, we will need to continue childhood vaccination for polio in the United States," Trepka said.

How do you know if you've been vaccinated?

Florida SHOTS is Florida's immunization registry, which began in 2003. All children born in the state beginning in 2003 have been automatically added to the system unless the parent of the child made a special opt out request. It includes information about vaccines administered by the Florida Department of Health as well as health care providers in Florida who use the system. It includes recent vaccines for adults to such as COVID-19 vaccines.

You can ask your healthcare provider to search the Florida SHOTS database for you. If you are 18 and older you can also submit a request to obtain your vaccination records from Florida SHOTS by filling out an online form.

If you're a parent you know whether your children are vaccinated.

But what if you are older, say, in your 50s or older, and can't find your pediatric vaccination records or have no one in your immediate family to ask whether you received the polio vaccine decades ago.

If you are this person and went to school in Florida or anywhere else in the U.S. Or Canada or countries where having the polio vaccine was mandatory to attend school, you're good. You're vaccinated, assured Dr. Jenny Montes de Oca at Coral Gables' Prime Care Associates to one of her 59-year-old patients who went to grade school in Miami Beach in the late 1960s and 1970s.

You can also try to contact the health department in the place in which you were born.

"Immunization registries are relatively new. Thus, for many adults, we can only know if we were vaccinated as children if our parents gave us the paper records or if a parent actually recalls the vaccine administration and recall can be unreliable. The current children of Florida won't have that problem when they are adults since their records are in one place and will be accessible to them," Trepka said.

For travelers

How do you know if you are traveling to a country with a high risk of polio and whether you ought to consider a polio booster?

The Centers for Disease Control and Prevention has an International Traveler's Health Website where you can look up specific recommendations for the countries you are traveling to. The information is continually updated based on epidemiologic information from around the world.

"Currently, there are many countries in Africa as well as the countries Afghanistan, Israel, the Occupied Palestinian Territories, Pakistan, Ukraine and Yemen, which are considered high risk for polio, and thus polio booster doses are recommended for those who have not previously had a booster," Trepka said.

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