POLIOMYELITIS VACCINATION TODAY - CRITICA L REMARKS

Vaccination against poliomyelitis remains an absolutely mandatory meas ure to prevent resurgence of this dreadful viral infection. Today, how ever, when the chance to get infected is extremely low, one has to rec onsider much more the inherent risk of such a living vaccine which is principally able to induce neurologic disease especially in immunocomp romised host the number of which is increasing in our population. Sinc e these attenuated vaccine strains multiply largely in the orointestin al tract of a vaccinee, those viruses are shed and easily spread into surroundings so that other persons which are not aware of this event a re exposed. But also in normal hosts the vaccine strains are able to p roduce disease because the genetic mutation leading to reduced virulen ce is not absolutely stable. Backmutations with increased virulence de velop during multiplication in the vaccinee and may threaten the vacci nee as well as contact persons. For the sake of security these consequ ences should be respected much mow. Since a dead vaccine of poliovirus es is available, one should much more often profit from this choice.