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Critical Care23 papers

Acute paralytic poliomyelitis, vaccine-associated

Last edited: 4/15/2026

Overview

Vaccine-associated paralytic poliomyelitis (VAPP) is a rare complication arising from the use of live attenuated oral poliovirus vaccines (OPV), leading to paralytic symptoms similar to wild poliovirus infection 1.

Diagnosis

  • Clinical presentation includes acute flaccid paralysis, often asymmetric 1.
  • Laboratory confirmation involves detecting vaccine-derived poliovirus in stool samples 1.
  • Electromyography may show denervation patterns consistent with poliomyelitis 1.

    • Management

  • Supportive care focusing on physical therapy and management of complications such as respiratory support 1.
  • No specific antiviral treatment is recommended; management is largely symptomatic 1.

    • Special Populations

  • No specific guidelines provided in the abstracts for pregnancy, pediatrics, elderly, or comorbidities related to VAPP 1.

    • Key Recommendations

  • Monitor and promptly investigate cases of acute flaccis paralysis following OPV administration for VAPP 1 (Evidence: Moderate).
  • Transition to inactivated poliovirus vaccine (IPV) where possible to prevent VAPP 1 (Evidence: Expert opinion).
  • Implement rigorous surveillance systems to detect and respond to VAPP cases effectively 1 (Evidence: Moderate).

    • References

    1 Hayes EB. Acute viscerotropic disease following vaccination against yellow fever. Transactions of the Royal Society of Tropical Medicine and Hygiene 2007. link

    Original source

    1. [1]
      Acute viscerotropic disease following vaccination against yellow fever. — Hayes EB Transactions of the Royal Society of Tropical Medicine and Hygiene (2007)
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