Is There a Need for `Catch-Up' Polio Vaccination in Preadolescence?

The introduction and widespread use of the inactivated and live poliovirus vaccines in the United States have brought about a dramatic reduction in the incidence of poliomyelitis: More than 20,000 paralytic cases were reported in 1952, whereas the current annual average is less than 20.^1,2 As a consequence of this extraordinary degree of control, there is virtually no wild poliovirus circulation in the United States; individual protection from wild virus introduction depends on successful vaccination. Data available in 1976 and 1977 indicated that a substantial proportion (perhaps one third) of American children younger than 5 years had not received a full course of trivalent oral polio vaccine (TOPV).^3,4 These and other findings led a study group convened by the Institute of Medicine, National Academy of Sciences, to recommend routine administration of an additional dose of TOPV at age 11 to 12 years.⁵ This dose was proposed not