Q&A: Poliovirus discovery in NY ‘hard to believe’

Last week, health officials in New York State announced the detection of poliovirus in sewage in Orange and Rockland counties, where only around 60% of young children are caught up on their polio vaccinations.

This followed the announcement in July that an unvaccinated Rockland County resident had contracted vaccine-derived polio and was paralyzed.

We spoke with Alanna E. Levine, MD, a spokesperson for the AAP and pediatrician in Rockland County, about the measures being taken locally to address the threat of polio and what providers can do to protect their patients.

Healio: Vaccine-derived poliovirus has been found in areas of New York with low rates of polio vaccination among children. How dangerous is that combination?

Levine: I am extremely concerned any time there is the presence of a vaccine-preventable disease in a vulnerable community, especially one that can lead to paralysis. As a pediatrician, my aim is to prevent illness rather than treat it. Vaccines are one of the greatest medical inventions of all time. We need to do everything we can to use the protections available to us.

Healio: Have you heard from any concerned parents yet? If so, how are you counseling them?

Levine: When the news broke that there was a case of polio in the county, we received numerous calls from parents wanting to make sure their children were up to date on their polio vaccines. We immediately ran reports for all our patients. Because we are strong advocates of vaccination, we found very strong compliance rates.

Healio: What advice do you have for fellow pediatricians who may face questions from parents about what to look for?

Levine: It’s hard to believe that in 2022, we must be thinking about polio in our differential diagnoses. However, I would caution all pediatricians to be thinking about it. My now 86-year-old father was hospitalized with polio at the age of 13. I never thought that it would hit so close to home again.

Healio: What is being done to get the other approximately 40% of children in these areas vaccinated?

Levine: The Rockland County Department of Health has been addressing our vaccination rates even before there was a reported case of polio. In June, they sent roughly 3,000 reminder letters to children who were behind on vaccines, particularly targeting zip codes with lower vaccination rates. In addition, the State of New York is hosting a webinar on Aug. 9 for Rockland health care providers. The Rockland County department of health is also working with local community providers to boost immunization efforts.

Healio: What about parents who want to catch their children up on the polio vaccine series but who are also unclear about their own status? Can they start the vaccine series in their child’s pediatrician’s office?

Levine: Parents should definitely reach out to their pediatrician’s office, their child’s medical home, to receive guidance on how to best get every eligible person vaccinated. The only thing I would add is that the polio vaccine is safe and effective. The efficacy is greater than 99% after three doses. My recommendation is that all children complete the infant series by 6 months of age.