Parents often ask me, “My baby already had the polio injection. Why the drops too?” It is a fair question, and this Saturday, 24 October, is World Polio Day, a good time to answer it clearly.
Quick answer: Indian children get two kinds of polio vaccine: oral drops (bOPV) and an injection (IPV). Each protects in a different way, and together they give the strongest protection. Follow your child’s schedule, keep the vaccination card safe, and give the free drops on Pulse Polio days until age five, even if your child is fully vaccinated.
What is polio?
Polio (poliomyelitis) is a highly infectious virus that mainly affects children under five. According to the WHO, it spreads mostly through stool: unwashed hands, or food and water contaminated with faeces. Most infected children have no symptoms or only a flu-like illness, but WHO notes that about 1 in 200 infections causes permanent paralysis, usually of the legs. There is no cure. It can only be prevented by vaccination.
Why does it still matter in India?
India’s last case of wild polio was in Howrah, West Bengal, on 13 January 2011, and our region was certified polio-free in 2014. But wild polio still circulates in Pakistan and Afghanistan, and as WHO warns, as long as a single child anywhere is infected, children in all countries are at risk. High vaccine coverage is what keeps the virus out.
Drops and shots: how they work together
- Polio drops (bOPV): two drops of live, weakened vaccine by mouth. They protect against polio types 1 and 3.
- Polio injection (IPV): killed vaccine that covers all three types, including type 2. The government programme uses a small dose given just under the skin, called fIPV (fractional IPV).
The Health Ministry’s immunisation manual explains that IPV given with the drops builds better gut (intestinal) immunity, which helps stop spread, and a child who gets only one is less well protected.
The polio vaccine schedule
In the government (UIP) schedule:
- Drops: at birth, 6, 10 and 14 weeks, and a booster at 16 to 23 months
- fIPV injection: at 6 weeks, 14 weeks and 9 to 11 months
Many private clinics use the Indian Academy of Pediatrics schedule: a full-dose IPV injection, often in a combination vaccine, at 6, 10 and 14 weeks, with boosters at 16 to 18 months and 4 to 6 years. After all three government fIPV doses, IAP says no extra IPV is needed at 16 to 18 months, but the 4 to 6 year booster is still advised. Children with a weakened immune system should not get the drops, so tell the vaccinator.
Pulse Polio days
Under the Pulse Polio programme, all children up to five years get drops in national and local rounds. These extra doses add to, not replace, routine vaccines.
What to watch for after vaccination
As the IAP’s parent guide notes, IPV can cause brief redness, swelling or pain where it was given. The drops are safe, though very rarely they can cause paralysis. For a mild fever after a vaccination day, see my guide on paracetamol after vaccines.
When to seek care
Go to emergency at once if your child suddenly cannot move part of the body, a limb looks floppy or weak, or they have difficulty breathing, as the NHS advises. In India, any sudden weakness or floppiness in a child under 15 must be checked and reported to the polio surveillance network, even though we are polio-free.
Unsure if your child is up to date? Bring the vaccination card and I will gladly check it with you, including catch-up doses such as measles (MMR); you can book a visit here.
Key takeaways
- Polio has no cure, but it is fully preventable with vaccines.
- Drops and the injection protect in different ways; children need both.
- Give Pulse Polio drops until age five, even if fully vaccinated.
- Sudden floppy weakness in a child is an emergency.
Frequently asked questions
My child has had all the polio vaccines. Are pulse polio drops still needed?
Yes. The Indian Academy of Pediatrics advises that every child, whether vaccinated with drops or injections, should get the oral drops on every Pulse Polio day until five years of age. Campaign drops are extra, not a replacement for routine doses.
Is the polio injection the same as the polio drops?
No. The injection (IPV) contains killed virus of all three polio types. The drops (bOPV) contain live, weakened virus of types 1 and 3. Used together, they give stronger protection for your child and the community.
We missed a polio dose. Do we have to start again?
No. You do not restart the schedule. Your pediatrician or health worker simply continues from the dose that was missed. Bring the vaccination card so the next doses can be planned.
Can my child get the polio vaccine with a cold?
Usually yes. India’s immunisation manual says a mild illness is not a reason to delay. If your child is very unwell or has a high fever above 38.5°C, vaccination is postponed until they recover.
Disclaimer: This article is for general information and does not replace a medical consultation. Please see your pediatrician for advice about your child.
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