Flawed immunisation policies in India led to polio paralysis

BMJ. 1998 Apr 25;316(7140):1264. doi: 10.1136/bmj.316.7140.1261f.


PIP: In accordance with World Health Organization (WHO) recommendations, India introduced 3 doses per child of oral poliomyelitis vaccine (OPV) into its immunization program during the late 1970s. It was hoped that infants would be protected from polio after having received the 3-dose vaccine course. However, the provision of only 3 doses of OPV contradicted research which suggested that additional doses would be necessary to protect children from wild polioviruses in India's tropical environment. During the 1980s, hundreds of thousands of children in India developed polio because of the inadequate vaccine protection they received under WHO recommendations. Moreover, the introduction of diphtheria/tetanus/pertussis (DTP) vaccine without adequately protecting infants from circulating wild polioviruses increased the risk of provocation poliomyelitis, a phenomenon in which an injection given to a child with silent poliovirus infection can trigger paralysis in the injected limb. Massive outbreaks of provocation poliomyelitis occurred. Given the appropriate policies, India could have eradicated polio a decade ago. However, it now seems unlikely that India will eradicate polio by the target year of 2000.

Publication types

  • News

MeSH terms

  • Diphtheria-Tetanus-Pertussis Vaccine / adverse effects
  • Humans
  • Immunization / adverse effects*
  • India / epidemiology
  • Paralysis / epidemiology
  • Paralysis / etiology*
  • Poliomyelitis / complications
  • Poliomyelitis / epidemiology
  • Poliomyelitis / prevention & control*


  • Diphtheria-Tetanus-Pertussis Vaccine