Serious adverse reactions after IPV immunization have not been documented. This change could help to prevent vaccine-associated poliomyelitis mostly occurring after the first dose of OPV immunization. They are considering new concepts of shifting from OPV to IPV or from OPV to mixed schedules. Some other industrialized countries that use OPV in their routine immunization programs, and which had no wild poliomyelitis cases for many years but some vaccine-associated poliomyelitis, are reassessing their immunization strategy. Since 1 January 2000, all children have received four doses of IPV at ages 2 months, 4 months, 6–18 months, and 4–6 years. The US 2000 childhood immunization schedule, proposed by the Advisory Committee of Immunization Practices (ACIP), the American Academy of Pediatrics, and the American Academy of Family Physicians, recommended an all-IPV schedule for routine use in the USA, aimed at the elimination of the rare vaccine-associated paralytic poliomyelitis. A few countries (for example Denmark, Hungary, Italy, Lithuania, and Israel) use a mixed schedule, starting primary immunization with IPV followed by OPV. Inactivated poliomyelitis vaccine produced by improvements in manufacturing technology (potency-enhanced IPV-eIPV was licensed in 1987) is used for routine immunization in an increasing number of countries (for example in Finland, France, Germany, Iceland, the Netherlands, Norway, Sweden, and certain provinces of Canada) and is recommended in other countries for certain specific purposes, for example for persons with underlying immunological disorders or non-immunized adults exposed to high risk. In Meyler's Side Effects of Drugs (Sixteenth Edition), 2016 Inactivated poliomyelitis vaccine
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