Immunization, Vaccines and Biologicals

The scientific rationale for IPV introduction

The documents on this page provide scientific and technical background related to the introduction of IPV and the switch from trivalent OPV (tOPV) to bivalent OPV (bOPV). These documents provide an overview of Objective 2, recommendations by WHO and technical information related to scheduling and multiple injections.

Background and Technical Rationale – Handbook

Comprehensive Technical Module - PowerPoint

WHO IPV Recommendations

Weekly Epidemiologic Record (WER) – Polio vaccines: WHO Position Paper, January 2014

Weekly Epidemiologic Record (WER) Meeting of the Strategic Advisory Group of Experts on Immunization, November 2013 – conclusions and recommendations

SAGE working group – scientific evidence October 2012

SAGE rationale for IPV at 14 weeks – October 2012

Scheduling of IPV

To minimize the risks associated with the withdrawal of type 2 containing OPV, WHO recommends that all countries introduce at least one dose of Inactivated Poliovirus Vaccine (IPV) into their routine immunization schedule by the end of 2015. The IPV dose should be administered at 14 weeks of age or the nearest immunization visit after that.

For example, in countries with a routine DTP vaccine schedule of 6, 10, and 14 weeks of age, IPV should be given at 14 weeks with DTP3, or for countries with a 2, 3, and 4 month schedule, IPV should be given at 4 months. The IPV dose should be given in addition to all other scheduled vaccine doses, including OPV, and doing so, may require multiple vaccine injections.

A catch-up strategy, targeting children that have already been immunized with three doses of Penta/OPV, is not recommended for IPV because these children will have been vaccinated with tOPV, and thus immunized against all three types of polio, including type 2. It is also important to note that IPV should be administered at the first immunization contact after 14 weeks of age, and scheduling at 9 months or later is not recommended.

Multiple vaccine injections

Many countries have immunization schedules where children receive multiple vaccine injections at one visit. Globally, many middle and high-income countries have been safely using multiple injections for more than a decade. Vaccination schedules that involve multiple injections during the same visit are based on many years of pre-licensure and post-licensure safety and effectiveness data, including concomitant use studies.

As countries consider the potential implications of adding IPV to immunization schedules, the following resources may be helpful. Please also see the ‘Planning’ page for resources to support health worker training on multiple injections.

Multiple Injections: Acceptability and Safety

Background note and frequently asked questions

Practical considerations for the introduction of IPV

Summary of WHO recommendations for IPV and other factors to consider

Other Publications

Please let us know if you have additional questions that are not covered through this site by emailing


Related links

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    IPV Introduction, OPV Withdrawal and Routine Immunization Strengthening
    About the Polio Endgame Strategic Plan
    The scientific rationale for IPV introduction
    IPV safety, and price and presentation options
    Resources for planning and IPV introduction
    Relevant lessons learned and successful strategies
    Online library of literature and peer-review publications