Vaccine (and antibiotic injections) associated paralytic Poliomyelitis (VAPP)
Provocation polio  Nervous system disease & vaccines 
See: Drug Induced Meningitis (DIAM) Vaccine induced meningitis Antibiotics & Meningitis

Albrecht RM.    Poliomyelitis from a vaccinee. Lancet. 1968 Jun 22;1(7556):1371. No abstract available.PMID: 4172671; UI: 68278677.   

Arya SC.    Vaccine-associated poliomyelitis. Lancet. 1994 Mar 5;343(8897):610-1. No abstract available.PMID: 7906372; UI: 94150215.    

Arlazoroff A.     [The replacement of poliomyelitis by vaccine-associated poliomyelitis]. Harefuah. 1987 Dec 15;113(12):415-6. Hebrew. No abstract available.PMID: 3452586; UI: 88255980.

Arlazoroff A, et al.     Vaccine-associated contact paralytic poliomyelitis with atypical neurological presentation. Acta Neurol Scand. 1987 Sep;76(3):210-4. PMID: 3687370; UI: 88073121.     

Asindi AA, et al.  Vaccine-induced polioencephalomyelitis in Scotland. Scott Med J. 1988 Aug;33(4):306-7. PMID: 2847313; UI: 89043914.      

Basa, SN, "Paralytic Poliomyelitis Following Inoculation With Combined DTP Prophylactic. A review of Sixteen cases with Special Reference to Immunization Schedules in Infancy", J Indian Med Assoc, Feb 1, 1973, 60:97-99.

Basu SN.       A review of paralytic poliomyelitis cases occurring after polio vaccination. J Indian Med Assoc. 1986 Jul;84(7):203-6. No abstract available.PMID: 3794352; UI: 87084836.
Basillico FC, et al.     Vaccine-associated poliomyelitis in a contact. JAMA. 1978 May 26;239(21):2275. No abstract available.PMID: 650811; UI: 78174165.
Biberi-Moroeanu S, et al.     Commentary on the oral poliomyelitis vaccine (Sabin) -- associated cases of acute persisting spinal paralysis. Arch Roum Pathol Exp Microbiol. 1978 Jul-Dec;37(3-4):355-68. No abstract available.PMID: 757664; UI: 80152712.
Boese T, et al.   [Vaccine-related paralytic poliomyelitis with severe pareses. Report of one case]. Klin Padiatr. 1978 Nov;190(6):607-9. German. PMID: 213638; UI: 79051431.
Brown B.      Inactivated poliovirus vaccine and vaccine-associated paralytic poliomyelitis. JAMA. 1997 Jan 22-29;277(4):295. No abstract available.PMID: 9002483; UI: 97155979.
Burgess MA, et al.     Vaccine-associated paralytic poliomyelitis. Commun Dis Intell. 1999 Mar 18;23(3):80-1. No abstract available.PMID: 10323041; UI: 99256417.
Beausoleil JL, et al.    Vaccine-associated paralytic poliomyelitis. J Child Neurol. 1994 Jul;9(3):334-5. No abstract available.PMID: 7930418; UI: 95015658.      
Bhagwat SM, et al.  Oral polio vaccine (Sabin): Vaccine-associated poliolike illnesses. Indian J Med Sci. 1966 Dec;20(12):903-6. No abstract available.PMID: 5980154; UI: 67249902.

Chitsike I, et al.    Paralytic poliomyelitis associated with live oral poliomyelitis vaccine in child with HIV infection in Zimbabwe: case report. BMJ. 1999 Mar 27;318(7187):841-3. PMID: 10092261; UI: 99192485.

Chang TW, et al.    Paralytic poliomyelitis in a child with hypogammaglobulinemia: probable implication of type I vaccine strain.
Pediatrics. 1966 Apr;37(4):630-6. No abstract available.PMID: 5930025; UI: 66121641.
Derenne F, et al.      [Acute anterior poliomyelitis in the mother of a vaccinated child]. Presse Med. 1989 Jan 28;18(3):129-30. French. No abstract available.PMID: 2521943; UI: 89145172.
Deivanayagam N, et al.     Intramuscular injection as a provoking factor for paralysis in acute poliomyelitis. A case control study. Indian Pediatr. 1993 Mar;30(3):335-40. PMID: 8365783; UI: 93374463.   
Diamanti E, et al.      Surveillance of suspected poliomyelitis in Albania, 1980-1995: suggestion of increased risk of vaccine associated poliomyelitis. Vaccine. 1998 May-Jun;16(9-10):940-8. PMID: 9682341; UI: 98347263.    
Feigin RD, et al.  Vaccine-related paralytic poliomyelitis in an immunodeficient child. J Pediatr. 1971 Oct;79(4):642-7. No abstract available.PMID: 4106164; UI: 72003487.
Friedrich F.     Genomic modifications in Sabin vaccine strains isolated from vaccination-associated cases, healthy contacts and healthy vaccinees. Acta Virol. 1996 Jun;40(3):157-70. Review. PMID: 8891097; UI: 97046175.
Friedrich F, et al.     Type 2 poliovirus recombinants isolated from vaccine-associated cases and from healthy contacts in Brazil. Acta Virol. 1996 Feb;40(1):27-33. PMID: 8886095; UI: 97040803.
Friedrich F, et al.    Poliovirus type 1 isolated from a vaccine-associated case of paralytic poliomyelitis in Brazil. Braz J Med Biol Res. 1996 Jan;29(1):15-8. PMID: 8731326; UI: 96341537.
Friedrich F. Rare adverse events associated with oral poliovirus vaccine in Brazil. Braz J Med Biol Res. 1997 Jun;30(6):695-703. Review. PMID: 9292105; UI: 97437572.       
Georgescu MM, et al.  Evolution of the Sabin type 1 poliovirus in humans: characterization of strains isolated from patients with vaccine-associated paralytic poliomyelitis. J Virol. 1997 Oct;71(10):7758-68. PMID: 9311861; UI: 97456547.
Gromeier M, et al.      Mechanism of injury-provoked poliomyelitis. J Virol. 1998 Jun;72(6):5056-60. PMID: 9573275; UI: 98241746     
Gross TP, et al.    Vaccine-associated poliomyelitis in a household contact with Netherton's syndrome receiving long-term steroid therapy. J Med. 1987 Oct;83(4):797-800. PMID: 3674066; UI: 88046854.
Heyne K. [Paralytic poliomyelitis following vaccination contact in the 1st trimenon of an infant]. Med Welt. 1977 Sep 9;28(36):1439-41. German. No abstract available.PMID: 904451; UI: 78009622.
Gonzalez E, et al.     [Poliomyelitis associated with a vaccine: 2 clinical cases]. Rev Med Chil. 1988 May;116(5):461-4. Spanish. No abstract available.PMID: 2854294; UI: 89222077.

Groom SN, et al.     Vaccine-associated poliomyelitis. Lancet. 1994 Mar 5;343(8897):609-10. No abstract available.PMID: 7906370; UI: 94150213.    

Haneberg B, et al.  Poliomyelitis associated with oral poliovaccine. Report on two cases. Acta Paediatr Scand. 1972 Jan;61(1):105-8. No abstract available.PMID: 5018571; UI: 72160352.
Heyne K.    [Paralytic poliomyelitis following vaccination contact in the 1st trimenon of an infant]. Med Welt. 1977 Sep 9;28(36):1439-41. German. No abstract available.PMID: 904451; UI: 78009622.
Ion-Nedelcu N, et al.  Vaccine-associated paralytic poliomyelitis and HIV infection. Lancet. 1994 Jan 1;343(8888):51-2. No abstract available.PMID: 7905058; UI: 94125700     
Izurieta HS, et al.   Vaccine-associated paralytic poliomyelitis in the United States: no evidence of elevated risk after simultaneous intramuscular injections of vaccine. Pediatr Infect Dis J. 1995 Oct;14(10):840-6. PMID: 8584308; UI: 96117418.       
Kruppenbacher JP, et al.     [Vaccine poliomyelitis as a complication of oral vaccination]. Offentl Gesundheitswes. 1983 Oct;45(10):528-31. German. No abstract available.PMID: 6227849; UI: 84068994.
Kitamura I, et al.   Poliomyelitis from a vaccine. Lancet. 1969 Mar 1;1(7592):465. No abstract available.PMID: 4179522; UI: 69112749.      
Maass G, et al.  Acute spinal paralysis after the administration of oral poliomyelitis vaccine in the Federal Republic of Germany (1963-1984). J Biol Stand. 1987 Apr;15(2):185-91. No abstract available.PMID: 3597450; UI: 87250678.
Mertens T, et al.   Two cases of vaccine-induced poliomyelitis. Acta Paediatr Scand. 1984 Jan;73(1):133-4. No abstract available.PMID: 6322508; UI: 84149786.
Mermel L, et al.  Vaccine-associated paralytic poliomyelitis. N Engl J Med. 1993 Sep 9;329(11):810-1. No abstract available.PMID: 8350905; UI: 93354422.    
Malvy DJ, et al.    Elimination of poliomyelitis in France: epidemiology and vaccine status. Public Health Rev. 1993-94;21(1-2):41-9. PMID: 8041889; UI: 94316808.
Morse LJ.     Poliomyelitis from a vaccine. Lancet. 1968 Jun 15;1(7555):1312-3. No abstract available.PMID: 4172166; UI: 68241606.     
Morse LJ, et al.     Vaccine-acquired paralytic poliomyelitis in an unvaccinated mother. JAMA. 1966 Sep 19;197(12):1034-5. No abstract available.PMID: 5953205; UI: 67017850.    
Mathur GP, et al.    Intramuscular injection as a provocative factor in paralytic poliomyelitis. Indian Pediatr. 1994 May;31(5):529-31. No abstract available.PMID: 7875883; UI: 95181066.  

Mermel L, et al. Vaccine-associated paralytic poliomyelitis. N Engl J Med. 1993 Sep 9;329(11):810-1. No abstract available. PMID: 8350905; UI: 93354422.

Manki A, et al.    [Neurologic diseases of enterovirus infections: polioviruses, coxsackieviruses, echoviruses, and enteroviruses type 68-72]. Nippon Rinsho. 1997 Apr;55(4):849-54. Review. Japanese. PMID: 9103882; UI: 97257335.   

Neurologic diseases are common manifestations in enteroviral infections, and most common is aseptic meningitis in children. Only a few percents of poliovirus infected children may result in aseptic meningitis or paralytic poliomyelitis. VAPP (Vaccine Associated Paralytic Poliomyelitis) should be considered among patients with a recent history of receiving OPV (oral polio vaccine). Recently PCR analysis has been used in order to differentiate vaccine-strain from wild-strain poliovirus. There are no specific laboratory findings about enterovirus infections in CNS, however CSF (cerebrospinal fluid) in acute phase may show elevated, predominant polymorphonuclear cells and mean-while shift to mononuclear cell dominance. The G-CSF concentration in CSF with enteroviral meningitis is elevated, which indicates that induced G-CSF is responsible for neutrophil predominance in CSF.

Nicoll A.      Vaccine related poliomyelitis in non-immunised relatives and household contacts. Br Med J (Clin Res Ed). 1987 Feb 7;294(6568):374. No abstract available.PMID: 3101887; UI: 87129607.
Novello F, et al.   Paralytic poliomyelitis in Italy (1981-85). Eur J Epidemiol. 1987 Mar;3(1):54-60. PMID: 3582600; UI: 87219006    
[No authors listed]     Vaccine associated poliomyelitis. Commun Dis Rep CDR Wkly. 1992 Jan 31;2(5):21. No abstract available.PMID: 1285181; UI: 94061171.
[No authors listed]   Paralytic poliomyelitis--United States, 1980-1994. MMWR Morb Mortal Wkly Rep. 1997 Jan 31;46(4):79-83. PMID: 9048844; UI: 97201015.     
[No authors listed]    National poliomyelitis immunization days--People's Republic of China, 1993. MMWR Morb Mortal Wkly Rep. 1993 Nov 5;42(43):837-9. PMID: 8413173; UI: 94019159.
[No authors listed]     Editorial: Vaccine-associated poliomyelitis. Med J Aust. 1973 Oct 27;2(17):795-6. No abstract available.PMID: 4760230; UI: 74048144.
Nkowane BM, et al.    Vaccine-associated paralytic poliomyelitis. United States: 1973 through 1984. JAMA. 1987 Mar 13;257(10):1335-40. PMID: 3029445; UI: 87141492.
Orzechowska-Wolczyk M, Szulc-Kuberska J, Zawadzki Z.  [Case of poliomyelitis in the mother of a child vaccinated against poliomyelitis] Wiad Lek. 1976 Jun 1;29(11):1007-10. Polish. No abstract available. PMID: 180696 [PubMed - indexed for MEDLINE]
Pohl KR, et al.  Ataxia-telangiectasia in a child with vaccine-associated paralytic poliomyelitis. J Pediatr. 1992 Sep;121(3):405-7. PMID: 1517916; UI: 92389138.
Querfurth H, et al.    Vaccine-associated paralytic poliomyelitis. Regional case series and review. Arch Neurol. 1990 May;47(5):541-4. Review. PMID: 2185721; UI: 90240955.
Ross RT.     Intramuscular injections and vaccine-associated poliomyelitis. N Engl J Med. 1995 Jul 6;333(1):63; discussion 64. No abstract available.PMID: 7632271; UI: 95295769  
Rosenthal T, et al.    [Vaccine-associated poliomyelitis]. Harefuah. 1976 Jan 1;90(1):25-6. Hebrew. No abstract available.PMID: 1248774; UI: 76119223      
Sabin AB.     Vaccine-associated poliomyelitis cases. Bull World Health Organ. 1969;40(6):947-9. No abstract available.PMID: 5307605; UI: 70029794.     
Shaw EB, et al.    Vaccine-derived poliomyelitis. Am J Dis Child. 1970 Jun;119(6):546. No abstract available.PMID: 4315316; UI: 70180909.      
Strebel PM, et al.   Intramuscular injections within 30 days of immunization with oral poliovirus vaccine--a risk factor for vaccine-associated paralytic poliomyelitis. N Engl J Med. 1995 Feb 23;332(8):500-6. PMID: 7830731; UI: 95131970.       
Strebel PM, et al.   Paralytic poliomyelitis in Romania, 1984-1992. Evidence for a high risk of vaccine-associated disease and reintroduction of wild-virus infection. Am J Epidemiol. 1994 Dec 15;140(12):1111-24. PMID: 7998593; UI: 95091240        

Strebel PM, et al.    Epidemiology of poliomyelitis in the United States one decade after the last reported case of indigenous wild virus-associated disease. Clin Infect Dis. 1992 Feb;14(2):568-79. Review. PMID: 1554844; UI: 92208140.    

Strebel PM, et al.   Paralytic poliomyelitis in Romania, 1984-1992. Evidence for a high risk of vaccine-associated disease and reintroduction of wild-virus infection. Am J Epidemiol. 1994 Dec 15;140(12):1111-24. PMID: 7998593; UI: 95091240. 
BACKGROUND. In Romania the rate of vaccine-associated paralytic poliomyelitis is for unexplained reasons 5 to 17 times higher than in other countries. Long ago it was noted that intramuscular injections administered during the incubation period of wild-type poliovirus infection increased the risk of paralytic disease (a phenomenon known as "provocation" poliomyelitis). We conducted a case-control study to explore the association between intramuscular injections and vaccine-associated poliomyelitis in Romania. ...RESULTS. Of the 31 children with vaccine-associated disease, 27 (87 percent) had received one or more intramuscular injections within 30 days before the onset of paralysis, as compared with 77 of the 151 controls (51 percent) (matched odds ratio, 31.2; 95 percent confidence interval, 4.0 to 244.2). Nearly all the intramuscular injections were of antibiotics, and the association was strongest for the patients who received 10 or more injections (matched odds ratio for > or = 10 injections as compared with no injections, 182.1; 95 percent confidence interval, 15.2 to 2186.4). The risk of paralytic disease was strongly associated with injections given after the oral polio virus vaccine, but not with injections given before or at the same time as the vaccine (matched odds ratio, 56.7; 95 percent confidence interval, 8.9 to infinity). The attributable risk in the population for intramuscular injections given in the 30 days before the onset of paralysis was 86 percent (95 percent confidence interval, 66 to 95 percent); that is, we estimate that 86 percent of the cases of vaccine-associated paralytic poliomyelitis in this population might have been prevented by the elimination of intramuscular injections within 30 days after exposure to oral poliovirus vaccine. CONCLUSIONS. Provocation paralysis, previously described only for wild-type poliovirus infection, may rarely occur in a child who receives multiple intramuscular injections shortly after exposure to oral poliovirus vaccine, either as a vaccine recipient or through contact with a recent recipient. This phenomenon may explain the high rate of vaccine-associated paralytic poliomyelitis in Romania, where the use of intramuscular injections of antibiotics in infants with febrile illness is common.
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Sepkowitz S.   Vaccine-associated paralytic poliomyelitis. Pediatrics. 1997 Jan;99(1):145. No abstract available.PMID: 8989358; UI: 97143347.       
Sepkowitz S.    Intramuscular injections and vaccine-associated poliomyelitis. N Engl J Med. 1995 Jul 6;333(1):64. No abstract available.PMID: 7777003; UI: 95295771.
Sigmund J, et al.   [Flaccid paralysis following oral poliomyelitis vaccination]. Padiatr Padol. 1985;20(1):77-82. German. PMID: 3975062; UI: 85139282.      
Schonberger LB, et al.    Vaccine-associated poliomyelitis in the United States, 1961-1972. Am J Epidemiol. 1976 Aug;104(2):202-11. PMID: 181984; UI: 76250261.   
Sullivan AA, et al.     Vaccine-associated paralytic poliomyelitis. Med J Aust. 1995 Oct 16;163(8):423-4. No abstract available.PMID: 7476613; UI: 96043606.
Sutter RW, et al.    Attributable risk of DTP (diphtheria and tetanus toxoids and pertussis vaccine) injection in provoking paralytic poliomyelitis during a large outbreak in Oman. J Infect Dis. 1992 Mar;165(3):444-9. PMID: 1538150; UI: 92166422.
Sutter RW, et al.     Outbreak of paralytic poliomyelitis in Oman: evidence for widespread transmission among fully vaccinated children. Lancet. 1991 Sep 21;338(8769):715-20. PMID: 1679866; UI: 91367018.      
Tulchinsky TH, et al.   More on vaccine-associated paralytic poliomyelitis. N Engl J Med. 1993 Dec 23;329(26):1968-9. No abstract available.PMID: 8247068; UI: 94067254. 
Tate CA, et al.    Case report: acute vaccine-associated paralytic poliomyelitis. Muscle Nerve. 1997 Feb;20(2):253-4. No abstract available.PMID: 9040673; UI: 97193081  
Varughese PV, et al.    Eradication of indigenous poliomyelitis in Canada: impact of immunization strategies. Can J Public Health. 1989 Sep-Oct;80(5):363-8. PMID: 2804867; UI: 90030013.
Walter Z, et al.    [6 cases of poliomyelitis associated with oral immunization]. Wiad Lek. 1973 May 15;26(10):901-5. Polish. No abstract available.PMID: 4351071; UI: 73195155.
Weinberg RJ, et al.   Intramuscular injections and vaccine-associated poliomyelitis. N Engl J Med. 1995 Jul 6;333(1):63; discussion 64. No abstract available.PMID: 7777002; UI: 95295770       
Weibel RE, et al.   Reporting vaccine-associated paralytic poliomyelitis: concordance between the CDC and the National Vaccine Injury Compensation Program. Am J Public Health. 1996 May;86(5):734-7. PMID: 8629730; UI: 96212373.
Wyatt HV.   Injections and poliomyelitis: what are the risks of vaccine associated paralysis? Dev Biol Stand. 1986;65:123-6. Review. PMID: 3549394; UI: 87162893.
Wyatt HV.     Vaccine-associated poliomyelitis. Lancet. 1994 Mar 5;343(8897):610. No abstract available.PMID: 7906371; UI: 94150214.
Wyatt HV.      Provocation of poliomyelitis by multiple injections. Trans R Soc Trop Med Hyg. 1985;79(3):355-8. PMID: 4035736; UI: 85301396.  
Wyatt HV, et al. Unnecessary injections and paralytic poliomyelitis in India. Trans R Soc Trop Med Hyg. 1992 Sep-Oct;86(5):546-9. PMID: 1475830; UI: 93118141.        
Wyatt HV, et al.   Unnecessary injections and poliomyelitis. Indian J Pediatr. 1993 May-Jun;60(3):327-9. No abstract available.PMID: 8253483; UI: 94075008.
Wyatt HV.    Unnecessary injections and poliomyelitis in Pakistan. Trop Doct. 1996 Oct;26(4):179-80. No abstract available. PMID: 8937237; UI: 97091570.     
Wyatt HV.    Poliomyelitis in developing countries: lower limb paralysis and injections. Trans R Soc Trop Med Hyg. 1989 Jul-Aug;83(4):545-9. PMID: 2617611; UI: 90141863.
Wright PF, et al.      Vaccine-associated poliomyelitis in a child with sex-linked agammaglobulinemia. J Pediatr. 1977 Sep;91(3):408-12. PMID: 197220; UI: 77251771.