A Critical Review: Are Vaccine-associated Paralytic Poliomyelitis and Acute Flaccid Paralysis a New Disaster?

India received status of Polio-free country in 2012. However Vaccine-Associated Paralytic Poliomyelitis (VAPP) surfaced worldwide wherever Sabin's oral polio vaccine (OPV) having attenuated live virus, was used. WHO's Global Polio Initiative to Eradicate Polio (1988), recommended use of OPV. USA (2000) and many European countries subsequently switched to the injectable Salk inactivated Polio Vaccine (IPV). Scandinavian countries used IPV all along. OPV is continued in the developing countries; it has low costs and ease of operation, for the mass campaigns. In gives intestinal immunity. India is a successful example of Polio eradication programme having played a model role. However, the risk of VAPP looms over the vaccinated children. Also Non-polio Acute Flaccid Polio (NPAFI) is on rise with 54788 AFP cases detected in 2013 manifesting polio-like clinical picture. No clinical difference exists in VAPP and wild Polioviruses(P1-P3) paralysis. WHO facilitated technology transfer to India to produce new Sabin IPV, as affordable immunisation programme. This critical review covers related issues and the controversies; it will acquaint therapists of this new menace, who eventually take the brunt during the secondary, tertiary prevention and management. Therapist must carefully educate the public on this sensitive issue.