Editing Polio vaccine (section)

==Side effects==
The inactivated polio vaccines are very safe. Mild redness or pain may occur at the site of injection. They are generally safe to be given to [[pregnancy|pregnant]] women and those who have [[HIV/AIDS]], but are otherwise well.<ref name="WHO2016" />

=== Allergic reaction to the vaccine ===
Inactivated polio vaccine can cause an allergic reaction in a few people, since the vaccine contains trace amounts of [[Antibiotic|antibiotics]], [[streptomycin]], [[polymyxin B]], and [[neomycin]]. It should not be given to anyone who has an allergic reaction to these medicines. Signs and symptoms of an allergic reaction, which usually appear within minutes or a few hours after receiving the injected vaccine, include breathing difficulties, weakness, hoarseness or wheezing, heart-rate fluctuations, skin rash, and dizziness.<ref>{{Cite web|title=Common and Rare Side Effects for poliovirus vaccine injection|url=https://www.webmd.com/drugs/2/drug-14411/poliovirus-vaccine-injection/details/list-sideeffects|access-date=24 August 2021|website=www.webmd.com|archive-date=24 August 2021|archive-url=https://web.archive.org/web/20210824070346/https://www.webmd.com/drugs/2/drug-14411/poliovirus-vaccine-injection/details/list-sideeffects|url-status=live}}</ref>

=== Vaccine-associated paralytic polio ===
A potential adverse effect of the Sabin OPV is caused by its known potential to recombine to a form that causes neurological infection and paralysis.<ref name="Shimizu_2004">{{cite journal | vauthors = Shimizu H, Thorley B, Paladin FJ, Brussen KA, Stambos V, Yuen L, Utama A, Tano Y, Arita M, Yoshida H, Yoneyama T, Benegas A, Roesel S, Pallansch M, Kew O, Miyamura T | title = Circulation of type 1 vaccine-derived poliovirus in the Philippines in 2001 | journal = Journal of Virology | volume = 78 | issue = 24 | pages = 13512–13521 | date = December 2004 | pmid = 15564462 | pmc = 533948 | doi = 10.1128/JVI.78.24.13512-13521.2004 }}</ref> The Sabin OPV results in vaccine-associated paralytic poliomyelitis (VAPP) in around one individual per every 2.7{{nbsp}}million doses administered, with symptoms identical to wild polio.<ref name="GPEI-OPV" /> Due to its improved genetic stability, the novel OPV (nOPV) has a reduced risk of this occurring.<ref>{{Cite web |date=April 2023 |title=nOPV2: Clinical Development and Evidence Summary |url=https://polioeradication.org/wp-content/uploads/2023/05/EN_nOPV2-Clinical-Development-Summary_Apr-2023.pdf |access-date=10 August 2024 |website=Global Polio Eradication Initiative}}</ref>

===Contamination concerns===
{{further|Vaccine contamination with SV40}}
In 1960, the [[rhesus monkey]] kidney cells used to prepare the poliovirus vaccines were determined to be infected with the [[SV40|simian virus-40]] (SV40),<ref name=SV>{{cite web| title = Simian Virus 40 (SV40), Polio Vaccine, and Cancer | work = Vaccine Safety | publisher = Centers for Disease Control| date = 22 April 2004 | url = https://www.cdc.gov/vaccinesafety/updates/archive/polio_and_cancer_factsheet.htm | archive-url = https://web.archive.org/web/20130522091608/http://www.cdc.gov/vaccinesafety/updates/archive/polio_and_cancer_factsheet.htm | archive-date = 22 May 2013 | access-date = 22 May 2013}}</ref> which was also discovered in 1960 and is a naturally occurring virus that infects monkeys. In 1961, SV40 was found to cause tumors in [[rodent]]s.<ref name="Eddy_1961">{{cite journal|vauthors=Eddy BE, Borman GS, Berkeley WH, Young RD|date=May 1961|title=Tumors induced in hamsters by injection of rhesus monkey kidney cell extracts|journal=Proceedings of the Society for Experimental Biology and Medicine|volume=107|pages=191–197|doi=10.3181/00379727-107-26576|pmid=13725644|s2cid=31275908}}</ref> More recently, the virus was found in certain forms of [[cancer]] in humans, for instance [[brain tumor|brain]] and [[bone tumor]]s, [[pleural]] and [[peritoneal]] mesothelioma, and some types of [[non-Hodgkin lymphoma]].<ref>{{cite journal|vauthors=Carbone M|date=December 1999|title=Simian virus 40 and human tumors: It is time to study mechanisms|journal=Journal of Cellular Biochemistry|volume=76|issue=2|pages=189–193|doi=10.1002/(SICI)1097-4644(20000201)76:2<189::AID-JCB3>3.0.CO;2-J|pmid=10618636|s2cid=795975 }}</ref><ref>{{cite journal|vauthors=Vilchez RA, Kozinetz CA, Arrington AS, Madden CR, Butel JS|date=June 2003|title=Simian virus 40 in human cancers|journal=The American Journal of Medicine|volume=114|issue=8|pages=675–684|doi=10.1016/S0002-9343(03)00087-1|pmid=12798456}}</ref> However, SV40 has not been determined to cause these cancers.<ref name=Engels>{{cite journal | vauthors = Engels EA | s2cid = 5861910 | title = Cancer risk associated with receipt of vaccines contaminated with simian virus 40: epidemiologic research | journal = Expert Review of Vaccines | volume = 4 | issue = 2 | pages = 197–206 | date = April 2005 | pmid = 15889993 | doi = 10.1586/14760584.4.2.197 | url = https://zenodo.org/record/1235758 | access-date = 30 June 2019 | archive-date = 20 April 2020 | archive-url = https://web.archive.org/web/20200420144252/https://zenodo.org/record/1235758 | url-status = live }}</ref>

SV40 was found to be present in stocks of the injected form of the IPV in use between 1955 and 1963;<ref name=SV/> it is not found in the OPV form.<ref name=SV/> Over 98 million Americans received one or more doses of polio vaccine between 1955 and 1963, when a proportion of vaccine was contaminated with SV40; an estimated 10–30 million Americans may have received a dose of vaccine contaminated with SV40.<ref name=SV/> Later analysis suggested that vaccines produced by the former [[Soviet bloc]] countries until 1980, and used in the [[USSR]], [[China]], [[Japan]], and several [[Africa]]n countries, may have been contaminated, meaning hundreds of millions more may have been exposed to SV40.<ref>{{cite magazine | vauthors = Bookchin D| title = Vaccine scandal revives cancer fear | magazine = New Scientist | date = 7 July 2004 |url=https://www.newscientist.com/news/news.jsp?id=ns99996116| archive-url = https://web.archive.org/web/20040720074452/http://www.newscientist.com/news/news.jsp?id=ns99996116| archive-date=20 July 2004 | access-date = 29 November 2008 }}</ref>

In 1998, the [[National Cancer Institute]] undertook a large study, using cancer case information from the institute's SEER database. The published findings from the study revealed no increased incidence of cancer in persons who may have received vaccine containing SV40.<ref name="Strickler_1998">{{cite journal|vauthors=Strickler HD, Rosenberg PS, Devesa SS, Hertel J, Fraumeni JF, Goedert JJ|date=January 1998|title=Contamination of poliovirus vaccines with simian virus 40 (1955–1963) and subsequent cancer rates|journal=JAMA|volume=279|issue=4|pages=292–295|doi=10.1001/jama.279.4.292|pmid=9450713|doi-access=free}}</ref> Another large study in Sweden examined cancer rates of 700,000 individuals who had received potentially contaminated polio vaccine as late as 1957; the study again revealed no increased cancer incidence between persons who received polio vaccines containing SV40 and those who did not.<ref name="Olin_1998">{{cite journal|vauthors=Olin P, Giesecke J|year=1998|title=Potential exposure to SV40 in polio vaccines used in Sweden during 1957: no impact on cancer incidence rates 1960 to 1993|journal=Developments in Biological Standardization|volume=94|pages=227–233|pmid=9776244}}</ref> The question of whether SV40 causes cancer in humans remains controversial, however, and the development of improved assays for detection of SV40 in human tissues will be needed to resolve the controversy.<ref name=Engels/>
[[File:Bundesarchiv B 145 Bild-F025952-0015, Bonn, Gesundheitsamt, Schutzimpfung.jpg|thumb|Doses of oral polio vaccine are added to [[sugar cube]]s for use in a 1967 vaccination campaign in [[Bonn]], [[West Germany]]]]
During the race to develop an oral polio vaccine, several large-scale human trials were undertaken. By 1958, the National Institutes of Health had determined that OPV produced using the Sabin strains was the safest.<ref name=Sanofi/> Between 1957 and 1960, however, [[Hilary Koprowski]] continued to administer his vaccine around the world. In Africa, the vaccines were administered to roughly one million people in the Belgian territories (now the [[Democratic Republic of the Congo]], [[Rwanda]], and [[Burundi]]).<ref name="Plotkin">{{cite journal|vauthors=Plotkin SA|date=April 2001|title=CHAT oral polio vaccine was not the source of human immunodeficiency virus type 1 group M for humans|journal=Clinical Infectious Diseases|volume=32|issue=7|pages=1068–1084|doi=10.1086/319612|pmid=11264036|doi-access=free}}</ref><ref name=Kowproski5>{{cite journal | vauthors = Koprowski H | title = Historical aspects of the development of live virus vaccine in poliomyelitis | journal = British Medical Journal | volume = 2 | issue = 5192 | pages = 85–91 | date = July 1960 | pmid = 14410975 | pmc = 2096806 | doi = 10.1136/bmj.2.5192.85 }}</ref> The results of these human trials have been controversial,<ref name=Collins_2000>{{cite news | vauthors = Collins H | title = The Gulp Heard Round the World | page = D-1 | website = The Philadelphia Inquirer | date = 6 November 2000 | url = http://www.koprowski.net/Polio+Article.htm | access-date = 29 November 2008 |url-status = usurped| archive-url = https://web.archive.org/web/20040405233046/http://www.koprowski.net/Polio%20Article.htm | archive-date = 5 April 2004 | df = dmy-all }}</ref> and unfounded [[OPV AIDS hypothesis|accusations in the 1990s]] arose that the vaccine had created the conditions necessary for transmission of [[simian immunodeficiency virus]] from [[Common chimpanzee|chimpanzee]]s to humans, causing [[HIV/AIDS]]. These hypotheses, however, [[OPV AIDS hypothesis|have been conclusively refuted]].<ref name="Plotkin" /> By 2004, cases of poliomyelitis in Africa had been reduced to just a small number of isolated regions in the western portion of the continent, with sporadic cases elsewhere. Recent local opposition to vaccination campaigns has evolved due to lack of adequate information,<ref>{{cite news |url=http://news.bbc.co.uk/2/hi/africa/2070634.stm |publisher=BBC News Online |title=Nigeria Muslims oppose polio vaccination |date=27 June 2002 |access-date=29 November 2008 |url-status = live|archive-url=https://web.archive.org/web/20081129152933/http://news.bbc.co.uk/2/hi/africa/2070634.stm |archive-date=29 November 2008 }}</ref><ref>{{cite news |vauthors=Dugger CW, McNeil DG |url=https://www.nytimes.com/2006/03/20/international/asia/20polio.html |title=Rumor, Fear and Fatigue Hinder Final Push to End Polio |work=[[The New York Times]] |date=20 March 2006 |access-date=29 November 2008 |url-status = live|archive-url=https://web.archive.org/web/20081210212451/http://www.nytimes.com/2006/03/20/international/asia/20polio.html?pagewanted=2 |archive-date=10 December 2008 }}</ref> often relating to fears that the vaccine might induce [[Infertility|sterility]].<ref>{{cite news |url=http://news.bbc.co.uk/2/hi/africa/4539757.stm |publisher=[[BBC News Online]] |title=Anti-polio vaccine Malians jailed |date=12 May 2005 |access-date=29 November 2008 |url-status = live|archive-url=https://web.archive.org/web/20060110000559/http://news.bbc.co.uk/2/hi/africa/4539757.stm |archive-date=10 January 2006 }}</ref> The disease has since resurged in [[Nigeria]] and several other African nations without necessary information, which [[epidemiologist]]s believe is due to refusals by certain local populations to allow their children to receive the polio vaccine.<ref name="Jegede"/>