On Tue, 20 Jul 2004 08:43:31 +0100, Julian Bradley
<[log in to unmask]> wrote:
> No-one doubts that VAPP occurs, or that the virus can be transmitted.
> The
> fact that you report not a single confirmed case of methotrexate
> associated
> paralytic polio does though lead me to question the conclusion.
Reasonably so.
The conclusion that one should not use the live Polio vaccine in the
vicinity of someone taking Methotrexate, in the UK, is valid, but not
because of a peculiarity related to methotrexate.
Rather it is because some years ago the balance tipped from being more
likely to catch wild Polio (by exposure having been immunised with the,
less effective, killed vaccine) to being more likely to catch back-mutated
vaccine Polio.
THerefore, as in the US some time ago, we should by now have changed from
live Polio vaccine to killed vaccine.
It is in the process of changing from a fashionable lateness in action to
a scandal, not of course the largest of those.
--
AKM
Homefield Surgery Heavitree Exeter 01392 214151
|