A recent case of a child in Kerala dying from vaccine-derived poliovirus (VDPV) has raised concerns about the safety of polio vaccination in immunocompromised individuals. Experts discuss the differences between wild poliovirus and VDPV, the transmission of the virus, and the importance of newborn screening for immunodeficiencies. They also highlight advancements in antiviral treatments and emphasize the need for public health guidelines to adapt to these emerging risks.