OBJECTIVES: To estimate the cost effectiveness of changing from live oral poliovirus vaccine to inactivated poliovirus vaccine in Colombia. METHODS: A review of scientific literature on Vaccine-Associated Paralytic Poliomyelitis in Latin America was made. An analysis of Vaccine-Associated Paralytic Poliomyelitis of data from Colombia was also realized. A Markov model was constructed to estimate the cost-effectiveness of the two strategies in two cohorts of children ranging from birth to 2 years of age. The model compared the risks and costs of live oral poliovirus vaccine and inactivated poliovirus vaccine in the two cohorts. RESULTS: Between 1988 and 1998 there were 9 detected cases of Vaccine-Associated Paralytic Poliomyelitis, for a rate of 1 per 1.6 millions in the first dose, and 1 per 2.5 millions of total administered doses. The introduction of the inactivated poliovirus vaccine would prevent 1 case of Vaccine-Associated Paralytic Poliomyelitis every two years, and it would prevent 64 DALY’s in each cohort of vaccinated children. Incremental cost-effectiveness ratio would be US$71,062  per DALY averted . CONCLUSIONS: .  Vaccination with inactivated poliovirus vaccine is not cost-effective even assuming a substantially greater incidence of Vaccine-Associated Paralytic Poliomyelitis, this given a GDP per capita of US$8,500 in 2008.