In 2001, highly evolved type 1 circulating vaccine-derived poliovirus (cVDPV) was isolated from three acute flaccid paralysis patients and one contact from three separate communities in the Philippines. Complete genomic sequencing of these four cVDPV isolates revealed that the capsid region was derived from the Sabin 1 vaccine strain but most of the noncapsid region was derived from an unidentified enterovirus unrelated to the oral poliovirus vaccine (OPV) strains. The sequences of the cVDPV isolates were closely related to each other, and the isolates had a common recombination site. Most of the genetic and biological properties of the cVDPV isolates were indistinguishable from those of wild polioviruses. However, the most recently identified cVDPV isolate from a healthy contact retained the temperature sensitivity and partial attenuation phenotypes. The sequence relationships among the isolates and Sabin 1 suggested that cVDPV originated from an OPV dose given in 1998 to 1999 and that cVDPV circulated along a narrow chain of transmission. Immunization with the oral poliovirus vaccine (OPV) is the cornerstone of the World Health Organization's program for the global eradication of poliomyelitis (15,44,55,56,65). The attenuated OPV strains of the three poliovirus serotypes (Sabin 1, 2, and 3) replicate in the gut of OPV recipients and can efficiently induce type-specific humoral and mucosal immunity (55), mimicking natural infection. However, replication of OPV in humans is frequently accompanied by genetic change of the vaccine virus, including reversion of key attenuating mutations (5,42