Inactivated polio vaccine and global polio eradication

Abstract

2012 will mark the 24th year of WHO's Global Poliomyelitis Eradication Initiative. 1 WHOGlobal eradication of poliomyelitis by the year 2000. Week Epidemiol Rec. 1988; 63: 161-162 Google Scholar Eradication has proven more difficult than originally envisioned because of geopolitical events, such as war, social disruption, and political indifference; social and cultural issues, such as distrust of poliovirus vaccines and vaccinators; and the unanticipated emergence of virulent vaccine-derived polioviruses in many locations. Few of these obstacles have bewildered the scientific community as much as the low efficacy of the major weapon in the arsenal, trivalent oral polio vaccine (OPV) in regions with dense populations, high birthrates, and poor sanitation resulting from diarrhoea due to enteric pathogens, particularly rotaviruses, and perhaps nutritional deficiencies and other factors. 2 Patriarca PA Wright PF John TJ Factors affecting the immunogenicity of oral poliovirus vaccine in developing countries. Rev Infect Dis. 1991; 13: 926-939 Crossref PubMed Scopus (358) Google Scholar , 3 Myaux JA Unicomb L Besser RE et al. Effect of diarrhea on the humoral response to oral polio vaccination. Pediatr Infect Dis J. 1996; 15: 204-209 Crossref PubMed Scopus (38) Google Scholar This dilemma has been most frustrating in northern India where, in some crowded, resource-poor areas, the overall effectiveness of each trivalent OPV dose is estimated to be 10% and some children have developed paralytic polio after as many as ten doses. 4 Grassly NC Fraser C Wenger J et al. New strategies for the elimination of polio from India. Science. 2006; 314: 1150-1153 Crossref PubMed Scopus (216) Google Scholar Immunogenicity of supplemental doses of poliovirus vaccine for children aged 6–9 months in Moradabad, India: a community-based, randomised controlled trialSupplemental mOPV1 resulted in almost total seroprevalence against poliovirus type 1, which is consistent with recent absence of poliomyelitis cases; whereas seroprevalence against types 2 and 3 was expected for routine vaccination histories. The immunogenicity of IPV produced in India (Panacea) was similar to that of an internationally manufactured IPV (GSK). Intradermal IPV was less immunogenic. Full-Text PDF