Introduction of Inactivated Poliovirus Vaccine and Trivalent Oral Polio Vaccine/Bivalent Oral Polio Vaccine Switch in the African Region.

Carol Tevi-Benissan,Halima Dao,Afework Assefa,Dah Cheikh,Bartholomew Dicky Akanmori,Blanche-Philomene Anya,Joseph Okeibunor,Joseph Nsiari-Muzenyi Biey,Yusuf Nasir,Messeret Eshetu,Gaël Maufras Du Châtellier,Richard Mihigo

doi:10.1093/infdis/jiw616

Abstract

The Polio Eradication and Endgame Strategic plan outlines the phased removal of oral polio vaccines (OPVs), starting with type 2 poliovirus–containing vaccine and introduction of inactivated polio vaccine in routine immunization to mitigate against risk of vaccine-associated paralytic polio and circulating vaccine-derived poliovirus. The objective includes strengthening routine immunization as the primary pillar to sustaining high population immunity. After 2 years without reporting any wild poliovirus (July 2014–2016), the region undertook the synchronized switch from trivalent OPV (tOPV) to bivalent OPV (bOPV) as recommended by the Strategic Advisory Group of Experts on Immunization. Consequently the 47 countries of the World Health Organization (WHO) African Region switched from the use of tOPV to bOPV within the stipulated period of April 2016. Planning started early, routine immunization was strengthened, and technical and financial support was provided for vaccine registration, procurement, destruction, logistics, and management across countries by WHO in collaboration with the United Nations Children’s Fund (UNICEF) and partners. National commitment and ownership, as well as strong coordination and collaboration between UNICEF and WHO and with partners, ensured success of this major, historic public health undertaking.

Highlights

Introduction of Inactivated Poliovirus Vaccine andTrivalent Oral Polio Vaccine/Bivalent Oral Polio Vaccine Switch in the African RegionCarol Tevi-Benissan,1Joseph Okeibunor,2 Gaël Maufras du Châtellier,3 Afework Assefa,4 Joseph Nsiari-Muzenyi Biey,5 Dah Cheikh,6 Messeret Eshetu,7 Blanche-Philomene Anya,1 Halima Dao,3 Yusuf Nasir,4 Bartholomew Dicky Akanmori,1 and Richard Mihigo1The Polio Eradication and Endgame Strategic plan outlines the phased removal of oral polio vaccines (OPVs), starting with type 2 poliovirus–containing vaccine and introduction of inactivated polio vaccine in routine immunization to mitigate against risk of vaccine-associated paralytic polio and circulating vaccine-derived poliovirus
The global switch from trivalent OPV (tOPV) to bivalent OPV (bOPV) represented a significant milestone in the effort to eradicate polio in the African Region, because it marked the eradication of WPV type 2 (WPV2) and, in the long term, should lead to the elimination of type 2 vaccine-derived polioviruses (VDPVs) [11]
Careful synchronization of the switch from tOPV to bOPV within and across OPV-using countries was observed with all 47 member states conducting the switch as recommended

Summary

Partnerships and coordination

CMYP 2016–2020 to be elaborated integrating RI activities, Development of the cMYP 2015–2017 integrating RI and NV introduc-. Most countries in the African Region take into account the work carried by the WHO prequalification in reviewing or providing regulatory approval for the importation and use of new vaccines. WHO gathered information from each of the 47 countries of the African Region on how vaccines have been registered previously or whether a waiver was given for importation and use. This included 16 countries (Angola, Burundi, Cape Verde, Comoros, Equatorial Guinea, Eritrea, Gambia, Guinea-Bissau, Lesotho, Liberia, Malawi, Namibia, Sao Tomé e Principe, Seychelles, Sierra Leone, Swaziland) that, in principle, accepted WHO-prequalified bOPV, without resorting to a dossier submission by the manufacturers and a review, either through an expedited pathway or a regular full review. Two joint reviews using the WHO collaborative procedure were organized for groups of Francophone and Anglophone countries, to facilitate licensure of IPV and bOPV

INTRODUCTION

Findings

DISCUSSION