Abstract
Moving from oral poliovirus vaccine to inactivated poliovirus vaccine in Sri Lanka: The rationale and challenges
Highlights
Sri Lanka is a low middle income country with a gross domestic product per capita of 3637.54 US dollars in 20161
As type-2 vaccine is responsible for 97% of the circulating vaccine derived polioviruses (cVDPV) + 40% of vaccineassociated paralytic poliomyelitis (VAPP), and no polio cases have occurred due to type-2 wild polioviruses (WPV) since 1999, all countries using trivalent OPV (tOPV) were to switch to Bivalent OPV (bOPV) in a synchronized manner as part of the polio endgame strategic plan[13]
For countries with a higher risk of importation and low coverage of immunization, the World Health Organisation (WHO) recommends moving from tOPV to bOPV with a single dose of inactivated poliovirus vaccine (IPV) at 14 weeks
Summary
Sri Lanka is a low middle income country with a gross domestic product per capita of 3637.54 US dollars in 20161. According to the polio endgame strategic plan, countries should administer at least one dose of IPV to children at 14 weeks of age, before the tOPV- bOPV switch[13]. For countries with a higher risk of importation and low coverage of immunization, the WHO recommends moving from tOPV to bOPV with a single dose of IPV at 14 weeks. Though the risk of importation of WPV is high, because of very good immunization coverage Sri Lanka could have adopted sequential schedules, which include both IPV and OPV. At the initiation of the polio endgame strategic plan, Global Polio Eradication Initiative (GPEI) had ensured sufficient stand-alone IPV vaccines to all OPV using countries, to introduce a single dose to their immunization programmes. For all that, considering the successes of the Sri Lanka immunization programme that have been achieved so far, as long as an uninterrupted vaccine supply can be ensured, Sri Lanka can be expected to move smoothly from bOPV to IPV by the year 2020
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