Oral Polio Vaccine Campaigns Research Articles

Between individualism and social solidarity in vaccination policy: the case of the 2013 OPV campaign in Israel.

BackgroundDuring the summer of 2013, after samples of poliomyelitis virus were found in sewage, Israel launched an intensive national oral polio vaccine (OPV) campaign. The clinical objective of the campaign was rather clear. With not a single case of infantile paralysis and with a population already highly protected with IPV (a dead version of the vaccine), the goal was to foster collective immunity so that risk populations could also be protected. This, however, entailed a rather unusual issue: how to persuade parents whose children already received an IPV to re-vaccinate their children, now with a live yet attenuated version of the virus that was excluded from the national vaccination program in 2004. The challenge therefore was a call for social solidarity - asking parents to vaccinate their children mainly for the sake of protecting unknown at risk populations and to take part in the larger global goals of the polio eradication program. This challenge stands at the core of our investigation. We see the OPV campaign of summer 2013 as a good case study of the tension between individualism and social solidarity in seeking the cooperation of the public.MethodsWe draw on a qualitative study that included participant observation, document reviews and interviews with policy-makers, parents, journalists, public health experts and community leaders. These data were analyzed in order to unravel the ways in which self-interest, community and solidarity were conceived by different agents during the vaccination campaign.ResultsThe family as a metaphor for social solidarity was the main discursive item in the public campaign. Tensions, dissonances and inconsistencies were found between different registers and agencies as to what is at stake and what is required.ConclusionsWe discuss the ethical and social implications of our findings in order to better understand how persuasion was used in the current case and for its future role in similar events, within and outside Israel, when global efforts to eradicate polio are ongoing.

Modeling the spread of polio in an IPV-vaccinated population: lessons learned from the 2013 silent outbreak in southern Israel.

BackgroundPolio eradication is an extraordinary globally coordinated health program in terms of its magnitude and reach, leading to the elimination of wild poliovirus (WPV) in most parts of the world. In 2013, a silent outbreak of WPV was detected in Israel, a country using an inactivated polio vaccine (IPV) exclusively since 2005. The outbreak was detected using environmental surveillance (ES) of sewage reservoirs. Stool surveys indicated the outbreak to be restricted mainly to children under the age of 10 in the Bedouin population of southern Israel. In order to curtail the outbreak, a nationwide vaccination campaign using oral polio vaccine (OPV) was conducted, targeting all children under 10.MethodsA transmission model, fitted to the results of the stool surveys, with additional conditions set by the ES measurements, was used to evaluate the prevalence of WPV in Bedouin children and the effectiveness of the vaccination campaign. Employing the parameter estimates of the model fitting, the model was used to investigate the effect of alternative timings, coverages and dosages of the OPV campaign on the outcome of the outbreak.ResultsThe mean estimate for the mean reproductive number was 1.77 (95 % credible interval, 1.46–2.30). With seasonal variation, the reproductive number maximum range was between zero and six. The mean estimate for the mean infectious periods was 16.8 (8.6–24.9) days. The modeling indicates the OPV campaign was effective in curtailing the outbreak. The mean estimate for the attack rate in Bedouin children under 10 at the end of 2014 was 42 % (22–65 %), whereas without the campaign the mean projected attack rate was 57 % (35–74 %). The campaign also likely shortened the duration of the outbreak by a mean estimate of 309 (2–846) days. A faster initiation of the OPV campaign could have reduced the incidence of WPV even if a lower coverage was reached, at the risk of prolonging the outbreak.ConclusionsOPV campaigns are essential for interrupting WPV transmission, even in a developed country setting with a high coverage of IPV. In this setting, establishing ES of WPV circulation is particularly crucial for early detection and containment of an outbreak.Electronic supplementary materialThe online version of this article (doi:10.1186/s12916-016-0637-z) contains supplementary material, which is available to authorized users.

Mass immunization with inactivated polio vaccine in conflict zones--Experience from Borno and Yobe States, North-Eastern Nigeria.

The use of Inactivated Polio Vaccine (IPV) in routine immunization to replace Oral Polio Vaccine (OPV) is crucial in eradicating polio. In June 2014, Nigeria launched an IPV campaign in the conflict-affected states of Borno and Yobe, the largest ever implemented in Africa. We present the initiatives and lessons learned. The 8-day event involved two parallel campaigns. OPV target age was 0-59 months, while IPV targeted all children aged 14 weeks to 59 months. The Borno state primary health care agency set up temporary health camps for the exercise and treated minor ailments for all. The target population for the OPV campaign was 685,674 children in Borno and 113,774 in Yobe. The IPV target population for Borno was 608,964 and for Yobe 111,570. OPV coverage was 105.1 per cent for Borno and 103.3 per cent for Yobe. IPV coverage was 102.9 per cent for Borno and 99.1 per cent for Yobe. (Where we describe coverage as greater than 100 per cent, this reflects original underestimates of the target populations.) A successful campaign and IPV immunization is viable in conflict areas.

An evaluation of community perspectives and contributing factors to missed children during an oral polio vaccination campaign--Katsina State, Nigeria.

Unvaccinated children contribute to accumulation of susceptible persons and the continued transmission of wild poliovirus in Nigeria. In September 2012, the Expert Review Committee (ERC) on Polio Eradication and Routine Immunization in Nigeria recommended that social research be conducted to better understand why children are missed during supplementary immunization activities (SIAs), also known as "immunization plus days (IPDs)" in Nigeria. Immediately following the SIA in October 2012, polio eradication partners and the government of Nigeria conducted a study to assess why children are missed. We used semistructured questionnaires and focus group discussions in 1 rural and 1 urban local government area (LGA) of Katsina State. Participants reported that 61% of the children were not vaccinated because of poor vaccination team performance: either the teams did not visit the homes (25%) or the children were reported absent and not revisited (36%). This lack of access to vaccine was more frequently reported by respondents from scattered/nomadic communities (85%). In 1 out of 4 respondents (25%), refusal was the main reason their child was not vaccinated. The majority of respondents reported they would have consented to their children being vaccinated if the vaccine had been offered. Poor vaccination team performance is a major contributor to missed children during IPD campaigns. Addressing such operational deficiencies will help close the polio immunity gap and eradicate polio from Nigeria.

Refusal of oral polio vaccine in northwestern Pakistan: A qualitative and quantitative study

BackgroundRefusal of the oral polio vaccine (OPV) is a difficulty faced by the Polio Eradication Initiative (PEI) in multiple endemic areas, including the Khyber Pakhtunkhwa Province (KPP), Pakistan. In 2007, we investigated community perceptions of the OPV and estimated the prevalence of OPV refusal in three districts in Swat Valley, KPP, a polio-endemic area. MethodsQualitative data concerning community perceptions were collected by focus group discussions among lady health workers (LHWs) and mothers with children <1 year old and by key informant interviews with local health managers and officials. Quantitative data collection followed using a questionnaire survey of 200 LHWs and a cluster sampling survey of 210 mothers (per district) with children <1 year old. ResultsThe qualitative assessments identified the grounded theory of OPV refusal involving facts known by the residents that are related to the OPV (too frequent OPV campaigns, an OPV boycott in northern Nigeria in 2003 and that birth control is viewed as is against Islam), the local interpretations of these facts (perceptions that OPV contained birth control or pork, that OPV was a foreign/central plot against Muslims, and that the vaccination was against the Hadith and the fate determined by God) and different manifestations of OPV refusal. Among the three districts studied, the proportion of LHWs who encountered OPV refusal ranged from 0 to 33%, whereas among the districts, the proportions of mothers unwilling to give OPV to their children ranged from 0.5 to 5.7%. Refusal of other injectable vaccines was almost equally prevalent for reasons that were very similar. ConclusionsThe PEI needs to reflect local value system in the path to polio eradication in the studied districts in the Swat Valley. The religious and cultural values as well as the interpretation of the international political situation are of particular importance.

Gestación y realización de la Primera Campaña Nacional de vacunación antipoliomielítica oral en España

This paper presents the intervention of Dr Luis Valenciano Clavel in the act that was held on July 2, 2013 under the title Celebrating the 50th anniversary of the establishment of poliovirus vaccination campaigns in Spain. (Tribute to Dr D Florencio Perez Gallardo), in Ernest Lluch Hall of the Ministry of Health, Social Services and Equality. Dr Luis Valenciano Clavel describes his experience and direct participation, along with Florencio Pérez Gallardo, during the first oral polio vaccination campaign in Spain, after returning from his stay in health centers of Germany and assuming the leadership of the Polio Diagnostic Laboratory of theNational School of Public Health. The success of the polio vaccination campaign, it gave rise to the current National Center of Virology, pivot of the current Institute of Health Carlos III.

Transient population bypassed by polio vaccination programmes in Yunnan Province, China

Four wild strains of polioviruses were isolated between 1995 and April 1996 around the Myanmar border with China. This may have occurred because immunization programs missed certain groups of children who migrated with their parents when they were searching for work. Market tradespeople, in particular, travel with their children. Since it is illegal for persons to live where they are not registered and for parents to have more than the number of children permitted by the family planning law, these children may not participate in national immunization days (NIDs) out of fear of being identified. In September and October of 1996, four markets in Yunnan Province were surveyed to determine the proportion of transients and the prevalence of oral polio vaccine (OPV) immunization; parents and guardians of 127 children, who appeared to be under the age of 5 years, were interviewed. The analysis included 91 children (45 boys and 46 girls), aged 1-3 years, who had complete information. Children were grouped as follows: 1) 37 nontransients who lived where their families were registered; 2) 15 transients from within Yunnan Province; 3) 32 transients from other provinces; and 4) 7 foreign transients. The following information was obtained for each child: 1) whether the child had received a routine OPV; 2) whether the child had a BCG scar; 3) whether the child had ever participated in a NID; and 4) whether the child had participated in the 9 supplementary OPV campaigns since 1990. There were no significant differences in sex or age between groups. As shown in a table of survey results, all indices of immunization were lower in transients. Of the nontransient children, 94.6% had received an OPV; 86.5% had a BCG scar; 89.2% had participated in a NID; and 89.2% had received OPV supplementation. The same figures for all transients as a group were 44.4%, 50.0%, 37.0%, and 38.9%, respectively. For the intraprovincial group, the figures were 66.7%, 46.7%, 60.0%, and 46.7%, respectively. For the extraprovincial group, the figures were 34.4%, 53.1%, 21.9%, and 37.5%, respectively. For foreign transients, the figures were 42.9%, 42.9%, 57.1%, and 28.6%, respectively.

Antipolio prophylaxis of immunocompromised children during a nationwide oral poliovaccine campaign

A nationwide vaccination campaign with oral poliovirus vaccine was organized in Finland in 1985 to halt an outbreak of poliomyelitis. Immunocompromised persons and their household contacts were excluded from the oral poliovirus vaccine target group and given instead a dose of inactivated poliovirus vaccine. This gave us an opportunity to determine whether immunocompromised persons are protected from poliomyelitis during an outbreak and oral poliovirus campaign. Fourteen children, ages 3 to 17 years, with leukemia were given a booster dose of a novel high antigen content, trivalent inactivated poliovirus vaccine. All but two responded by an at least 4-fold increase in serum-neutralizing antibodies to at least one poliovirus serotype. These results indicate that children with acute lymphocytic leukemia in remission respond well to a booster dose of inactivated poliovirus vaccine. Antibody concentrations to the uncommon local epidemic strain of type 3 poliovirus remained, however, relatively low in most patients (median, 1:6) suggesting relatively impaired heterologous response to vaccination. Possible spread of live vaccine viruses to the inactivated poliovirus-vaccinated children and their close contacts was evaluated by examining weekly fecal specimens from 20 children and their 19 regular adult contacts for cytopathic viruses. No polioviruses were isolated from 224 specimens examined, indicating that this high risk population was well-protected from unintended exposure to live polioviruses.

Antipolio prophylaxis of immunocompromised children during a nationwide oral poliovaccine campaign

Antipolio prophylaxis of immunocompromised children during a nationwide oral poliovaccine campaign