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Stopping poliovirus vaccination after eradication: issues and challenges
D J Wood1, R W Sutter, W R Dowdle
1Division of Virology, National Institute for Biological Standards and Control, Hertfordshire, England. dwood@nibsc.ac.uk
Bulletin of the World Health Organization
|May 17, 2000
Summary
Global polio cases have dropped 85% since 1988, nearing eradication. Stopping poliovirus vaccination requires scientific review, risk-benefit analysis, and contingency plans to prevent resurgence.
Area of Science:
- Public Health
- Virology
- Immunization Programs
Background:
- Polio cases have significantly decreased globally since 1988.
- The number of polio-endemic countries has reduced substantially, indicating progress towards eradication.
Purpose of the Study:
- To review the scientific basis for discontinuing poliovirus vaccination.
- To provide an update on the processes for polio certification, containment, and cessation of immunization.
- To identify critical unanswered scientific questions regarding the potential risks of stopping vaccination.
Main Methods:
- Review of current scientific knowledge on poliovirus and polio eradication.
- Analysis of risk-benefit considerations for stopping vaccination.
- Examination of processes for global certification and containment strategies.
- Identification of research needs for future policy decisions.
Main Results:
- Eradication of poliomyelitis is approaching, necessitating a discussion on stopping vaccination.
- Key requirements for discontinuing vaccination include robust scientific data, risk-benefit analysis, contingency plans, vaccine stockpiling, and global endorsement.
- Unanswered questions remain regarding the potential for sustained transmission of vaccine-derived poliovirus and its re-emergence in unvaccinated populations.
Conclusions:
- Stopping polio vaccination is a complex decision requiring comprehensive scientific evaluation and preparedness.
- Further research is crucial to address uncertainties surrounding vaccine-derived poliovirus transmission and potential long-term risks.
- A phased approach involving certification, containment, and careful consideration of scientific evidence is necessary before global immunization cessation.