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The scientific basis for stopping polio immunisation--issues and challenges.
1National Institute for Biological Standards and Control, Potters Bar, UK.
Developments in Biologicals
|January 5, 2002
Summary
Global polio eradication is nearing completion. Research suggests oral poliovirus vaccine (OPV) strains may not sustain transmission after immunization stops, but further study is needed to ensure safe cessation of polio immunization programs.
Area of Science:
- * Global health
- * Vaccinology
- * Infectious disease epidemiology
Background:
- * Global efforts are close to eradicating poliomyelitis.
- * Current strategy relies on universal childhood immunization, primarily with the oral poliovirus vaccine (OPV).
- * A shift to no immunization post-eradication is anticipated, necessitating careful planning.
Purpose of the Study:
- * To explore the scientific uncertainties surrounding the cessation of polio immunization.
- * To assess the risk of OPV-derived poliovirus transmission after immunization ceases.
- * To inform strategies for the safe discontinuation of polio vaccination campaigns.
Main Methods:
- * Review of existing evidence on poliovirus transmission dynamics.
- * Analysis of studies examining poliovirus shedding post-OPV campaigns.
- * Identification of knowledge gaps in understanding OPV-derived strain transmissibility.
Main Results:
- * Evidence suggests poliovirus is not detected beyond three months after mass OPV campaigns in some settings.
- * This indicates a potential for limited sustained transmission of OPV-derived strains.
- * Significant knowledge gaps remain regarding transmissibility in diverse ecological settings and persistent infections.
Conclusions:
- * Cessation of polio immunization requires a consensus built on robust scientific understanding.
- * Further research is crucial to address uncertainties in OPV-derived strain transmissibility.
- * Informed decision-making on stopping polio immunization necessitates the best available scientific evidence.