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Correction: Wassilak et al. Impediments to Progress Toward Polio Eradication During 2014-2024: Effectively Addressing the Current Challenges. <i>Vaccines</i> 2025, <i>13</i>, 1060.

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Tracking poliovirus through wastewater: environmental surveillance insights from Haïti (2020-2023).

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Impediments to Progress Toward Polio Eradication During 2014-2024: Effectively Addressing the Current Challenges.

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Characterization of environmental and clinical surveillance inputs to support prospective integrated modeling of the polio endgame.

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Advancing poliovirus eradication: lessons learned from piloting direct molecular detection of polioviruses in high-risk and priority geographies.

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Antiviral Development for the Polio Endgame: Current Progress and Future Directions.

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Updated: Jul 26, 2025

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Worst-case scenarios: Modeling uncontrolled type 2 polio transmission.

Dominika A Kalkowska1, Eric Wiesen2, Steven G F Wassilak2

  • 1Kid Risk, Inc., Orlando, Florida, USA.

Risk Analysis : an Official Publication of the Society for Risk Analysis
|June 21, 2023
PubMed
Summary

Type 2 poliovirus remains a global threat, with over 3,000 cases reported since 2016. Current strategies, including novel oral poliovirus vaccine (nOPV2), show no near-term eradication probability for type 2 poliovirus.

Keywords:
dynamic modelingeradicationinterdependent risksoral poliovirus vaccinepolio

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Area of Science:

  • Epidemiology
  • Virology
  • Public Health

Background:

  • The Global Polio Eradication Initiative (GPEI) ceased most type 2 oral poliovirus vaccine (OPV2) use in 2016.
  • Since then, over 3,000 paralytic polio cases caused by type 2 vaccine-derived polioviruses have been reported across 39 countries.
  • Type 2 poliovirus transmission persists, posing risks of importation into high-transmission areas.

Purpose of the Study:

  • To model the future trajectory of type 2 poliovirus transmission.
  • To assess the probability of eradicating type 2 poliovirus with current and novel interventions.
  • To identify strategies for avoiding catastrophic scenarios of polio expansion.

Main Methods:

  • Utilized polio endgame modeling based on prior studies.
  • Assessed current national and GPEI outbreak response performance.
  • Evaluated the impact of novel type 2 oral poliovirus vaccine (nOPV2) under emergency use.

Main Results:

  • Current strategies, even with nOPV2, show no probability of eradicating type 2 polioviruses in the near term.
  • Worst-case scenarios predict rapid expansion of paralytic polio cases.
  • Continued transmission risks high-consequence events and jeopardizes the goal of polio eradication.

Conclusions:

  • Avoiding catastrophic polio scenarios requires developing strategies to significantly raise population immunity to type 2 polioviruses.
  • The current approach to managing type 2 poliovirus is insufficient for eradication.
  • Urgent development of new strategies is crucial to achieve the permanent end of poliomyelitis.