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Quantifying the benefits of improved operations for polio outbreak response: A model-based analysis
Yuming Sun1, Pinar Keskinocak1, Stephanie D Kovacs2
1H. Milton Stewart School of Industrial and Systems Engineering, Georgia Institute of Technology, Atlanta, GA, USA.
Vaccine
|May 30, 2026
Summary
Prioritizing under-vaccinated individuals for novel oral poliovirus type 2 vaccine (nOPV2) and increasing vaccination rounds can reduce circulating vaccine-derived poliovirus type 2 (cVDPV2) outbreaks. However, reactive strategies alone may not be enough for elimination in high-risk areas.
Area of Science:
- Epidemiology
- Public Health
- Vaccinology
Background:
- Novel type 2-containing oral poliovirus vaccine (nOPV2) introduced in 2021 for outbreak response.
- Stopping circulating vaccine-derived poliovirus type 2 (cVDPV2) outbreaks remains challenging despite nOPV2's reduced reversion risk.
- Improved outbreak response operations are crucial for cVDPV2 control.
Purpose of the Study:
- Evaluate the impact of prioritizing under-vaccinated individuals for nOPV2.
- Assess the effect of increasing the number of vaccination rounds on cVDPV2 transmission.
- Model cVDPV2 transmission dynamics and outbreak response strategies in Nigeria.
Main Methods:
- Simulated cVDPV2 transmission in Nigeria (2024-2028) using an adapted poliovirus model.
- Compared three allocation strategies: baseline, priority (OPV2/IPV history), and idealized.
- Varied vaccination rounds from 3 to 5 per response.
Main Results:
- Transmission interruption only achieved with idealized allocation and five vaccination rounds.
- Priority allocation by OPV2 history reduced outbreak size and nOPV2 doses compared to baseline.
- Priority allocation by IPV history increased outbreak size and nOPV2 use.
- Other scenarios showed continued cVDPV2 transmission through 2028.
Conclusions:
- Prioritizing under-vaccinated individuals (by OPV2 history) and increasing vaccination rounds reduce cVDPV2 transmission.
- Reactive outbreak response alone may be insufficient for cVDPV2 elimination in high-risk settings like Nigeria.
- Future strategies should consider expanded nOPV2 use in routine immunization for cVDPV2 elimination.
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