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Poliomyelitis in selected African and Asian countries
1National Vaccine Program Office, Rockville, Maryland.
Public Health Reviews
|January 1, 1993
Summary
Routine immunization often fails to prevent polio in developing nations. Alternative strategies like mass vaccination days or combined oral poliovirus vaccine (OPV) and inactivated poliovirus vaccine (IPV) schedules may be necessary for global eradication.
Area of Science:
- Public Health
- Infectious Disease Epidemiology
- Vaccinology
Background:
- Polio persistence in developing countries is linked to incomplete routine immunization coverage.
- Vaccine failure, rather than lack of vaccination, has driven recent polio epidemics.
- Oral poliovirus vaccine (OPV) efficacy is lower in developing countries, challenging global eradication efforts.
Purpose of the Study:
- To evaluate alternative strategies for achieving global polio eradication.
- To address the limitations of routine OPV administration in diverse settings.
- To explore tactics beyond traditional immunization programs.
Main Methods:
- Analysis of polio epidemiology in developing countries.
- Review of national vaccination day campaigns (e.g., Latin America).
- Examination of combined OPV and enhanced-potency inactivated poliovirus vaccine (IPV) schedules (e.g., West Bank and Gaza).
Main Results:
- National vaccination days show success but have logistical challenges and high OPV demands.
- Combined OPV/IPV schedules require fewer contacts and OPV doses.
- Combined schedules provide more consistent short- and long-term antibody responses and boost mucosal immunity.
Conclusions:
- Reliance solely on routine OPV is insufficient for global polio eradication.
- Aggressive strategies, such as national vaccination days or combined OPV/IPV schedules, are crucial.
- Combined OPV/IPV offers advantages in efficacy, logistics, and immune response for polio eradication.