A developing country perspective on vaccine-associated paralytic poliomyelitis
When the Expanded Programme on Immunization was established and oral poliovirus vaccine (OPV) was introduced for developing countries to use exclusively, national leaders of public health had no opportunity to make an informed choice between OPV and the inactivated poliovirus vaccine (IPV). Today, a...
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| Format: | Article |
| Language: | English |
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The World Health Organization
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| Series: | Bulletin of the World Health Organization |
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| Online Access: | http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862004000100011&lng=en&tlng=en |
| _version_ | 1827334733221068800 |
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| author | T. Jacob John |
| author_facet | T. Jacob John |
| author_sort | T. Jacob John |
| collection | DOAJ |
| description | When the Expanded Programme on Immunization was established and oral poliovirus vaccine (OPV) was introduced for developing countries to use exclusively, national leaders of public health had no opportunity to make an informed choice between OPV and the inactivated poliovirus vaccine (IPV). Today, as progress is made towards the goal of global eradication of poliomyelitis attributable to wild polioviruses, all developing countries where OPV is used face the risk of vaccine-associated paralytic poliomyelitis (VAPP). Until recently, awareness of VAPP has been poor and quantitative risk analysis scanty but it is now well known that the continued use of OPV perpetuates the risk of VAPP. Discontinuation or declining immunization coverage of OPV will increase the risk of emergence of circulating vaccine-derived polioviruses (cVDPV) that re-acquire wild virus-like properties and may cause outbreaks of polio. To eliminate the risk of cVDPV, either very high immunization coverage must be maintained as long as OPV is in use, or IPV should replace OPV. Stopping OPV without first achieving high immunization coverage with IPV is unwise on account of the possibility of emergence of cVDPV. Increasing numbers of developed nations prefer IPV, and manufacturing capacities have not been scaled up, so its price remains prohibitively high and unaffordable by developing countries, where, in addition, large-scale field experience with IPV is lacking. Under these circumstances, a policy shift to increase the use of IPV in national immunization programmes in developing countries is a necessary first step; once IPV coverage reaches high levels (over 85%), the withdrawal of OPV may begin. |
| first_indexed | 2024-03-07T18:02:01Z |
| format | Article |
| id | doaj.art-cffa6e2feccb4c939ddd09ae18f116be |
| institution | Directory Open Access Journal |
| issn | 0042-9686 |
| language | English |
| last_indexed | 2024-03-07T18:02:01Z |
| publisher | The World Health Organization |
| record_format | Article |
| series | Bulletin of the World Health Organization |
| spelling | doaj.art-cffa6e2feccb4c939ddd09ae18f116be2024-03-02T10:39:54ZengThe World Health OrganizationBulletin of the World Health Organization0042-9686821535710.1590/S0042-96862004000100011S0042-96862004000100011A developing country perspective on vaccine-associated paralytic poliomyelitisT. Jacob John0Kerala State Institute of Virology and Infectious DiseasesWhen the Expanded Programme on Immunization was established and oral poliovirus vaccine (OPV) was introduced for developing countries to use exclusively, national leaders of public health had no opportunity to make an informed choice between OPV and the inactivated poliovirus vaccine (IPV). Today, as progress is made towards the goal of global eradication of poliomyelitis attributable to wild polioviruses, all developing countries where OPV is used face the risk of vaccine-associated paralytic poliomyelitis (VAPP). Until recently, awareness of VAPP has been poor and quantitative risk analysis scanty but it is now well known that the continued use of OPV perpetuates the risk of VAPP. Discontinuation or declining immunization coverage of OPV will increase the risk of emergence of circulating vaccine-derived polioviruses (cVDPV) that re-acquire wild virus-like properties and may cause outbreaks of polio. To eliminate the risk of cVDPV, either very high immunization coverage must be maintained as long as OPV is in use, or IPV should replace OPV. Stopping OPV without first achieving high immunization coverage with IPV is unwise on account of the possibility of emergence of cVDPV. Increasing numbers of developed nations prefer IPV, and manufacturing capacities have not been scaled up, so its price remains prohibitively high and unaffordable by developing countries, where, in addition, large-scale field experience with IPV is lacking. Under these circumstances, a policy shift to increase the use of IPV in national immunization programmes in developing countries is a necessary first step; once IPV coverage reaches high levels (over 85%), the withdrawal of OPV may begin.http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862004000100011&lng=en&tlng=envacuna antipolio oralpoliomielitispoliomielitisvacuna antipolio de virus inactivadosvacuna antipolio de virus inactivadospoliovirusprogramas de inmunizaciónpaíses en desarrollo |
| spellingShingle | T. Jacob John A developing country perspective on vaccine-associated paralytic poliomyelitis Bulletin of the World Health Organization vacuna antipolio oral poliomielitis poliomielitis vacuna antipolio de virus inactivados vacuna antipolio de virus inactivados poliovirus programas de inmunización países en desarrollo |
| title | A developing country perspective on vaccine-associated paralytic poliomyelitis |
| title_full | A developing country perspective on vaccine-associated paralytic poliomyelitis |
| title_fullStr | A developing country perspective on vaccine-associated paralytic poliomyelitis |
| title_full_unstemmed | A developing country perspective on vaccine-associated paralytic poliomyelitis |
| title_short | A developing country perspective on vaccine-associated paralytic poliomyelitis |
| title_sort | developing country perspective on vaccine associated paralytic poliomyelitis |
| topic | vacuna antipolio oral poliomielitis poliomielitis vacuna antipolio de virus inactivados vacuna antipolio de virus inactivados poliovirus programas de inmunización países en desarrollo |
| url | http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862004000100011&lng=en&tlng=en |
| work_keys_str_mv | AT tjacobjohn adevelopingcountryperspectiveonvaccineassociatedparalyticpoliomyelitis AT tjacobjohn developingcountryperspectiveonvaccineassociatedparalyticpoliomyelitis |