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
2004-01-01
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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 |
| _version_ | 1797282332785246208 |
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| author | John T. Jacob |
| author_facet | John T. Jacob |
| author_sort | John T. Jacob |
| 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 | 2024-03-07T17:11:17Z |
| format | Article |
| id | doaj.art-fa1145883f194fdba5898cbb258fd653 |
| institution | Directory Open Access Journal |
| issn | 0042-9686 |
| language | English |
| last_indexed | 2024-03-07T17:11:17Z |
| publishDate | 2004-01-01 |
| publisher | The World Health Organization |
| record_format | Article |
| series | Bulletin of the World Health Organization |
| spelling | doaj.art-fa1145883f194fdba5898cbb258fd6532024-03-03T01:14:52ZengThe World Health OrganizationBulletin of the World Health Organization0042-96862004-01-018215357A developing country perspective on vaccine-associated paralytic poliomyelitisJohn T. JacobWhen 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=S0042-96862004000100011Poliovirus vaccine, Oral/adverse effectsPoliomyelitis/epidemiologyPoliomyelitis/chemically inducedPoliovirus vaccine, Inactivated/therapeutic usePoliovirus vaccine, Inactivated/economicsPoliovirus/drug effectsImmunization programsDeveloping countries |
| spellingShingle | John T. Jacob A developing country perspective on vaccine-associated paralytic poliomyelitis Bulletin of the World Health Organization Poliovirus vaccine, Oral/adverse effects Poliomyelitis/epidemiology Poliomyelitis/chemically induced Poliovirus vaccine, Inactivated/therapeutic use Poliovirus vaccine, Inactivated/economics Poliovirus/drug effects Immunization programs Developing countries |
| 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 | Poliovirus vaccine, Oral/adverse effects Poliomyelitis/epidemiology Poliomyelitis/chemically induced Poliovirus vaccine, Inactivated/therapeutic use Poliovirus vaccine, Inactivated/economics Poliovirus/drug effects Immunization programs Developing countries |
| url | http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862004000100011 |
| work_keys_str_mv | AT johntjacob adevelopingcountryperspectiveonvaccineassociatedparalyticpoliomyelitis AT johntjacob developingcountryperspectiveonvaccineassociatedparalyticpoliomyelitis |