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Poliovirus vaccine options: another step forward

Published: 1 January 2021
The Lancet , Volume 397, pp 2-3; doi:10.1016/s0140-6736(20)32629-5

Abstract: Now, more than 20 years after the initial target for polio eradication, the Global Polio Eradication Initiative (GPEI) remains off track in its mission to stop and prevent the transmission of all three types of wild-type polioviruses.1Kalkowska DA Wassilak SGF Cochi SL Pallansch MA Thompson KM Global transmission of live polioviruses: updated integrated dynamic modeling of the polio endgame.Risk Anal. 2020; (published online Jan 22.)https://doi.org/10.1111/risa.13447Crossref Scopus (12) Google Scholar The GPEI successfully certified global eradication of type 2 polioviruses in September, 2015,2WHO14th Meeting of the Global Commission for Certification of Poliomyelitis Eradication (GCC), Bali, Indonesia, 20–21 September, 2015 Summary of findings, decisions and recommendations.http://polioeradication.org/wp-content/uploads/2016/07/1Report.pdfDate: 2015Date accessed: June 1, 2020Google Scholar and type 3 in October, 2019,3WHOReport from the Twentieth Meeting of the Global Commission for Certification of Poliomyelitis Eradication, Geneva, Switzerland, 17–18 October 2019.http://polioeradication.org/wp-content/uploads/2016/07/20th-meeting-of-the-Global-Commission-for-the-Certification-of-Eradication-of-Poliomyelitis-17-18-October-2019.pdfDate: 2019Date accessed: December 31, 2019Google Scholar with the remaining most transmissible and virulent type 1 confined to Afghanistan and Pakistan. In April and May, 2016, the GPEI coordinated global cessation of type 2 oral poliovirus vaccine (OPV2) use. However, this effort did not lead to the end of all type 2 live poliovirus transmission, with the annual reported cases caused by these vaccine-derived polioviruses increasing from 71 in 2018, to 366 in 2019, and 739 in 2020 (as of Dec 3).4WHO Global Polio Eradication InitiativeCirculating vaccine-derived poliovirus.http://polioeradication.org/wp-content/uploads/2020/12/weekly-polio-analyses-cVDPV-20201203.pdfDate: 2020Date accessed: December 4, 2020Google Scholar Monovalent OPV2 remains the primary defence against type 2 circulating vaccine-derived poliovirus outbreaks. Increased demand and limited supplies in 2020 led the GPEI to procure the production of more monovalent OPV2 and trivalent OPV (containing all three OPV types), which both carry the risk of reversion that could seed the creation of new type 2 circulating vaccine-derived polioviruses.5Duintjer Tebbens RJ Pallansch MA Kew OM et al.Risks of paralytic disease due to wild or vaccine-derived poliovirus after eradication.Risk Anal. 2006; 26: 1471-1505Crossref PubMed Scopus (119) Google Scholar, 6Duintjer Tebbens RJ Pallansch MA Kim J-H et al.Review: oral poliovirus vaccine evolution and insights relevant to modeling the risks of circulating vaccine-derived polioviruses (cVDPVs).Risk Anal. 2013; 23: 680-702Crossref Scopus (66) Google Scholar To mitigate these risks, the GPEI accelerated the development and production of novel OPV2 strains, and issued an addendum to its 2019–23 strategic plan.7WHO Global Polio Eradication InitiativeStrategy for the response to type 2 circulating vaccine-derived poliovirus 2020–2021: addendum to the polio eradication and endgame strategic plan (2019–2023).http://polioeradication.org/wp-content/uploads/2020/04/Strategy-for-the-response-to-type-2-circulating-Vaccine-Derived-Poliovirus-20200406.pdfDate: 2020Date accessed: March 10, 2020Google Scholar
Keywords: Modeling / anal / Google Scholar / Wild / Scopus / Vaccine Derived / Pallansch MA

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