Assessing the Risk of Vaccine-derived Outbreaks After Reintroduction of Oral Poliovirus Vaccine in Postcessation Settings

Fu, Rui; Altamirano, Jonathan; Sarnquist, Clea; Maldonado, Yvonne; Andrews, Jason R.

doi:10.1093/cid/ciy605

Cited by 8 publications

(9 citation statements)

References 20 publications

(20 reference statements)

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“…Recently, a 2018 study applied an IB model calibrated to stool shedding data from communities in Mexico to explore the impacts of using OPV for outbreak response 5 years after OPV cessation [ 170 ]. In 2019, one theoretical DEB modeling exercise explored the potential role of human exposure to polioviruses from the environment [ 171 ].…”

Section: Summary Of Publications Reviewedmentioning

confidence: 99%

“…After OPV2 cessation, in a review of lessons learned KRI emphasized the importance of reaching under-vaccinated subpopulations [ 69 ], characterized the probabilities of potentially needing to restart OPV2 vaccine production and use on a large scale [ 77 ], and discussed the complex vaccine choices and logistics of managing vaccine supplies [ 80 ]. Several studies by others also explored the dynamics of OPV cessation and the risks of reestablished transmission [ 153 , 170 ].…”

Section: Themesmentioning

confidence: 99%

“…Giving IPV doses sequentially before OPV doses in a national immunization schedule can eliminate VAPP, which is important in high- and upper middle-income countries that achieve high coverage and want to minimize risks associated with vaccine use. In contrast, for countries with relatively lower coverage, IPV may provide some protection from paralysis to the small fraction of children who only receive IPV, but it does not substantially contribute to population immunity to transmission and it may lead to the potential for silent transmission or delayed detection of transmission of LPVs [ 26 – 28 , 39 , 97 , 133 , 162 , 164 , 166 , 170 ]. The high cost of IPV also remains an issue, with the relatively high cost of the vaccine and its administration making IPV use not cost-effective.…”

Section: Themesmentioning

confidence: 99%

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Review of poliovirus modeling performed from 2000 to 2019 to support global polio eradication

Thompson¹,

Kalkowska²

2020

Expert Review of Vaccines

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Introduction: Over the last 20 years (2000-2019) the partners of the Global Polio Eradication Initiative (GPEI) invested in the development and application of mathematical models of poliovirus transmission as well as economics, policy, and risk analyses of polio endgame risk management options, including policies related to poliovirus vaccine use during the polio endgame. Areas covered: This review provides a historical record of the polio studies published by the three modeling groups that primarily performed the bulk of this work. This review also systematically evaluates the polio transmission and health economic modeling papers published in English in peerreviewed journals from 2000 to 2019, highlights differences in approaches and methods, shows the geographic coverage of the transmission modeling performed, identified common themes, and discusses instances of similar or conflicting insights or recommendations. Expert opinion: Polio modeling performed during the last 20 years substantially impacted polio vaccine choices, immunization policies, and the polio eradication pathway. As the polio endgame continues, national preferences for polio vaccine formulations and immunization strategies will likely continue to change. Future modeling will likely provide important insights about their costeffectiveness and their relative benefits with respect to controlling polio and potentially achieving and maintaining eradication.

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Section: Summary Of Publications Reviewedmentioning

confidence: 99%

Section: Themesmentioning

confidence: 99%

Section: Themesmentioning

confidence: 99%

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Review of poliovirus modeling performed from 2000 to 2019 to support global polio eradication

Thompson¹,

Kalkowska²

2020

Expert Review of Vaccines

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“…cVDPVs have been designated a Public Health Emergency of International Concern, for which the only effective control is use of stockpiled monovalent OPV2. Use of this vaccine carries the inherent risk of seeding new cVDPVs, particularly with waning mucosal immunity of the population following OPV2 cessation 8, 9. IPV use cannot generate cVDPVs but these vaccines do not induce primary intestinal mucosal immunity, so IPV use is ineffective in interrupting transmission in settings where transmission is predominantly via the faecal–oral route 10, 11.…”

Section: Introductionmentioning

confidence: 99%

The safety and immunogenicity of two novel live attenuated monovalent (serotype 2) oral poliovirus vaccines in healthy adults: a double-blind, single-centre phase 1 study

et al. 2019

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Summary Background Use of oral live-attenuated polio vaccines (OPV), and injected inactivated polio vaccines (IPV) has almost achieved global eradication of wild polio viruses. To address the goals of achieving and maintaining global eradication and minimising the risk of outbreaks of vaccine-derived polioviruses, we tested novel monovalent oral type-2 poliovirus (OPV2) vaccine candidates that are genetically more stable than existing OPVs, with a lower risk of reversion to neurovirulence. Our study represents the first in-human testing of these two novel OPV2 candidates. We aimed to evaluate the safety and immunogenicity of these vaccines, the presence and extent of faecal shedding, and the neurovirulence of shed virus. Methods In this double-blind, single-centre phase 1 trial, we isolated participants in a purpose-built containment facility at the University of Antwerp Hospital (Antwerp, Belgium), to minimise the risk of environmental release of the novel OPV2 candidates. Participants, who were recruited by local advertising, were adults (aged 18–50 years) in good health who had previously been vaccinated with IPV, and who would not have any contact with immunosuppressed or unvaccinated people for the duration of faecal shedding at the end of the study. The first participant randomly chose an envelope containing the name of a vaccine candidate, and this determined their allocation; the next 14 participants to be enrolled in the study were sequentially allocated to this group and received the same vaccine. The subsequent 15 participants enrolled after this group were allocated to receive the other vaccine. Participants and the study staff were masked to vaccine groups until the end of the study period. Participants each received a single dose of one vaccine candidate (candidate 1, S2/cre5/S15domV/rec1/hifi3; or candidate 2, S2/S15domV/CpG40), and they were monitored for adverse events, immune responses, and faecal shedding of the vaccine virus for 28 days. Shed virus isolates were tested for the genetic stability of attenuation. The primary outcomes were the incidence and type of serious and severe adverse events, the proportion of participants showing viral shedding in their stools, the time to cessation of viral shedding, the cell culture infective dose of shed virus in virus-positive stools, and a combined index of the prevalence, duration, and quantity of viral shedding in all participants. This study is registered with EudraCT, number 2017-000908-21 and ClinicalTrials.gov , number NCT03430349 . Findings Between May 22 and Aug 22, 2017, 48 volunteers were screened, of whom 15 (31%) volunteers were excluded for reasons relating to the inclusion or exclusion criteria, three (6%) volunteers were not treated because of restrictions to the number of participants in each group, and 30 (63%) volunteers were sequentially allocated to groups (15 participants per group). Both no...

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“…Unintended and long-lasting impacts on humans, as seen with the large-scale field use of oral vaccines for poliovirus and smallpox virus (54,55), have not been observed with oral rabies virus vaccines (56,57). Only very few sporadic adverse events in animals or humans, without any epidemiologic impact, have been reported when baits were distributed randomly in the environment (56)(57)(58)(59)(60)(61)(62)(63).…”

Section: Safety Of Oral Rabies Vaccinesmentioning

confidence: 99%

Role of Oral Rabies Vaccines in the Elimination of Dog-Mediated Human Rabies Deaths

Wallace¹,

Cliquet²,

Fehlner-Gardiner³

et al. 2020

Emerg. Infect. Dis.

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S ince the advent of Pasteur's germ theory and the general acceptance that infectious diseases do not develop spontaneously, humankind has strived to reduce and eliminate pathogens that pose a serious public health threat. Incorporating routine vaccinations to control human diseases such as pneumonia, diarrhea, pertussis, measles, and polio contributed to the prevention of >10 million human deaths during 2010-2015 (1). Intensive global efforts toward disease eradication have focused on only a few diseases, including Guinea worm disease (dracunculiasis) (>99% reduction in human cases), smallpox (eradicated in 1980), rinderpest (eradicated in 2011), polio (99% reduction in human cases), and lymphatic filariasis (73% reduction in human cases) (2-6). Those disease eradication efforts have focused on pathogens that are host-restricted or affect only a single host. In 2015, the world called for action by setting a goal of zero human dog-mediated rabies deaths by 2030 worldwide. In 2018, the World Health Organization (WHO), the World Organisation for Animal Health (OIE), the Food and Agriculture Organization of the United Nations, and the Global Alliance for Rabies Control launched the Global Strategic Plan for global elimination of dog-mediated human rabies deaths by 2030, which represents the first major effort to eliminate a classical zoonosis and poses

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Assessing the Risk of Vaccine-derived Outbreaks After Reintroduction of Oral Poliovirus Vaccine in Postcessation Settings

Cited by 8 publications

References 20 publications

Review of poliovirus modeling performed from 2000 to 2019 to support global polio eradication

Review of poliovirus modeling performed from 2000 to 2019 to support global polio eradication

The safety and immunogenicity of two novel live attenuated monovalent (serotype 2) oral poliovirus vaccines in healthy adults: a double-blind, single-centre phase 1 study

Role of Oral Rabies Vaccines in the Elimination of Dog-Mediated Human Rabies Deaths

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