Persistence of vaccine-derived poliovirus following a mass vaccination campaign in Cuba: implications for stopping polio vaccination after global eradication

Abstract

Our results suggest that in a country with high population immunity, vaccine-derived virus is unlikely to establish ongoing circulation.

Poliovirus Vaccine Shedding among Persons with HIV in Abidjan, Cote d’Ivoire

“…Nationwide, ∼2.5 million children aged !5 years have been vaccinated with OPV during each of 2 rounds (3-5 days each) held in the autumn of each year during 1996-2002. The large quantities of OPV administered during mass campaigns over short time periods result in intense vaccine virus excretion and circulation during the weeks after the campaign [22]. In terms of vaccine spread, Cote d'Ivoire has high population density in urban areas, as well as substantial immunity gaps; reported routine immunization coverage for 3 doses of OPV was 54% in 2002.…”

Polio: Obstacles to Eradication

“…У регіонах з високиì рівнеì охоплен-ня населення вакöинаöією кількість випадків захворювання зведена до ìініìуìу [26].…”

Poliovirus Vaccines: Past, Present, and Future

“…Following the launch of trivalent OPV in 1963, the steep decrease continued, with the eradication of indigenous wild poliovirus in the United States occurring in the early 1970s. 11,12 The effect of OPV in the United States and in Cuba 13,14 prompted the Pan American Health Organization to advocate OPV programs in Central and South America, leading to the eradication of circulating wild poliovirus from the Western hemisphere in 1991. 15 In 1988, the World Health Organization announced a goal of global eradication of wild poliovirus at a time when there were an estimated 350 000 paralytic poliomyelitis cases each year.…”

“…This phenomenon has caused more than 15 detected outbreaks since the year 2000, all of which have been associated with OPV programs in which fewer than 50% of children were successfully immunized. 3,14,36,37 Although most of these outbreaks have involved fewer than 25 paralytic poliomyelitis cases, 1 large outbreak due to type 2 vaccine-derived poliovirus has been reported in Nigeria, and this outbreak is still ongoing more than 5 years after it began. 38,39 It appears that the only safe route to the eradication of all circulating paralytogenic poliovirus is the conversion from the use of OPV to IPV.…”