Title

Preeradication Vaccine Policy Options for Poliovirus Infection and Disease Control

Authors

Authors

K. M. Thompson; M. A. Pallansch; R. J. D. Tebbens; S. G. Wassilak; J. H. Kim;S. L. Cochi

Comments

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Abbreviated Journal Title

Risk Anal.

Keywords

Policy options; poliovirus; vaccination; ORAL POLIOMYELITIS VACCINE; ENHANCED-POTENCY; CONTROLLED-TRIAL; IMMUNE-RESPONSE; RISK-MANAGEMENT; IMMUNOLOGICAL RESPONSE; ANTIBODY-RESPONSES; SEROLOGIC RESPONSE; PARALYTIC DISEASE; ECONOMIC-ANALYSIS; Public, Environmental & Occupational Health; Mathematics, ; Interdisciplinary Applications; Social Sciences, Mathematical Methods

Abstract

With the circulation of wild poliovirus (WPV) types 1 and 3 continuing more than a decade after the original goal of eradicating all three types of WPVs by 2000, policymakers consider many immunization options as they strive to stop transmission in the remaining endemic and outbreak areas and prevent reintroductions of live polioviruses into nonendemic areas. While polio vaccination choices may appear simple, our analysis of current options shows remarkable complexity. We offer important context for current and future polio vaccine decisions and policy analyses by developing decision trees that clearly identify potential options currently used by countries as they evaluate national polio vaccine choices. Based on a comprehensive review of the literature we (1) identify the current vaccination options that national health leaders consider for polio vaccination, (2) characterize current practices and factors that appear to influence national and international choices, and (3) assess the evidence of vaccine effectiveness considering sources of variability between countries and uncertainties associated with limitations of the data. With low numbers of cases occurring globally, the management of polio risks might seem like a relatively low priority, but stopping live poliovirus circulation requires making proactive and intentional choices to manage population immunity in the remaining endemic areas and to prevent reestablishment in nonendemic areas. Our analysis shows remarkable variability in the current national polio vaccine product choices and schedules, with combination vaccine options containing inactivated poliovirus vaccine and different formulations of oral poliovirus vaccine making choices increasingly difficult for national health leaders.

Journal Title

Risk Analysis

Volume

33

Issue/Number

4

Publication Date

1-1-2013

Document Type

Review

Language

English

First Page

516

Last Page

543

WOS Identifier

WOS:000317295900002

ISSN

0272-4332

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