Cited by 144Viral Infections and Immunology ResearchVaccine Coverage and HesitancyVirology and Viral Diseases

Polio eradication: the OPV paradox

Dowdle, Walter R., De Gourville, Esther, Kew, Olen M., Pallansch, Mark A., Wood, David J.·2003·Reviews in Medical Virology

Abstract

Routine and mass administration of oral polio vaccine (OPV) since 1961 has prevented many millions of cases of paralytic poliomyelitis. The public health value of this inexpensive and easily administered product has been extraordinary. Progress of the Global Polio Eradication Initiative has further defined the value of OPV as well as its risk through vaccine‐associated paralytic poliomyelitis (VAPP) and vaccine‐derived polioviruses (VDPV). Although both are rare, once wild poliovirus transmission has been interrupted by OPV, the only poliomyelitis due to poliovirus will be caused by OPV. Poliovirus will be eradicated only when OPV use is discontinued. This paradox provides a major incentive for eventually stopping polio immunization or replacing OPV, but it also introduces complexity into the process of identifying safe and scientifically sound strategies for doing so. The core post eradication immunization issues include the risk/benefits of continued OPV use, the extent of OPV replacement with IPV, possible strategies for discontinuing OPV, and the potential for development and licensure of a safe and effective replacement for OPV. Formulation of an informed post eradication immunization policy requires careful evaluation of polio epidemiology, surveillance capability, vaccine availability, laboratory containment, and the risks posed by the very tool responsible for successful interruption of wild poliovirus transmission. Copyright © 2003 John Wiley & Sons, Ltd.

Integrity signals

Registry

Crossref · 10.1002/rmv.401

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86 of 86 references verified0 citation errors · 0 not checkable

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  • OPV has attained an outstanding record of safety and efficacy over the four decades of worldwide use.

    “it is remarkable that OPV has attained such an outstanding record of safety and efficacy over the four decades of worldwide use (43, 55).”
  • The use of mutable live polioviruses in OPV administered by the natural route of infection presents special challenges not encountered with smallpox eradication.

    “the use of mutable live polioviruses in OPV administered by the natural route of infection present special challenges not encountered with smallpox eradication”

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Authors
Dowdle, W. R., De Gourville, E., Kew, O. M., Pallansch, M. A., & Wood, D. J.
Affiliations
  • Centers for Disease Control and Prevention (US)
  • World Health Organization (CH)
Corresponding author
Dowdle, Walter R.
Venue
Reviews in Medical Virology
Publisher
Wiley
Published
2003-08-15
Volume
13
Issue
5
Pages
277-291
ISSN
  • 1052-9276 (ISSN-L)
  • 1099-1654
OpenAlex
W2008370272
Cited by
144
References
85
Citations by year
2026: 4 · 2025: 8 · 2024: 6 · 2023: 3 · 2022: 3 · 2021: 5 · 2020: 2 · 2019: 3 · 2018: 10 · 2017: 3 · 2016: 3 · 2015: 4 · 2014: 11 · 2013: 8 · 2012: 5
FWCI
1.89
Type
journal article
Language
en
Open access
closed
Locations
  • Reviews in Medical Virology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Viral Infections and Immunology Research
  • Social Sciences › Health › Vaccine Coverage and Hesitancy
  • Health Sciences › Medicine › Epidemiology › Virology and Viral Diseases
Keywords
polio eradication, oral polio vaccine, vaccine-associated paralytic poliomyelitis, vaccine-derived poliovirus, poliovirus, inactivated poliovirus vaccine, wild poliovirus transmission, polio surveillance, laboratory containment
MeSH terms
Health Policy, Humans, Poliomyelitis, Poliovirus Vaccine, Inactivated, Poliovirus Vaccine, Oral, Immunization Programs

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