Polio eradication: the OPV paradox
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.
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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).”
From VACCINE-DERIVED POLIOVIRUSES AND THE ENDGAME STRATEGY FOR GLOBAL POLIO ERADICATION (2005) · cites this paper as [43]
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”
From VACCINE-DERIVED POLIOVIRUSES AND THE ENDGAME STRATEGY FOR GLOBAL POLIO ERADICATION (2005) · cites this paper as [43]
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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.
- ORCID
- Pallansch, Mark A.
- 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
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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