Cited by 193Viral Infections and Immunology ResearchVaccine Coverage and HesitancyVirology and Viral Diseases

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Cessation of Trivalent Oral Poliovirus Vaccine and Introduction of Inactivated Poliovirus Vaccine — Worldwide, 2016

Open access

Hampton, Lee M., Farrell, Margaret, Ramirez-Gonzalez, Alejandro, Menning, Lisa, Shendale, Stephanie, Lewis, Ian, Rubin, Jennifer, Garon, Julie, Harris, Jennifer, Hyde, Terri, Wassilak, Steven, Patel, Manish, Nandy, Robin, Chang-Blanc, Diana, Immunization Systems Management Group of the Global Polio Eradication Initiative·2016·MMWR Morbidity and Mortality Weekly Report

DOI 10.15585/mmwr.mm6535a3

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Abstract

Since the 1988 World Health Assembly resolution to eradicate poliomyelitis, transmission of the three types of wild poliovirus (WPV) has been sharply reduced (1). WPV type 2 (WPV2) has not been detected since 1999 and was declared eradicated in September 2015. Because WPV type 3 has not been detected since November 2012, WPV type 1 (WPV1) is likely the only WPV that remains in circulation (1). This marked progress has been achieved through widespread use of oral poliovirus vaccines (OPVs), most commonly trivalent OPV (tOPV), which contains types 1, 2, and 3 live, attenuated polioviruses and has been a mainstay of efforts to prevent polio since the early 1960s. However, attenuated polioviruses in OPV can undergo genetic changes during replication, and in communities with low vaccination coverage, can result in vaccine-derived polioviruses (VDPVs) that can cause paralytic polio indistinguishable from the disease caused by WPVs (2). Among the 721 polio cases caused by circulating VDPVs (cVDPVs*) detected during January 2006-May 2016, type 2 cVDPVs (cVDPV2s) accounted for >94% (2). Eliminating the risk for polio caused by VDPVs will require stopping all OPV use. The first stage of OPV withdrawal involved a global, synchronized replacement of tOPV with bivalent OPV (bOPV) containing only types 1 and 3 attenuated polioviruses, planned for April 18-May 1, 2016, thereby withdrawing OPV type 2 from all immunization activities (3). Complementing the switch from tOPV to bOPV, introduction of at least 1 dose of injectable, trivalent inactivated poliovirus vaccine (IPV) into childhood immunization schedules reduces risks from and facilitates responses to cVDPV2 outbreaks. All 155 countries and territories that were still using OPV in immunization schedules in 2015 have reported that they had ceased use of tOPV by mid-May 2016.(†) As of August 31, 2016, 173 (89%) of 194 World Health Organization (WHO) countries included IPV in their immunization schedules.(§) The cessation of tOPV use is a major milestone toward the global goal of eradicating polio; however, careful surveillance for polioviruses and prompt, aggressive responses to polio outbreaks are still needed to realize a polio-free world.

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Authors: Hampton, L. M., Farrell, M., Ramirez-Gonzalez, A., Menning, L., Shendale, S., Lewis, I., Rubin, J., Garon, J., Harris, J., Hyde, T., Wassilak, S., Patel, M., Nandy, R., Chang-Blanc, D., & Immunization Systems Management Group of the Global Polio Eradication Initiative
Affiliations: Centers for Disease Control and Prevention (US)
Corresponding author: Hampton, Lee M.
ORCID: Hampton, Lee M.
Shendale, Stephanie
Harris, Jennifer
Hyde, Terri
Wassilak, Steven
Patel, Manish
Nandy, Robin
Venue: MMWR Morbidity and Mortality Weekly Report
Publisher: Centers for Disease Control MMWR Office
Published: 2016-09-09
Volume: 65
Issue: 35
Pages: 934-938
ISSN: 0149-2195 (ISSN-L)
1545-861X
DOI: 10.15585/mmwr.mm6535a3
OpenAlex: W2510158554
Cited by: 193
References: 11
Citations by year: 2026: 8 · 2025: 8 · 2024: 13 · 2023: 24 · 2022: 17 · 2021: 19 · 2020: 25 · 2019: 16 · 2018: 29 · 2017: 27 · 2016: 6
FWCI: 21.28
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: MMWR Morbidity and Mortality Weekly Report (publishedVersion)
PubMed (publishedVersion)
Funders: U.S. Department of Health and Human Services
Centers for Disease Control and Prevention
Topics: Health Sciences › Medicine › Infectious Diseases › Viral Infections and Immunology Research
Social Sciences › Health › Vaccine Coverage and Hesitancy
Health Sciences › Medicine › Epidemiology › Virology and Viral Diseases
Keywords: trivalent oral polio vaccine, inactivated poliovirus vaccine, vaccine-derived poliovirus, poliovirus type 2, bivalent oral poliovirus vaccine, polio eradication, wild poliovirus, polio vaccination coverage, childhood immunization schedule, polio surveillance
MeSH terms: Disease Outbreaks, Humans, Poliomyelitis, Poliovirus Vaccine, Inactivated, Poliovirus Vaccine, Oral, Global Health, Drug Substitution

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Cessation of Trivalent Oral Poliovirus Vaccine and Introduction of Inactivated Poliovirus Vaccine — Worldwide, 2016

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