Why the study?
Multiple vaccine options exist for polio prevention, but the dynamics and economic impacts of ending use of one or more vaccines to simplify the eradication endgame needed exploration amid rising global cases since 2016.
What are the epidemiological and economic impacts of different polio vaccine strategies (OPV vs IPV) in OPV-using countries?
What are the epidemiological and economic impacts of different polio vaccine strategies (OPV vs IPV) in OPV-using countries?
Modeling suggests that abruptly ending OPV use and relying solely on IPV could lead to a massive resurgence of polio, whereas restarting trivalent OPV may minimize cases and costs.
Caution against abrupt OPV cessation; leaves open optimal coordinated strategies for the polio endgame.
BACKGROUND: Multiple vaccine options are available for polio prevention and risk management. Integrated global risk, economic, and poliovirus transmission modeling provides a tool to explore the dynamics of ending all use of one or more poliovirus vaccines to simplify the polio eradication endgame. RESEARCH DESIGN AND METHODS: With global reported cases of poliomyelitis trending higher since 2016, we apply an integrated global model to simulate prospective vaccine policies and strategies for OPV-using countries starting with initial conditions that correspond to the epidemiological poliovirus transmission situation at the beginning of 2022. RESULTS: Abruptly ending all OPV use in 2023 and relying only on IPV to prevent paralysis with current routine immunization coverage would lead to expected reestablished endemic transmission of poliovirus types 1 and 2, and approximately 150,000 expected cases of poliomyelitis per year. Alternatively, if OPV-using countries restart trivalent OPV (tOPV) use for all immunization activities and end IPV use, the model shows the lowest anticipated annual polio cases and lowest costs. CONCLUSIONS: Poor global risk management and coordination of OPV cessation remain a critical failure mode for the polio endgame, and national and global decision makers face difficult choices due to multiple available polio vaccine options and immunization strategies.
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Thompson et al. (2022) studied this question.
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