Invited Commentary: The Scientific Basis for Stopping Polio Immunization

This article summarizes the WHO-sponsored meeting of virologists, immunologists, and epidemiologists in March 1998 to address the final and controversial stage of the polio eradication initiative. The meeting commissioned Fine and Carneiro's literature review and mathematical model delineating the important gaps in the scientific knowledge and helped define the research agenda of the remaining few years of the initiative. Fine and Carneiro proposed that the possibility of continuing circulation of vaccine-derived polioviruses (VDPV) could not be excluded with absolute certainty. They also argued that VDPV may continue to circulate after use of oral polio vaccine stops and that immunodeficient persons may be a potential reservoir from which VDPV could be reintroduced into the general population. Their work further highlights that high-level enterovirus surveillance will be essential in the years after immunization has stopped.