Key result
The incidence of non-polio acute flaccid paralysis in India was directly proportional to the doses of oral polio vaccine received, with an extra 47,500 new cases reported in 2011.
Why the study?
Does the oral polio vaccine programme increase the incidence of non-polio acute flaccid paralysis?
Does the oral polio vaccine programme increase the incidence of non-polio acute flaccid paralysis?
Effect estimate: R2 = 55.6%
p-value: p=<0.001
The polio eradication programme in India was associated with a significant increase in non-polio acute flaccid paralysis, raising ethical concerns about the continuation of such vertical programmes.
It was hoped that following polio eradication, immunisation could be stopped. However the synthesis of polio virus in 2002, made eradication impossible. It is argued that getting poor countries to expend their scarce resources on an impossible dream over the last 10 years was unethical. Furthermore, while India has been polio-free for a year, there has been a huge increase in non-polio acute flaccid paralysis (NPAFP). In 2011, there were an extra 47,500 new cases of NPAFP. Clinically indistinguishable from polio paralysis but twice as deadly, the incidence of NPAFP was directly proportional to doses of oral polio received. Though this data was collected within the polio surveillance system, it was not investigated. The principle of primum-non-nocere was violated. The authors suggest that the huge bill of US$ 8 billion spent on the programme, is a small sum to pay if the world learns to be wary of such vertical programmes in the future.
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Vashisht et al. (2012) conducted an editorial in Poliomyelitis and non-polio acute flaccid paralysis (NPAFP). Oral Polio Vaccine (OPV) was evaluated on Correlation between non-polio AFP rate and cumulative OPV doses received (R2 = 55.6%, p=<0.001). The incidence of non-polio acute flaccid paralysis in India was directly proportional to the doses of oral polio vaccine received, with an extra 47,500 new cases reported in 2011.
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