Options for Poliomyelitis Vaccination in the United States Workshop Summary (1996) / Chapter Skim
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HISTORY AND CURRENT STATUS
HISTORY AND CURRENT STATUS
Pages 3-13
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and use worldwide and led to a dramatic drop in the incidence of paralytic poliomyelitis. The Sabin live attenuated vaccine (OPV)
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routine reporting through the morbidity reporting system for contagious diseases, (2) the Vaccine Adverse Event Reporting System (a passive surveillance system, stimulated by provider letters, to which vaccine-associated cases of polio may be reported)
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It is particularly difficult to ascertain the risk of spread following importation when the level of immunity in the population is high. Vaccine-Associated Paralytic Poliomyelitis Between 1980 and 1992, a total of 109 cases of vaccine-associated polio were reported in the United States, an average of 8.4 cases per year.2 During 20f these, 41 were immunologically normal vaccine recipients, 38 were normal contacts of immunologically normal vaccine recipients, 7 had community-acquired cases of polio, and 23 were vaccine recipients or contacts who were immunologically abnormal (17 vaccine recipients and 6 contacts)
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. All of the immunologically abnormal vaccine recipients were found to be immunologically abnormal only after they developed VAPP, and none were found to be infected with the human immunodeficiency virus (HIV)
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The data suggest that prior IPV decreases fecal shedding of OPV virus; to the extent that it does, some contact cases may be prevented. However, the more shedding is reduced, the less potential benefit people in undervaccinated areas will receive from the transmission of OPV virus.
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The family believes that polio vaccination policy should be changed to rely primarily on the inactivated polio vaccine to prevent over children and families from suffering nc they have.
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a good surveillance system, with units reporting weekly on the presence or absence of cases of acute flaccid paralysis (AFP)
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The last imported case was in 1988, in a Pakistani child born in Toronto and living in a large apartment complex with many recent immigrants from Pakistan. The isolated strain was determined to be typical of that found on the Indian subcontinent.
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made the change cost neutral. Ontario switched from IPV to OPV in 1989 and then back to IPV, the change necessitated by the temporary lack of an IPV supply; implementation of the policy change was relatively easy.
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in 1994 was in the WHO's southeast Asia region, which comprises the Indian subcontinent and Indonesia; India and Bangladesh account for almost all of this, with more than 60 percent of the cases reported worldwide in 1994 being in India. A substantial proportion of the estimated costs of polio eradication are paid by countries where polio is endemic, rather than by external donor organizations.
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immunization policy has had a strong influence on physicians and public health professionals in developing countries. The WHO leadership believes that eradication of polio in countries where it is endemic can only be accomplished through mass vaccination with OPV and that a change to IPV in those countries could jeopardize the global eradication effort.
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