A handbook for training regional consultants and briefing NITAG members on technical aspects related to introduction of IPV as it relates to the Polio Eradication and Endgame Strategic Plan.
Background and Technical Rationale for Introduction of one dose of Inactivated Polio Vaccine (IPV) in Routine Immunization Schedule
This document outlines steps for IPV Introduction, OPV Withdrawal, and Routine Immunization Strengthening
Brief on IPV Introduction, OPV Withdrawal, and Routine Immunization Strengthening
The GPEI sets priorities to make 2015 the last stand of the poliovirus around the world
The last few years have seen the Global Polio Eradication Initiative (GPEI) evolve and grow in response to the threats posed to the world by the final strongholds of the poliovirus. Despite being more geographically limited than ever before, at the end of 2014 the virus continues to pose challenges that must be faced in 2015 if we are to protect children from this disease forever. Polio eradication efforts in 2015 will have five priorities: refining surveillance to catch any remaining virus, keeping Africa and the Middle East polio-free, providing a surge of support to Pakistan and Afghanistan, preparing for the withdrawal of oral polio vaccine type 2 and continuing to demonstrate and build on the differences that the polio programme makes to strengthen routine immunization programmes.
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IPV in 5 dose vials,
produced by Bilthoven Biologicals, was recently prequalified and approved for
use up to 28 days after opening if the following
additional criteria, defined by the WHO, are fully met.
expiration date of the vaccine has not passed.
vaccine vial has been, and will continue to be, stored at WHO- or
further details on the handling of multi-dose vaccine vials after opening,
follow the link for WHO Policy Statement: Multi-dose Vial Policy, Revision
What type of protection do polio vaccines offer?
When a child receives OPV, the vaccine virus enters
the child’s mouth and gut and replicates. The child then mounts immune
responses in three places: (1) antibody
response in the blood that protects against the virus invading the nervous
system and causing paralysis, (2) immune
response in the mouth which prevents shedding of virus in oral secretions
and spread from those secretions and (3) intestinal
immunity (also called gut or mucosal immunity), which prevents shedding of
the virus in the stool. Thus, children vaccinated with OPV who come into
contact with wild poliovirus are less likely to excrete poliovirus in their
oral fluids or stool than unvaccinated persons. The predominant mode of
transmission in the developing world is thought to be fecal-oral. Virus
is shed in the feces and, in poor sanitary conditions and with suboptimal
hygiene measures, can infect other persons if transmitted by dirty hands or contaminated
food and water. Therefore, strong intestinal immunity prevents transmission.
an inactivated vaccine (killed virus) that stimulates a very good humoral
response (antibodies in the blood) in children after only 1 or 2 doses. IPV
also prevents children from excreting virus in their mouths as effectively as
OPV and hence to the extent that polioviruses are transmitted through oral
secretions, IPV is very effective at blocking that type of transmission. However, IPV alone does not induce the same
level of intestinal immunity as OPV.
Thus, while individuals vaccinated with IPV alone are protected against
paralysis, they may excrete the virus and allow it to spread.
combination of IPV with bOPV provides the advantages of both vaccines: strong
intestinal immunity and antibody protection against the two serotypes in bOPV,
types 1 and 3. This combination gives both the child and the child’s community
the best protection.
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