1,720,995 research outputs found
Costs and Benefits of Including Inactivated in Addition to Oral Poliovirus Vaccine in Outbreak Response After Cessation of Oral Poliovirus Vaccine Use
No full textBackground: After stopping serotype 2–containing oral poliovirus vaccine use, serotype 2 poliovirus outbreaks may still occur and require outbreak response supplemental immunization activities (oSIAs). Current oSIA plans include the use of both serotype 2 monovalent oral poliovirus vaccine (mOPV2) and inactivated poliovirus vaccine (IPV). Methods: We used an existing model to compare the effectiveness of mOPV2 oSIAs with or without IPV in response to a hypothetical postcessation serotype 2 outbreak in northwest Nigeria. We considered strategies that co-administer IPV with mOPV2, use IPV only for older age groups, or use only IPV during at least one oSIA. We considered the cost and supply implications and estimated from a societal perspective the incremental cost-effectiveness and incremental net benefits of adding IPV to oSIAs in the context of this hypothetical outbreak in 2017. Results: Adding IPV to the first or second oSIA resulted in a 4% to 6% reduction in expected polio cases compared to exclusive mOPV2 oSIAs. We found the greatest benefit of IPV use if added preemptively as a ring around the initial oSIA target population, and negligible benefit if added to later oSIAs or older age groups. We saw an increase in expected polio cases if IPV replaced mOPV2 during an oSIA. None of the oSIA strategies that included IPV for this outbreak represented a cost-effective or net beneficial intervention compared to reliance on mOPV2 only. Conclusions: While adding IPV to oSIAs results in marginal improvements in performance, the poor cost-effectiveness and current limited IPV supply make it economically unattractive for high-risk settings in which IPV does not significantly affect transmission
Using integrated modeling to support the global eradication of vaccine-preventable diseases
No full textPolio endgame risks and the possibility of restarting the use of oral poliovirus vaccine
No full textIntroduction: Ending all cases of poliomyelitis requires successful cessation of all oral poliovirus vaccine (OPV), but the Global Polio Eradication Initiative (GPEI) partners should consider the possibility of an OPV restart. Areas covered: We review the risks of continued live poliovirus transmission after OPV cessation and characterize events that led to OPV restart in a global model that focused on identifying optimal strategies for OPV cessation and the polio endgame. Numerous different types of events that occurred since the globally coordinated cessation of serotype 2-containing OPV in 2016 highlight the possibility of continued outbreaks after homotypic OPV cessation. Modeling suggests a high risk of uncontrolled outbreaks once more than around 5,000 homotypic polio cases occur after cessation of an OPV serotype, at which point restarting OPV would become necessary to protect most populations. Current efforts to sunset the GPEI and transition its responsibilities to national governments poses risks that may limit the ability to implement management strategies needed to minimize the probability of an OPV restart. Expert commentary: OPV restart remains a real possibility, but risk management choices made by the GPEI partners and national governments can reduce the risks of this low-probability but high-consequence event
Health and economic consequences of different options for timing the coordinated global cessation of the three oral poliovirus vaccine serotypes
No full textEconomic Evaluation of the Benefits and Costs of Disease Elimination and Eradication Initiatives
No full textModeling the costs and benefits of temporary recommendations for poliovirus exporting countries to vaccinate international travelers
No full textPlanning for globally coordinated cessation of bivalent oral poliovirus vaccine: risks of non-synchronous cessation and unauthorized oral poliovirus vaccine use
No full textAbstract Background Oral polio vaccine (OPV) containing attenuated serotype 2 polioviruses was globally withdrawn in 2016, and bivalent OPV (bOPV) containing attenuated serotype 1 and 3 polioviruses needs to be withdrawn after the certification of eradication of all wild polioviruses to eliminate future risks from vaccine-derived polioviruses (VDPVs). To minimize risks from VDPVs, the planning and implementation of bOPV withdrawal should build on the experience with withdrawing OPV containing serotype 2 polioviruses while taking into account similarities and differences between the three poliovirus serotypes. Methods We explored the risks from (i) a failure to synchronize OPV cessation and (ii) unauthorized post-cessation OPV use for serotypes 1 and 3 in the context of globally-coordinated future bOPV cessation and compared the results to similar analyses for serotype 2 OPV cessation. Results While the risks associated with a failure to synchronize cessation and unauthorized post-cessation OPV use appear to be substantially lower for serotype 3 polioviruses than for serotype 2 polioviruses, the risks for serotype 1 appear similar to those for serotype 2. Increasing population immunity to serotype 1 and 3 poliovirus transmission using pre-cessation bOPV supplemental immunization activities and inactivated poliovirus vaccine in routine immunization reduces the risks of circulating VDPVs associated with non-synchronized cessation or unauthorized OPV use. Conclusions The Global Polio Eradication Initiative should synchronize global bOPV cessation during a similar window of time as occurred for the global cessation of OPV containing serotype 2 polioviruses and should rigorously verify the absence of bOPV in immunization systems after its cessation
Implementation of coordinated global serotype 2 oral poliovirus vaccine cessation: risks of potential non-synchronous cessation
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