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Macklin GR, O'Reilly KM, Grassly NC, Edmunds WJ, Mach O, Santhana Gopala Krishnan R, Voorman A, Vertefeuille JF, Abdelwahab J, Gumede N, Goel A, Sosler S, Sever J, Bandyopadhyay AS, Pallansch MA, Nandy R, Mkanda P, Diop OM, Sutter RW. Evolving epidemiology of poliovirus serotype 2 following withdrawal of the serotype 2 oral poliovirus vaccine. Science 2020; 368:401-405. [PMID: 32193361 PMCID: PMC10805349 DOI: 10.1126/science.aba1238] [Citation(s) in RCA: 81] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 03/11/2020] [Indexed: 11/02/2022]
Abstract
Although there have been no cases of serotype 2 wild poliovirus for more than 20 years, transmission of serotype 2 vaccine-derived poliovirus (VDPV2) and associated paralytic cases in several continents represent a threat to eradication. The withdrawal of the serotype 2 component of oral poliovirus vaccine (OPV2) was implemented in April 2016 to stop VDPV2 emergence and secure eradication of all serotype 2 poliovirus. Globally, children born after this date have limited immunity to prevent transmission. Using a statistical model, we estimated the emergence date and source of VDPV2s detected between May 2016 and November 2019. Outbreak response campaigns with monovalent OPV2 are the only available method to induce immunity to prevent transmission. Yet our analysis shows that using monovalent OPV2 is generating more paralytic VDPV2 outbreaks with the potential for establishing endemic transmission. A novel OPV2, for which two candidates are currently in clinical trials, is urgently required, together with a contingency strategy if this vaccine does not materialize or perform as anticipated.
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Affiliation(s)
- G R Macklin
- Centre of Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, UK.
- Polio Eradication, World Health Organization, Geneva, Switzerland
| | - K M O'Reilly
- Centre of Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - N C Grassly
- Department of Infectious Disease Epidemiology, Imperial College London, London, UK
| | - W J Edmunds
- Centre of Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - O Mach
- Polio Eradication, World Health Organization, Geneva, Switzerland
| | | | - A Voorman
- Bill and Melinda Gates Foundation, Seattle, WA, USA
| | - J F Vertefeuille
- Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - J Abdelwahab
- United Nations Children's Fund (UNICEF), New York, NY, USA
| | - N Gumede
- Regional Office for Africa, World Health Organization, Brazzaville, Congo
| | - A Goel
- Polio Eradication, World Health Organization, Geneva, Switzerland
| | - S Sosler
- Gavi (the Vaccine Alliance), Geneva, Switzerland
| | - J Sever
- Rotary International, Evanston, IL, USA
| | | | - M A Pallansch
- Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - R Nandy
- United Nations Children's Fund (UNICEF), New York, NY, USA
| | - P Mkanda
- Regional Office for Africa, World Health Organization, Brazzaville, Congo
| | - O M Diop
- Polio Eradication, World Health Organization, Geneva, Switzerland
| | - R W Sutter
- Polio Eradication, World Health Organization, Geneva, Switzerland
- Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
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Mihigo R, Okeibunor J, O’Malley H, Masresha B, Mkanda P, Zawaira F. Investing in life saving vaccines to guarantee life of future generations in Africa. Vaccine 2016; 34:5827-5832. [DOI: 10.1016/j.vaccine.2016.06.036] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 06/10/2016] [Indexed: 11/16/2022]
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Ado JM, Etsano A, Shuaib F, Damisa E, Mkanda P, Gasasira A, Banda R, Korir C, Johnson T, Dieng B, Corkum M, Enemaku O, Mataruse N, Ohuabunwo C, Baig S, Galway M, Seaman V, Wiesen E, Vertefeuille J, Ogbuanu IU, Armstrong G, Mahoney FJ. Progress Toward Poliomyelitis Eradication in Nigeria. J Infect Dis 2014; 210 Suppl 1:S40-9. [DOI: 10.1093/infdis/jiu318] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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