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Updated Characterization of Outbreak Response Strategies for 2019–2029: Impacts of Using a Novel Type 2 Oral Poliovirus Vaccine Strain

Author

Listed:
  • Dominika A. Kalkowska
  • Mark A. Pallansch
  • Amanda Wilkinson
  • Ananda S. Bandyopadhyay
  • Jennifer L. Konopka‐Anstadt
  • Cara C. Burns
  • M. Steven Oberste
  • Steven G. F. Wassilak
  • Kamran Badizadegan
  • Kimberly M. Thompson

Abstract

Delays in achieving the global eradication of wild poliovirus transmission continue to postpone subsequent cessation of all oral poliovirus vaccine (OPV) use. Countries must stop OPV use to end all cases of poliomyelitis, including vaccine‐associated paralytic polio (VAPP) and cases caused by vaccine‐derived polioviruses (VDPVs). The Global Polio Eradication Initiative (GPEI) coordinated global cessation of all type 2 OPV (OPV2) use in routine immunization in 2016 but did not successfully end the transmission of type 2 VDPVs (VDPV2s), and consequently continues to use type 2 OPV (OPV2) for outbreak response activities. Using an updated global poliovirus transmission and OPV evolution model, we characterize outbreak response options for 2019–2029 related to responding to VDPV2 outbreaks with a genetically stabilized novel OPV (nOPV2) strain or with the currently licensed monovalent OPV2 (mOPV2). Given uncertainties about the properties of nOPV2, we model different assumptions that appear consistent with the evidence on nOPV2 to date. Using nOPV2 to respond to detected cases may reduce the expected VDPV and VAPP cases and the risk of needing to restart OPV2 use in routine immunization compared to mOPV2 use for outbreak response. The actual properties, availability, and use of nOPV2 will determine its effects on type 2 poliovirus transmission in populations. Even with optimal nOPV2 performance, countries and the GPEI would still likely need to restart OPV2 use in routine immunization in OPV‐using countries if operational improvements in outbreak response to stop the transmission of cVDPV2s are not implemented effectively.

Suggested Citation

  • Dominika A. Kalkowska & Mark A. Pallansch & Amanda Wilkinson & Ananda S. Bandyopadhyay & Jennifer L. Konopka‐Anstadt & Cara C. Burns & M. Steven Oberste & Steven G. F. Wassilak & Kamran Badizadegan & , 2021. "Updated Characterization of Outbreak Response Strategies for 2019–2029: Impacts of Using a Novel Type 2 Oral Poliovirus Vaccine Strain," Risk Analysis, John Wiley & Sons, vol. 41(2), pages 329-348, February.
    • Handle: RePEc:wly:riskan:v:41:y:2021:i:2:p:329-348
    DOI: 10.1111/risa.13622
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    References listed on IDEAS

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    1. Radboud J. Duintjer Tebbens & Mark A. Pallansch & Dominika A. Kalkowska & Steven G. F. Wassilak & Stephen L. Cochi & Kimberly M. Thompson, 2013. "Characterizing Poliovirus Transmission and Evolution: Insights from Modeling Experiences with Wild and Vaccine‐Related Polioviruses," Risk Analysis, John Wiley & Sons, vol. 33(4), pages 703-749, April.
    2. Radboud J. Duintjer Tebbens & Mark A. Pallansch & Konstantin M. Chumakov & Neal A. Halsey & Tapani Hovi & Philip D. Minor & John F. Modlin & Peter A. Patriarca & Roland W. Sutter & Peter F. Wright & S, 2013. "Review and Assessment of Poliovirus Immunity and Transmission: Synthesis of Knowledge Gaps and Identification of Research Needs," Risk Analysis, John Wiley & Sons, vol. 33(4), pages 606-646, April.
    3. Radboud J. Duintjer Tebbens & Mark A. Pallansch & Konstantin M. Chumakov & Neal A. Halsey & Tapani Hovi & Philip D. Minor & John F. Modlin & Peter A. Patriarca & Roland W. Sutter & Peter F. Wright & S, 2013. "Expert Review on Poliovirus Immunity and Transmission," Risk Analysis, John Wiley & Sons, vol. 33(4), pages 544-605, April.
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