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Lopez Cavestany R, Eisenhawer M, Diop OM, Verma H, Quddus A, Mach O. The Last Mile in Polio Eradication: Program Challenges and Perseverance. Pathogens 2024; 13:323. [PMID: 38668278 PMCID: PMC11053864 DOI: 10.3390/pathogens13040323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 04/04/2024] [Accepted: 04/06/2024] [Indexed: 04/29/2024] Open
Abstract
As the Global Polio Eradication Initiative (GPEI) strategizes towards the final steps of eradication, routine immunization schedules evolve, and high-quality vaccination campaigns and surveillance systems remain essential. New tools are consistently being developed, such as the novel oral poliovirus vaccine to combat outbreaks more sustainably, as well as non-infectiously manufactured vaccines such as virus-like particle vaccines to eliminate the risk of resurgence of polio on the eve of a polio-free world. As the GPEI inches towards eradication, re-strategizing in the face of evolving challenges and preparing for unknown risks in the post-certification era are critical.
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Affiliation(s)
- Rocio Lopez Cavestany
- Polio Eradication, World Health Organization, 1202 Geneva, Switzerland; (M.E.); (O.M.D.); (H.V.); (A.Q.); (O.M.)
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Emanuele CA, Jean Baptiste AE, Chévez AE, Magarinos M, Antelo MV, Arza S, Cain E, Rey-Benito G, Velandia-Gonzalez M, Salas D. Maintaining the Region of the Americas free of polio: best practices for incident management support teams. Rev Panam Salud Publica 2024; 48:e23. [PMID: 38562959 PMCID: PMC10984221 DOI: 10.26633/rpsp.2024.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 01/04/2024] [Indexed: 04/04/2024] Open
Abstract
The Pan American Health Organization (PAHO) and its Member States have been leading the efforts to eradicate wild poliovirus in the Region of Americas since smallpox's successful elimination in 1971. The region became the first to be certified free of wild poliovirus in 1994. However, in July 2022, an unvaccinated patient with no recent travel history was diagnosed with poliomyelitis in the United States of America. In response to the emergence of a circulating vaccine-derived poliovirus in the United States, PAHO established the Polio Incident Management Support Team. This team has been coordinating response efforts, focusing on: coordination, planning, and monitoring; risk communication and community engagement; surveillance and case investigation; vaccination; and rapid response. In this paper, we identified and documented best practices observed following establishment of the Incident Management Support Team (September 2022-2023) through a comprehensive review and analysis of various data sources and country-specific data from the polio surveillance dashboard. The aim was to share these best practices, highlighting technical support and implementation of polio measures by Member States. Despite several challenges, the Americas region remains polio-free. Polio risk is declining, with a July 2023 assessment showing fewer countries at medium, high, and very high risk. This progress reflects improved immunization coverage, surveillance, containment, health determinants, and outbreak preparedness and response. The PAHO Polio Incident Management Support Team has played a key role in supporting these efforts.
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Affiliation(s)
- Carlos A. Emanuele
- Pan American Health OrganizationRegional Office of the World Health OrganizationWashington, D.C.United States of AmericaPan American Health Organization, Regional Office of the World Health Organization, Washington, D.C., United States of America.
| | - Anne E. Jean Baptiste
- Pan American Health OrganizationRegional Office of the World Health OrganizationWashington, D.C.United States of AmericaPan American Health Organization, Regional Office of the World Health Organization, Washington, D.C., United States of America.
| | - Ana E. Chévez
- Pan American Health OrganizationRegional Office of the World Health OrganizationWashington, D.C.United States of AmericaPan American Health Organization, Regional Office of the World Health Organization, Washington, D.C., United States of America.
| | - Mirta Magarinos
- Pan American Health OrganizationRegional Office of the World Health OrganizationWashington, D.C.United States of AmericaPan American Health Organization, Regional Office of the World Health Organization, Washington, D.C., United States of America.
| | - Maite V. Antelo
- Pan American Health OrganizationRegional Office of the World Health OrganizationWashington, D.C.United States of AmericaPan American Health Organization, Regional Office of the World Health Organization, Washington, D.C., United States of America.
| | - Sonia Arza
- Pan American Health OrganizationRegional Office of the World Health OrganizationWashington, D.C.United States of AmericaPan American Health Organization, Regional Office of the World Health Organization, Washington, D.C., United States of America.
| | - Emilia Cain
- Pan American Health OrganizationRegional Office of the World Health OrganizationWashington, D.C.United States of AmericaPan American Health Organization, Regional Office of the World Health Organization, Washington, D.C., United States of America.
| | - Gloria Rey-Benito
- Pan American Health OrganizationRegional Office of the World Health OrganizationWashington, D.C.United States of AmericaPan American Health Organization, Regional Office of the World Health Organization, Washington, D.C., United States of America.
| | - Martha Velandia-Gonzalez
- Pan American Health OrganizationRegional Office of the World Health OrganizationWashington, D.C.United States of AmericaPan American Health Organization, Regional Office of the World Health Organization, Washington, D.C., United States of America.
| | - Daniel Salas
- Pan American Health OrganizationRegional Office of the World Health OrganizationWashington, D.C.United States of AmericaPan American Health Organization, Regional Office of the World Health Organization, Washington, D.C., United States of America.
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Zhao T, Li J, Huang T, Ying ZF, Che YC, Zhao ZM, Fu YT, Tao JH, Yang QH, Wei DK, Li GL, Yi L, Zhao YP, Chen HB, Wang JF, Jiang RJ, Yu L, Cai W, Yang W, Xie MX, Yin QZ, Pu J, Shi L, Hong C, Deng Y, Cai LK, Zhou J, Wen Y, Li HS, Huang W, Mo ZJ, Li CG, Li QH, Yang JS. Immune persistence after different polio sequential immunization schedules in Chinese infants. NPJ Vaccines 2024; 9:50. [PMID: 38424078 PMCID: PMC10904800 DOI: 10.1038/s41541-024-00831-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 02/05/2024] [Indexed: 03/02/2024] Open
Abstract
Trivalent oral poliovirus vaccine (tOPV) has been withdrawn and instead an inactivated poliovirus vaccine (IPV) and bivalent type 1 and type 3 OPV (bOPV) sequential immunization schedule has been implemented since 2016, but no immune persistence data are available for this polio vaccination strategy. This study aimed to assess immune persistence following different polio sequential immunization schedules. Venous blood was collected at 24, 36, and 48 months of age from participants who had completed sequential schedules of combined IPV and OPV in phase III clinical trials. The serum neutralizing antibody titers against poliovirus were determined, and the poliovirus-specific antibody-positive rates were evaluated. A total of 1104 participants were enrolled in this study. The positive rates of poliovirus type 1- and type 3-specific antibodies among the sequential immunization groups showed no significant difference at 24, 36, or 48 months of age. The positive rates of poliovirus type 2-specific antibody in the IPV-IPV-tOPV group at all time points were nearly 100%, which was significantly higher than the corresponding rates in other immunization groups (IPV-bOPV-bOPV and IPV-IPV-bOPV). Immunization schedules involving one or two doses of IPV followed by bOPV failed to maintain a high positive rate for poliovirus type 2-specific antibody.
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Affiliation(s)
- Ting Zhao
- Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, China
| | - Jing Li
- Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, China
| | - Teng Huang
- Guangxi Province Center for Disease Control and Prevention, Nanning, China
| | - Zhi-Fang Ying
- National Institutes for Food and Drug Control, Beijing, China
| | - Yan-Chun Che
- Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, China
| | - Zhi-Mei Zhao
- Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, China
| | - Yu-Ting Fu
- Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, China
| | - Jun-Hui Tao
- Liujiang District Center for Disease Prevention and Control, Liuzhou, China
| | - Qing-Hai Yang
- Liucheng County Center for Disease Prevention and Control, Liuzhou, China
| | - Ding-Kai Wei
- Rongan County Center for Disease Prevention and Control, Liuzhou, China
| | - Guo-Liang Li
- Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, China
| | - Li Yi
- Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, China
| | - Yu-Ping Zhao
- Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, China
| | - Hong-Bo Chen
- Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, China
| | - Jian-Feng Wang
- National Institutes for Food and Drug Control, Beijing, China
| | - Rui-Ju Jiang
- Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, China
| | - Lei Yu
- Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, China
| | - Wei Cai
- Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, China
| | - Wei Yang
- Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, China
| | - Ming-Xue Xie
- Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, China
| | - Qiong-Zhou Yin
- Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, China
| | - Jing Pu
- Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, China
| | - Li Shi
- Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, China
| | - Chao Hong
- Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, China
| | - Yan Deng
- Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, China
| | - Lu-Kui Cai
- Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, China
| | - Jian Zhou
- Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, China
| | - Yu Wen
- Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, China
| | - Hong-Sen Li
- Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, China
| | - Wei Huang
- Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, China
| | - Zhao-Jun Mo
- Guangxi Province Center for Disease Control and Prevention, Nanning, China.
| | - Chang-Gui Li
- National Institutes for Food and Drug Control, Beijing, China.
| | - Qi-Han Li
- Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, China.
| | - Jing-Si Yang
- Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, China.
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Randell M, Sheel M, Dynes M, Li M, Danchin M, Oktarinda, Sukesmi F, Saraswati LD, Tinessia A, Jenkins K, Dewi LA, Saman S, Yosephine P, Leask J, Wahyono TYM. Influence of the COVID-19 pandemic on caregiver beliefs and experiences of routine childhood immunisation in Indonesia. Vaccine 2024; 42:812-818. [PMID: 38220491 DOI: 10.1016/j.vaccine.2024.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 11/03/2023] [Accepted: 01/02/2024] [Indexed: 01/16/2024]
Abstract
The COVID-19 pandemic contributed to significant health services declines in South-East Asia including Indonesia, which experienced a decline in routine immunisation of children. This study investigated the influence of the pandemic on the beliefs and experiences of caregivers of children related to routine immunisation. This study involved a cross-sectional survey among 1399 caregivers of children aged 0-24 months in Central Java and West Nusa Tenggara provinces from March-April 2022. Data on beliefs and experiences of childhood immunizations were captured using core items from the WHO/UNICEF Behavioural and Social Drivers of Immunization (BeSD) survey. Bivariate and multivariate logistic regression analyses identified factors associated with uptake of routine immunisations. While nearly all caregivers (95.7%) reported wanting their child to receive all recommended routine immunisations, only 40.3% of children aged 2-24 months were up-to-date with all vaccines for age. Factors associated with up-to-date included higher parental education (aOR: 1.76, 95% CI 1.02-3.05), higher household income (aOR: 1.54, 95% CI 1.09-2.18), and caregivers who found it moderately or very easy to get immunisations (aOR: 2.26/2.22, 95% CI 1.06-4.83/1.06-4.69). Recovery efforts should prioritise responding to the factors associated with immunisation status (e.g., perceived ease of access) and on families experiencing disadvantage (e.g., caregivers with lower education and household income) to ensure protections against future outbreaks that are responsive to the context-specific needs and priorities of districts and communities.
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Affiliation(s)
- Madeleine Randell
- University of Sydney, School of Public Health, Faculty of Medicine and Health, Sydney, Australia
| | - Meru Sheel
- University of Sydney, School of Public Health, Faculty of Medicine and Health, Sydney, Australia
| | - Michelle Dynes
- UNICEF East Asia & Pacific Regional Office, Bangkok, Thailand
| | - Mu Li
- University of Sydney, School of Public Health, Faculty of Medicine and Health, Sydney, Australia
| | - Margie Danchin
- Murdoch Children's Research Institute, University of Melbourne and Royal Children's Hospital, Melbourne, Australia
| | - Oktarinda
- Universitas Indonesia, Department of Epidemiology, Faculty of Public Health, Depok, Indonesia
| | - Fitriyani Sukesmi
- Universitas Indonesia, Department of Epidemiology, Faculty of Public Health, Depok, Indonesia
| | - Lintang Dian Saraswati
- Universitas Diponegoro, Department of Epidemiology, Faculty of Public Health, Semarang, Indonesia
| | - Adeline Tinessia
- University of Sydney, School of Public Health, Faculty of Medicine and Health, Sydney, Australia
| | - Kylie Jenkins
- University of Sydney, School of Public Health, Faculty of Medicine and Health, Sydney, Australia
| | - Lulu Ariyantheny Dewi
- Republic of Indonesia Ministry of Health, Directorate of Immunization, Jakarta, Indonesia
| | | | - Prima Yosephine
- Republic of Indonesia Ministry of Health, Directorate of Immunization, Jakarta, Indonesia
| | - Julie Leask
- University of Sydney, School of Public Health, Faculty of Medicine and Health, Sydney, Australia.
| | - Tri Yunis Miko Wahyono
- Universitas Indonesia, Department of Epidemiology, Faculty of Public Health, Depok, Indonesia
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Patikorn C, Kategeaw W, Perdrizet J, Li X, Chaiyakunapruk N. Implementation challenges and real-world impacts of switching pediatric vaccines: A global systematic literature review. Hum Vaccin Immunother 2023; 19:2177459. [PMID: 36880656 PMCID: PMC10026932 DOI: 10.1080/21645515.2023.2177459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
Abstract
Switching a vaccine for another on a pediatric national immunization program is often done for the betterment of society. However, if poorly implemented, switching vaccines could result in suboptimal transitions with negative effects. A systematic review was conducted to evaluate the existing knowledge from identifiable documents on implementation challenges of pediatric vaccine switches and the real-world impact of those challenges. Thirty-three studies met the inclusion criteria. We synthesized three themes: vaccine availability, vaccination program deployment, and vaccine acceptability. Switching pediatric vaccines can pose unforeseen challenges to health-care systems worldwide and additional resources are often required to overcome those challenges. Yet, the magnitude of the impact, especially economic and societal, was frequently under-researched with variability in reporting. Therefore, an efficient vaccine switch requires a thorough consideration of the added benefits of replacing the existing vaccine, preparation, planning, additional resource allocation, implementation timing, public-private partnerships, outreach campaigns, and surveillance for program evaluation.
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Affiliation(s)
- Chanthawat Patikorn
- Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, UT, USA
- Department of Social and Administrative Pharmacy, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Warittakorn Kategeaw
- Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, UT, USA
| | - Johnna Perdrizet
- Global Health Economics and Outcomes Research, Pfizer Inc, New York, NY, USA
| | - Xiuyan Li
- Global Health Economics and Outcomes Research, Pfizer Inc, New York, NY, USA
| | - Nathorn Chaiyakunapruk
- Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, UT, USA
- IDEAS Center, Veterans Affairs Salt Lake City Healthcare System, Salt Lake City, UT, USA
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Sowe A, Namatovu F, Cham B, Gustafsson PE. Missed opportunities for vaccination at point of care and their impact on coverage and urban-rural coverage inequity in the Gambia. Vaccine 2023; 41:7647-7654. [PMID: 37996292 DOI: 10.1016/j.vaccine.2023.11.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 11/07/2023] [Accepted: 11/18/2023] [Indexed: 11/25/2023]
Abstract
INTRODUCTION Identifying actionable targets is crucial to improve overall and equity in vaccination coverage, and in line with the global Immunization Agenda 2030. Therefore, this study seeks to assess the prevalence of missed opportunities for simultaneous vaccination (MOSVs) and their impact on vaccination coverage and urban-rural inequity in The Gambia. METHODS We used data of children aged 12-23 months from The Gambia 2019/2020 demographic and health survey (weighted n = 1355) with seen vaccination cards. We analyzed: the frequency of MOSVs; percentage point coverage reduction attributable to MOSVs for 18 vaccine doses and full basic vaccination; and MOSVs' contribution to urban-rural coverage inequity through Blinder-Oaxaca decomposition. RESULTS Sixty percent of children experienced MOSVs, in both urban and rural areas, but urban MOSVs were more seldom corrected (35.9 % vs 45.3 %). All eighteen vaccine doses assessed could have achieved between one to eleven percentage points higher coverage if MOSVs had been avoided, with full basic vaccination gaining even more. While MOSV correction did not impact overall urban-rural coverage inequity, it did exacerbate (explained coefficient = -0.1007; P = 0.002) inequities among children who experienced MOSVs, explaining 95 % of the observed difference. CONCLUSION Our study highlights the prevalence and negative impact of MOSVs on overall vaccination coverage. Although MOSVs did not contribute significantly to the total urban-rural inequity in coverage, they have detrimental effects on vaccination coverage and urban-rural inequity among children who had experienced MOSVs. Addressing MOSVs, can enhance coverage and reduce the risk of under-vaccination, aligning with global initiatives.
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Affiliation(s)
- Alieu Sowe
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden; Expanded Program on Immunization, Ministry of Health, Banjul, the Gambia.
| | - Fredinah Namatovu
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Bai Cham
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Bakau, the Gambia; School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Per E Gustafsson
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
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Itoh E, Shimizu S, Ami Y, Iwase Y, Someya Y. Dose-sparing effect of Sabin-derived inactivated polio vaccine produced in Japan by intradermal injection device for rats. Biologicals 2023; 82:101677. [PMID: 37031619 DOI: 10.1016/j.biologicals.2023.101677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 03/01/2023] [Accepted: 03/29/2023] [Indexed: 04/11/2023] Open
Abstract
The live-attenuated oral polio vaccine has long been used as the standard for polio prevention, but in order to minimize the emergence of pathogenic revertants, the inactivated polio vaccine (IPV), which is administered intramuscularly or subcutaneously, is being increasingly demanded worldwide. However, there is a global shortage of IPV, and its cost is an obstacle in developing countries. Therefore, dose-sparing with intradermal administration of IPV has been investigated. In this study, rats were immunized by intradermal (ID) and intramuscular (IM) administration of Sabin-derived inactivated polio vaccine (sIPV) produced in Japan, and the immune responses were evaluated. The results showed that one-fifth (1/5)-dose of ID administration yielded neutralizing antibody titers comparable to the full-dose IM administration, whereas 1/5-dose of IM administration was less effective than the full dose. Furthermore, a vertical puncture-type ID injection device (Immucise) that was originally developed for humans was modified for rats, resulting in successful and stable ID administration into the thin skin of rats. Based on these results, the ID administration of sIPV using Immucise in clinical use is expected to offer benefits such as reduced amounts of vaccine per dose, cost-effectiveness, and thereby the feasibility of vaccination for more people.
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Affiliation(s)
- Eriko Itoh
- R&D, Pharmaceutical Solutions Division, Medical Care Solutions Company, TERUMO CORPORATION, Japan
| | - Sakiko Shimizu
- R&D, Pharmaceutical Solutions Division, Medical Care Solutions Company, TERUMO CORPORATION, Japan
| | - Yasushi Ami
- Management Department of Biosafety, Laboratory Animal, and Pathogen Bank, National Institute of Infectious Diseases, Japan
| | - Yoichiro Iwase
- R&D, Pharmaceutical Solutions Division, Medical Care Solutions Company, TERUMO CORPORATION, Japan.
| | - Yuichi Someya
- Department of Virology II, National Institute of Infectious Diseases, Japan.
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Mei R, Kwok SLL, Lau EHY, Lo THK, Wu JT, Lin L, Leung K. Battle of Polio eradication in the Western Pacific Region in the transition to COVID-19 endemicity. J Infect 2023; 86:629-631. [PMID: 36822410 PMCID: PMC9942451 DOI: 10.1016/j.jinf.2023.02.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 02/17/2023] [Indexed: 02/25/2023]
Affiliation(s)
- Ruobing Mei
- Laboratory of Data Discovery for Health Limited (D(2)4H), Hong Kong Science Park, Hong Kong Special Administrative Region of China; WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Shirley L L Kwok
- Laboratory of Data Discovery for Health Limited (D(2)4H), Hong Kong Science Park, Hong Kong Special Administrative Region of China; WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Eric H Y Lau
- Laboratory of Data Discovery for Health Limited (D(2)4H), Hong Kong Science Park, Hong Kong Special Administrative Region of China; WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Tiffany H K Lo
- Laboratory of Data Discovery for Health Limited (D(2)4H), Hong Kong Science Park, Hong Kong Special Administrative Region of China; WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Joseph T Wu
- Laboratory of Data Discovery for Health Limited (D(2)4H), Hong Kong Science Park, Hong Kong Special Administrative Region of China; WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region of China; The University of Hong Kong - Shenzhen Hospital, Shenzhen, China
| | - Leesa Lin
- Laboratory of Data Discovery for Health Limited (D(2)4H), Hong Kong Science Park, Hong Kong Special Administrative Region of China; WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region of China; Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.
| | - Kathy Leung
- Laboratory of Data Discovery for Health Limited (D(2)4H), Hong Kong Science Park, Hong Kong Special Administrative Region of China; WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region of China; The University of Hong Kong - Shenzhen Hospital, Shenzhen, China.
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9
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Batson A, Glassman A, Federgruen A, Diment J, Ganguly NK, Makoni S, Plotkin S. The world needs to prepare now to prevent polio resurgence post eradication. BMJ Glob Health 2022; 7:bmjgh-2022-011485. [PMID: 36581335 PMCID: PMC9806073 DOI: 10.1136/bmjgh-2022-011485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 12/10/2022] [Indexed: 12/31/2022] Open
Affiliation(s)
- Amie Batson
- Executive Director, WomenLift Health, Seattle, Washington, USA
| | - Amanda Glassman
- Executive Vice President, Center for Global Development, Washington, DC, USA
| | - Awi Federgruen
- Chair of the Decision, Risk, and Operations (DRO) Division, Columbia University, New York, New York, USA
| | - Judith Diment
- Coordinator of Polio Eradication Advocacy Task Force, UK National Advocacy Adviser for Polio, Rotary International, London, UK
| | - Nirmal Kumar Ganguly
- Former Director General, Indian Council of Medical Research (ICMR), Delhi, India
| | - Simba Makoni
- Former Minister, Ministry of Finance and Economic Development, Harare, Zimbabwe
| | - Stanley Plotkin
- Emeritus Professor at the Wistar Institute, Vaccinologist, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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10
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Suarez-Zuluaga DA, van der Pol LA, van 't Oever AG, Bakker WA, Thomassen YE. Development of an animal component free production process for Sabin inactivated polio vaccine. Vaccine X 2022; 12:100223. [PMID: 36217423 PMCID: PMC9547281 DOI: 10.1016/j.jvacx.2022.100223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 09/16/2022] [Accepted: 09/28/2022] [Indexed: 11/15/2022] Open
Abstract
Inactivated polio vaccine production using attenuated Sabin strains (sIPV) instead of wild type polio viruses (cIPV) is an initiative encouraged by the World Health Organization. This use of attenuated viruses is preferred as it reduces risks related to potential outbreaks during IPV production. Previously, an sIPV production process was set up based on the cIPV production process. Optimizing this process while using only animal component free (ACF) substances allows reduction of operational costs and mitigates risks of adverse effects related with animal derived compounds. Here, development of a process for production of sIPV using only ACF compounds, is described. The upstream process required a change in cell growth medium from serum-containing medium to ACF medium, while virus production media remained the same as the already used M199 medium was free of animal components. In the downstream process multiple modifications in existing unit operations were made including addition of a diafiltration step prior to inactivation. After optimizing each unit operation, robustness of the whole process was demonstrated using design of experiments (DoE) methodology. By using DoE we were able to vary different process parameters across unit operations to assess the impact on our quality attributes. The developed process was robust as the observed variation for quality attributes due to differences in process parameters remained within specification. The resulting pilot process showed not only to be robust, but also to have a considerable higher product yield when compared to the serum containing sIPV process. Product yields are now comparable to the cIPV process based on using wild type polio viruses. Moreover, the potency of the produced vaccine was comparable that of cIPV vaccine. The developed ACF sIPV process can be transferred to vaccine manufacturers at the end-of pre-clinical development phase, at lab- or pilot scale, before production of clinical trial material.
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11
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Huyen DTT, Anh DD, Trung NT, Hong DT, Thanh TT, Truong LN, Jeyaseelan V, Lopez Cavestany R, Hendley WS, Mainou BA, Mach O. Inactivated Poliovirus Vaccine Closing the Type 2 Immunity Gap in Vietnam. J Pediatric Infect Dis Soc 2022; 11:413-416. [PMID: 35801634 PMCID: PMC9520283 DOI: 10.1093/jpids/piac046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 05/26/2022] [Indexed: 11/13/2022]
Abstract
This was a cross-sectional community-based serological survey of polio antibodies assessing the immunogenicity of inactivated poliovirus vaccine (IPV) focusing on poliovirus serotype 2. IPV was administered to 5-month-old children. Type 2 antibody seroprevalence when measured 1 month after IPV administration was >95%. One IPV dose successfully closed the immunity gap.
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Affiliation(s)
- Dang Thi Thanh Huyen
- Expanded Program on Immunizations Department, National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Dang Duc Anh
- Expanded Program on Immunizations Department, National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Nguyen Thanh Trung
- Expanded Program on Immunizations Department, National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Duong Thi Hong
- Expanded Program on Immunizations Department, National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Tran Trung Thanh
- Expanded Program on Immunizations Department, National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | | | | | | | - William S Hendley
- CNA, Contracting Agency to the Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Bernardo A Mainou
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Ondrej Mach
- Corresponding Author: Ondrej Mach, MD MPH, Polio Department, World Health Organization, Appia 20, 1201 Genève, Switzerland; Telephone: +41227911863. E-mail:
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Miranda-García MA, Hoffelner M, Stoll H, Ruhaltinger D, Cichutek K, Siedler A, Bekeredjian-Ding I. A 5-year look-back at the notification and management of vaccine supply shortages in Germany. EURO SURVEILLANCE : BULLETIN EUROPEEN SUR LES MALADIES TRANSMISSIBLES = EUROPEAN COMMUNICABLE DISEASE BULLETIN 2022; 27. [PMID: 35485267 PMCID: PMC9052770 DOI: 10.2807/1560-7917.es.2022.27.17.2100167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BackgroundUnavailability of vaccines endangers the overall goal to protect individuals and whole populations against infections.MethodsThe German notification system includes the publication of vaccine supply shortages reported by marketing authorisation holders (MAH), information on the availability of alternative vaccine products, guidance for physicians providing vaccinations and an unavailability reporting tool to monitor regional distribution issues.AimThis study provides a retrospective analysis of supply issues and measures in the context of European and global vaccine supply constraints.Resultsbetween October 2015 and December 2020, the 250 notifications concerned all types of vaccines (54 products). Most shortages were caused by increased demand associated with immigration in Germany in 2015 and 2016, new or extended vaccine recommendations, increased awareness, or changes in global immunisation programmes. Shortages of a duration up to 30 days were mitigated using existing storage capacities. Longer shortages, triggered by high demand on a national level, were mitigated using alternative products and re-allocation; in a few cases, vaccines were imported. However, for long lasting supply shortages associated with increased global demand, often occurring in combination with manufacturing issues, few compensatory mechanisms were available. Nevertheless, only few critical incidents were identified: (i) shortage of hexavalent vaccines endangering neonatal immunisation programmes in 2015;(ii) distribution issues with influenza vaccines in 2018; and (iii) unmet demand for pneumococcal and influenza vaccines during the coronavirus disease (COVID)-19 pandemic.ConclusionVaccine product shortages in Germany resemble those present in neighbouring EU states and often reflect increased global demand not matched by manufacturing capacities.
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Affiliation(s)
| | | | | | | | | | - Anette Siedler
- Robert-Koch-Institut, Department for Infectious Disease Epidemiology, Berlin, Germany
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13
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Cooper LV, Bandyopadhyay AS, Gumede N, Mach O, Mkanda P, Ndoutabé M, Okiror SO, Ramirez-Gonzalez A, Touray K, Wanyoike S, Grassly NC, Blake IM. Risk factors for the spread of vaccine-derived type 2 polioviruses after global withdrawal of trivalent oral poliovirus vaccine and the effects of outbreak responses with monovalent vaccine: a retrospective analysis of surveillance data for 51 countries in Africa. THE LANCET. INFECTIOUS DISEASES 2022; 22:284-294. [PMID: 34648733 PMCID: PMC8799632 DOI: 10.1016/s1473-3099(21)00453-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 07/07/2021] [Accepted: 07/20/2021] [Indexed: 01/12/2023]
Abstract
BACKGROUND Expanding outbreaks of circulating vaccine-derived type 2 poliovirus (cVDPV2) across Africa after the global withdrawal of trivalent oral poliovirus vaccine (OPV) in 2016 are delaying global polio eradication. We aimed to assess the effect of outbreak response campaigns with monovalent type 2 OPV (mOPV2) and the addition of inactivated poliovirus vaccine (IPV) to routine immunisation. METHODS We used vaccination history data from children under 5 years old with non-polio acute flaccid paralysis from a routine surveillance database (the Polio Information System) and setting-specific OPV immunogenicity data from the literature to estimate OPV-induced and IPV-induced population immunity against type 2 poliomyelitis between Jan 1, 2015, and June 30, 2020, for 51 countries in Africa. We investigated risk factors for reported cVDPV2 poliomyelitis including population immunity, outbreak response activities, and correlates of poliovirus transmission using logistic regression. We used the model to estimate cVDPV2 risk for each 6-month period between Jan 1, 2016, and June 30, 2020, with different numbers of mOPV2 campaigns and compared the timing and location of actual mOPV2 campaigns and the number of mOPV2 campaigns required to reduce cVDPV2 risk to low levels. FINDINGS Type 2 OPV immunity among children under 5 years declined from a median of 87% (IQR 81-93) in January-June, 2016 to 14% (9-37) in January-June, 2020. Type 2 immunity from IPV among children under 5 years increased from 3% (<1-6%) in January-June, 2016 to 35% (24-47) in January-June, 2020. The probability of cVDPV2 poliomyelitis among children under 5 years was negatively correlated with OPV-induced and IPV-induced immunity and mOPV2 campaigns (adjusted odds ratio: OPV 0·68 [95% CrI 0·60-0·76], IPV 0·82 [0·68-0·99] per 10% absolute increase in estimated population immunity, mOPV2 0·30 [0·20-0·44] per campaign). Vaccination campaigns in response to cVDPV2 outbreaks have been smaller and slower than our model shows would be necessary to reduce risk to low levels, covering only 11% of children under 5 years who are predicted to be at risk within 6 months and only 56% within 12 months. INTERPRETATION Our findings suggest that as mucosal immunity declines, larger or faster responses with vaccination campaigns using type 2-containing OPV will be required to stop cVDPV2 transmission. IPV-induced immunity also has an important role in reducing the burden of cVDPV2 poliomyelitis in Africa. FUNDING Bill & Melinda Gates Foundation, Medical Research Council Centre for Global Infectious Disease Analysis, and WHO. TRANSLATION For the French translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Laura V Cooper
- Medical Research Council Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London, UK,Correspondence to: Dr Laura V Cooper, Medical Research Council Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London W2 1PG, UK
| | | | - Nicksy Gumede
- Regional Office for Africa, World Health Organization, Brazzaville, Republic of Congo
| | - Ondrej Mach
- Polio Eradication Department, World Health Organization, Geneva, Switzerland
| | - Pascal Mkanda
- Regional Office for Africa, World Health Organization, Brazzaville, Republic of Congo
| | - Modjirom Ndoutabé
- Regional Office for Africa, World Health Organization, Brazzaville, Republic of Congo
| | - Samuel O Okiror
- Regional Office for Africa, World Health Organization, Brazzaville, Republic of Congo
| | - Alejandro Ramirez-Gonzalez
- Expanded Programme on Immunization, Vaccines, and Biologicals Department, World Health Organization, Geneva, Switzerland
| | - Kebba Touray
- Regional Office for Africa, World Health Organization, Brazzaville, Republic of Congo
| | - Sarah Wanyoike
- Regional Office for Africa, World Health Organization, Brazzaville, Republic of Congo
| | - Nicholas C Grassly
- Medical Research Council Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London, UK
| | - Isobel M Blake
- Medical Research Council Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London, UK
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14
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Batson A, Federgruen A, Ganguly NK, Glassman A, Makoni S, Plotkin S. Polio eradication vaccine investment: how do we ensure polio vaccines are available to keep the world polio-free after transmission of wild poliovirus (wPV) has been interrupted? BMJ Glob Health 2021; 6:e006447. [PMID: 34810205 PMCID: PMC8609932 DOI: 10.1136/bmjgh-2021-006447] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 10/25/2021] [Indexed: 11/25/2022] Open
Affiliation(s)
- Amie Batson
- Global health strategist/expert; Former Chief Strategy Officer and Vice President of Applied Analytics and Learning, PATH, Seattle, Washington DC, USA
| | - Awi Federgruen
- Chair of the Decision, Risk, and Operations (DRO) Division, Columbia University & Graduate School of Business, Columbia University, New York, New York, USA
| | - Nirmal Kumar Ganguly
- Honorary Senior Research Professor, Institute of Liver and Biliary Sciences, New Delhi, India
- Former Director General, Indian Council of Medical Research (ICMR), New Delhi, India
| | - Amanda Glassman
- Executive Vice President & Senior Fellow, Center for Global Development (CGD), Washington, DC, USA
| | - Simba Makoni
- Former Executive Secretary, Southern African Development Community, Gaborone, Botswana
| | - Stanley Plotkin
- University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Wistar Institute, Philadelphia, Pennsylvania, USA
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15
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Chu K, Han W, Jiang D, Jiang Z, Zhu T, Xu W, Hu Y, Zeng G. Cross-neutralization Capacity of Immune Serum from Different Dosage of Sabin Inactivated Poliovirus Vaccine Immunization against Multiple Individual Polioviruses. Expert Rev Vaccines 2021; 20:761-767. [PMID: 33861679 DOI: 10.1080/14760584.2021.1919091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Introduction: Sabin strain inactivated poliovirus vaccine (sIPV) developed by Sinovac Biotech Co., Ltd., has shown good safety and immunogenicity against parental strains among infants in several finished pre-licensure clinical trials.Areas covered: To further study the neutralizing capacity of investigational sIPV immune serum against Sabin, Salk and recently circulating poliovirus strains, neutralization assay against ten individual strains was performed on backup serum collected from 250 infant participants of the finished phase II clinical trial.Expert commentary:: The sIPV can generate good immunogenicity against Sabin, Salk and recently circulating poliovirus strains. Taking into account its lower containment requirements and financial costs compared with the conventional Salk strain inactivated poliovirus vaccine, sIPV is an affordable and practical option for polio eradication.
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Affiliation(s)
- Kai Chu
- Department of Vaccine Evaluation, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Weixiao Han
- Clinical Research Department, Sinovac Biotech Co., Ltd., Beijing, China
| | - Deyu Jiang
- Center for Research & Department, Sinovac Biotech Co., Ltd.,Beijing, China
| | - Zhiwei Jiang
- Statistics department, Beijing Key Tech Statistic Technology Co., Ltd, Beijing
| | - Taotao Zhu
- Clinical Research Department,Sinovac Biotech Co., Ltd., Beijing China
| | - Wenbo Xu
- WHO WPRO Regional Reference Measles/Rubella Laboratory, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yuemei Hu
- Department of Vaccine Evaluation, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Gang Zeng
- Clinical Research Department, Sinovac Biotech Co., Ltd., Beijing, China
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16
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Zhao T, Li J, Shi H, Ye H, Ma R, Fu Y, Liu X, Li G, Yang X, Zhao Z, Yang J. Reduced mucosal immunity to poliovirus after cessation of trivalent oral polio vaccine. Hum Vaccin Immunother 2021; 17:2560-2567. [PMID: 33848232 PMCID: PMC8475588 DOI: 10.1080/21645515.2021.1911213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The switch from using only trivalent oral polio vaccine (tOPV) to sequential schedules combining inactivated poliovirus vaccine (IPV) and bivalent oral polio vaccine (bOPV) for polio vaccination will cause changes to mucosal immunity against polio in infants, which plays an important role in preventing the poliovirus spread. Here, we analyzed mucosal immunity against poliovirus in the intestine during different sequential vaccination schedules. We conducted clinical trials in Guangxi Province, China on 1,200 2-month-old infants who were randomly assigned to one of three vaccination schedule groups: IPV-bOPV-bOPV, IPV-IPV-tOPV, and IPV-IPV-bOPV, with vaccine doses administered at 8, 12, and 16 weeks of age. Stool samples were collected from 10% of participants in each group before administration of the second vaccine doses and at 1, 2, and 4 weeks after the administrations of the second and third vaccine doses. Immunoglobulin A (IgA) in the stool samples was measured to analyze the mucosal immune response in the intestine. Because of the absence of poliovirus type 2 in bOPV, the vaccination schedule of IPV-IPV-bOPV did not sufficiently raise intestinal mucosal immunity against poliovirus type 2, although some cross-immunity was seen. The level of intestinal mucosal immunity was related to shedding status; shedders could produce intestinal mucosa IgA more quickly. The intestinal mucosal immunity level was not related to serum neutralizing antibody level. In the combined sequential vaccination schedule of IPV and bOPV, the risk of circulating vaccine-derived poliovirus type 2 (cVDPV2) may be increased owing to insufficient intestinal mucosal immunity against poliovirus type 2.
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Affiliation(s)
- Ting Zhao
- Yunnan Key Laboratory of Vaccine Research & Development on Severe Infectious Disease, Institute of Medical Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Kunming, China
| | - Jing Li
- Yunnan Key Laboratory of Vaccine Research & Development on Severe Infectious Disease, Institute of Medical Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Kunming, China
| | - Hongyuan Shi
- Yunnan Key Laboratory of Vaccine Research & Development on Severe Infectious Disease, Institute of Medical Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Kunming, China
| | - Hui Ye
- Hangzhou Women's Hospital Hangzhou Maternity and Child Health Care Hospital, Hangzhou, China
| | - Rufei Ma
- Yunnan Key Laboratory of Vaccine Research & Development on Severe Infectious Disease, Institute of Medical Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Kunming, China
| | - Yuting Fu
- Yunnan Key Laboratory of Vaccine Research & Development on Severe Infectious Disease, Institute of Medical Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Kunming, China
| | - Xiaochang Liu
- Tianjin Centers for Disease Control and Prevention, Tianjin, China
| | - Guoliang Li
- Yunnan Key Laboratory of Vaccine Research & Development on Severe Infectious Disease, Institute of Medical Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Kunming, China
| | - Xiaolei Yang
- Yunnan Key Laboratory of Vaccine Research & Development on Severe Infectious Disease, Institute of Medical Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Kunming, China
| | - Zhimei Zhao
- Yunnan Key Laboratory of Vaccine Research & Development on Severe Infectious Disease, Institute of Medical Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Kunming, China
| | - Jingsi Yang
- Yunnan Key Laboratory of Vaccine Research & Development on Severe Infectious Disease, Institute of Medical Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Kunming, China
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17
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Cochi SL, Pallansch MA. The Long and Winding Road to Eradicate Vaccine-Related Polioviruses. J Infect Dis 2021; 223:7-9. [PMID: 32621744 PMCID: PMC10546420 DOI: 10.1093/infdis/jiaa393] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 06/25/2020] [Indexed: 11/13/2022] Open
Affiliation(s)
- Stephen L. Cochi
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Mark A. Pallansch
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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18
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Hettinga J, Carlisle R. Vaccination into the Dermal Compartment: Techniques, Challenges, and Prospects. Vaccines (Basel) 2020; 8:E534. [PMID: 32947966 PMCID: PMC7564253 DOI: 10.3390/vaccines8030534] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 09/08/2020] [Accepted: 09/09/2020] [Indexed: 01/06/2023] Open
Abstract
In 2019, an 'influenza pandemic' and 'vaccine hesitancy' were listed as two of the top 10 challenges to global health by the WHO. The skin is a unique vaccination site, due to its immune-rich milieu, which is evolutionarily primed to respond to challenge, and its ability to induce both humoral and cellular immunity. Vaccination into this dermal compartment offers a way of addressing both of the challenges presented by the WHO, as well as opening up avenues for novel vaccine formulation and dose-sparing strategies to enter the clinic. This review will provide an overview of the diverse range of vaccination techniques available to target the dermal compartment, as well as their current state, challenges, and prospects, and touch upon the formulations that have been developed to maximally benefit from these new techniques. These include needle and syringe techniques, microneedles, DNA tattooing, jet and ballistic delivery, and skin permeabilization techniques, including thermal ablation, chemical enhancers, ablation, electroporation, iontophoresis, and sonophoresis.
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Affiliation(s)
| | - Robert Carlisle
- Department of Engineering Science, Institute of Biomedical Engineering, University of Oxford, Oxford OX3 7DQ, UK;
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Verani JFDS, Laender F. A erradicação da poliomielite em quatro tempos. CAD SAUDE PUBLICA 2020; 36Suppl 2:e00145720. [DOI: 10.1590/0102-311x00145720] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 09/08/2020] [Indexed: 11/21/2022] Open
Abstract
O objetivo deste artigo é rever o “estado da arte” dos avanços, obstáculos e estratégias para atingir a erradicação global da pólio. As ações de controle da poliomielite iniciaram na década de 1960 com o advento das duas vacinas antipoliomielíticas, a vacina oral da pólio (VOP) e a vacina inativada da pólio (VIP). No período de 1985 a 2020, são implementadas estratégias para atingir a meta de erradicação do poliovírus selvagem (WPV). Após o sucesso da interrupção da transmissão autóctone do WPV na região da Américas, foi lançada a meta da erradicação global. Descrevemos o processo de erradicação em quatro tempos: (1) O advento das vacinas VIP e VOP iniciou a era do controle da poliomielite; (2) A utilização massiva e simultânea da VOP teve impacto significativo sobre a transmissão do poliovírus selvagem no final da década de 1970 no Brasil; (3) Políticas públicas (nacionais e internacionais) decidem pela erradicação da transmissão autóctone do poliovírus selvagem nas Américas e definem as estratégias epidemiológicas para interromper a transmissão; e (4) A implantação das estratégias de erradicação interrompeu a transmissão autóctone do WPV em quase todas as regiões do mundo, exceto no Paquistão e Afeganistão, onde, em 2020, cadeias de transmissão do WPV1 desafiam as estratégias de contenção do vírus. Por outro lado, a persistência e a disseminação da circulação do poliovírus derivado da VOP, em países com baixa cobertura vacinal, somadas às dificuldades para substituir a VOP pela VIP constituem, atualmente, os obstáculos para a erradicação a curto prazo. Finalmente, discutimos as estratégias para superar os obstáculos e os desafios na era pós-erradicação.
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20
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Hu Y, Xu K, Han W, Chu K, Jiang D, Wang J, Tian X, Ying Z, Zhang Y, Li C, Zhu F. Safety and Immunogenicity of Sabin Strain Inactivated Poliovirus Vaccine Compared With Salk Strain Inactivated Poliovirus Vaccine, in Different Sequential Schedules With Bivalent Oral Poliovirus Vaccine: Randomized Controlled Noninferiority Clinical Trials in China. Open Forum Infect Dis 2019; 6:ofz380. [PMID: 31660344 PMCID: PMC6786509 DOI: 10.1093/ofid/ofz380] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Accepted: 08/23/2019] [Indexed: 11/16/2022] Open
Abstract
Background A new Sabin strain inactivated poliovirus vaccine (sIPV) proved to be immunogenic and safe in all IPV primary immunization in the previous study, with the corresponding profiles in sequential immunizations unclear. Methods Two clinical trials on the “IPV + 2 bivalent oral polio vaccine (2bOPV)” (Trial A) and “2IPV + bOPV” (Trial B) vaccination were conducted. Both clinical trials were randomized, controlled, double-blinded, noninferiority trials, and wild-strain IPV (wIPV) was adopted as the control vaccine. In each clinical trial, 240 healthy infants were enrolled and randomly assigned to receive sequential vaccinations containing sIPV or wIPV. Immunogenicity and safety were assessed using per-protocol and safety populations, respectively. Results For Trial A, the seroconversion rates in the experimental and control groups were 100% and 99.1%, respectively, against type 1; both 100.0% against type 3. For Trial B, the seroconversion rates in experimental and control groups were 99.2% and 100.0%, respectively, against type 1; both 100% against type 3. No serious adverse events related to vaccines were reported. Conclusions The new sIPV demonstrated an immunogenicity noninferior to that of the wIPV and a good safety profile in sequential vaccination with bOPV. Clinical trial numbers NCT:03822754; NCT:03822767.
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Affiliation(s)
- Yuemei Hu
- Department of Vaccine Evaluation, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Kangwei Xu
- Department of Vaccine Evaluation, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China.,Division of Respiratory Virus Vaccines, National Institute for Food and Drug Control, Beijing, China.,Department of Clinical Research, Sinovac Biotech Co., Ltd., Beijing, China.,Center of Research & Development, Sinovac Biotech Co., Ltd., Beijing, China.,Project Management Center, Sinovac Biotech Co., Ltd., Beijing, China.,Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Weixiao Han
- Department of Clinical Research, Sinovac Biotech Co., Ltd., Beijing, China
| | - Kai Chu
- Department of Vaccine Evaluation, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Deyu Jiang
- Center of Research & Development, Sinovac Biotech Co., Ltd., Beijing, China
| | - Jianfeng Wang
- Division of Respiratory Virus Vaccines, National Institute for Food and Drug Control, Beijing, China
| | - Xiaohui Tian
- Department of Clinical Research, Sinovac Biotech Co., Ltd., Beijing, China
| | - Zhifang Ying
- Division of Respiratory Virus Vaccines, National Institute for Food and Drug Control, Beijing, China
| | - Ying Zhang
- Project Management Center, Sinovac Biotech Co., Ltd., Beijing, China
| | - Changgui Li
- Division of Respiratory Virus Vaccines, National Institute for Food and Drug Control, Beijing, China
| | - Fengcai Zhu
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
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