Latest articles about polio Routine vaccines: Polio
More than 112 million children immunised with Gavi support by the end of 2018
The Vaccine Alliance worked with the Global Polio Eradication Initiative (GPEI) to support one of the fastest roll-outs in the history of vaccination: the introduction of at least one dose of inactivated polio vaccine (IPV) into the routine immunisation schedules of all Gavi-supported countries. As of April 2019, all countries which had not yet introduced IPV into their routine immunisation programme have now done so.
Nepal became the first country to introduce the vaccine with Gavi support in September 2014 – just 10 months after the programme was initiated. With Mongolia and Zimbabwe’s introduction of IPV on 1 April 2019, all Gavi supported countries had successfully completed their introductions, collectively immunising more than 112 million children.
IPV coverage in Gavi-supported countries increased more than fivefold from just 13% in 2015 to 66% in 2018. With 16 countries having introduced since 2018, coverage is expected to increase and reach levels closer to DTP3 (ie, third dose of diphtheria, tetanus and pertussis vaccines, which is given at the same time as IPV).
GLOBAL POLIO ERADICATION EFFORTS
When the Global Polio Eradication Initiative (GPEI) was launched in 1988, polio was endemic in 125 countries and paralysed about 1,000 children per day. Thanks to global efforts and vaccination, polio cases have fallen by 99% since then, from an estimated 350,000 cases per year to 33 reported cases in 2018. In 2019, that number has tripled – with more than 100 reported cases and counting – underlining the challenges ahead to eradicate polio in the two remaining endemic countries.
Today, more than 18 million people are walking who would otherwise have been paralysed by the poliovirus. Only parts of three countries – Afghanistan, Nigeria and Pakistan – remain polio-endemic – and Nigeria has not reported a case of wild poliovirus (WPV) for more than three years. In 2018, Gavi was invited to join the GPEI as a full member and since then is participating in its governing bodies.
PHASED REMOVAL OF ORAL POLIO VACCINES
To eliminate the primary risk of emergence of all types of vaccine-derived polio cases, the Polio Eradication and Endgame Strategic Plan (PEESP) called for the phased removal of current Sabin-strain oral polio vaccine (OPV) – a critical and necessary step towards polio eradication. It’s important to clarify that the risk is not associated with the vaccine itself but rather low vaccination coverage. If a population is fully immunised, they will be protected against both vaccine-derived and wild polioviruses.
The process started in April 2016 with the “global switch” – the replacement of trivalent OPV (containing type 2 virus) with bivalent OPV (comprising poliovirus types 1 and 3 only). To minimise the risks associated with the switch, WHO recommended that all countries introduce at least one dose of IPV into their routine immunisation schedule before the transition. IPV provides protection against all three poliovirus types.
The World Health Organization (WHO) Strategic Advisory Group of Experts (SAGE) on Immunization also recommends that countries consider vaccinating children who were missed due to global supply constraints of IPV since the switch, as they are currently not protected against poliovirus type 2. Gavi supports countries that decide to implement these recommendations.
THE PRICE OF POLIO PROTECTION
For the tender period 2019–2022, the IPV price per dose has increased compared with the previous period (2014–2018). This means that Gavi funds $1.81 per dose in Gavi-supported countries, whereas middle-income countries are able to buy the vaccine through UNICEF for between $3.10 and $3.47 per dose. However, UNICEF anticipates lower prices from new manufacturers entering the market and potentially price reductions from current suppliers.