Updated characterization of poliovirus transmission in Pakistan and Afghanistan and the impacts of different outbreak response vaccine options

Details

• Alternative Title:
  J Infect Dis
• Personal Author:
  Kalkowska, Dominika A ; Pallansch, Mark A ; Cochi, Stephen L ; Thompson, Kimberly M
• Description:
  Background
  
  Pakistan and Afghanistan remain the only reservoirs of wild poliovirus transmission. Prior modeling suggested that before the COVID-19 pandemic, plans to stop the transmission of serotype 1 wild poliovirus (WPV1) and persistent serotype 2 circulating vaccine-derived poliovirus (cVDPV2) did not appear on track to succeed.
  
  Methods
  
  We updated an existing poliovirus transmission and Sabin-strain oral poliovirus vaccine (OPV) evolution model for Pakistan and Afghanistan to characterize the impacts of immunization disruptions and restrictions on human interactions (i.e., population mixing) due to the COVID-19 pandemic. We also consider different options for responding to outbreaks and for preventive supplementary immunization activities (SIAs).
  
  Results
  
  The modeling suggests that with some resumption of activities in the fall of 2020 to respond to cVDPV2 outbreaks and full resumption on January 1, 2021 of all polio immunization activities to pre-COVID-19 levels, Pakistan and Afghanistan would remain off-track for stopping all transmission through 2023 without improvements in quality.
  
  Conclusions
  
  Using trivalent OPV (tOPV) for SIAs instead of serotype 2 monovalent OPV (mOPV2) offers substantial benefits for ending the transmission of both WPV1 and cVDPV2, because tOPV increases population immunity for both serotypes 1 and 2 while requiring fewer SIA rounds, when effectively delivered in transmission areas.
  
  
• Subjects:
  AcademicSubjects/MED00290 Dynamic Modeling Eradication Major Article Outbreak Response Polio
• Source:
  J Infect Dis. 2021;
• Pubmed ID:
  33885734
• Pubmed Central ID:
  PMC8083227
• Document Type:
  Journal Article
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:a520af60ce0b0f4137952930f6973551cbf8f9fcbd2c7e311422037abbc199c2
• Download URL:
  https://stacks.cdc.gov/view/cdc/107345/cdc_107345_DS1.pdf
• File Type:
  [PDF - 1.77 MB ]