nOPV2 Polio Vaccine

Stopping the Spread of Polio Requires Action

Karen McClorey Hackett — Sun, 23 Mar 2025 17:14:01 +0000

Reviewer:

When the World Health Organization (WHO) confirmed at the end of 2024 that poliovirus detections and polio outbreaks remained a Public Health Emergency of International Concern, various agencies reviewed options to end this vaccine-preventable disease.

This WHO summary report from the Strategic Advisory Group of Experts on Immunization (SAGE) meeting on March 13, 2025, is now available for the general public's review.

Regarding polio eradication, SAGE raised urgent concerns that, despite the alarming rise in wild poliovirus cases within endemic regions, decisive action toward transformative changes in the eradication strategy has been lacking.

Additionally, SAGE highlighted the threat posed by circulating variant polioviruses, which are expanding into new territories, including several European nations.

From September through December 2024, vaccine-derived poliovirus type 2 was detected in wastewater systems of 16 European cities.

SAGE reaffirmed its strong support for the safe cessation of bivalent oral poliovirus vaccine (OPV) and endorsed the planning of pre-cessation vaccination campaigns.

In February 2025, a mass polio vaccination campaign with novel oral polio vaccine type 2 (nOPV2) reached nearly 603,000 children. In recent years, this vaccine has been administered over one billion times.

Furthermore, SAGE endorsed a risk-grading framework to guide countries contemplating transitioning to IPV-only routine immunization schedules.

It has been determined that a three-dose schedule of inactivated poliovirus vaccine (IPV) and whole-cell pertussis-containing hexavalent vaccine starting at six weeks of age or later is adequate, without the need for a scheduled IPV booster dose (4th dose).

However, this SAGE recommendation does not change WHO's existing recommendations for booster doses of other antigens in the second year of life, namely diphtheria, tetanus, and pertussis-containing vaccines.

In conclusion, SAGE has revised its recommendations to reflect the latest evidence.

As of March 23, 2025, the Global Polio Eradication Initiative uses two types of vaccine to stop polio transmission: IPV and OPV.

In the United States, the IPV has been exclusively offered since 2000.

When traveling to one of the 39 identified polio-risk areas in March 2025, the U.S. CDC suggests speaking with a travel vaccine expert about immunization options.

Sub Title:

Polio booster dose suggested when visiting poliovirus detection areas in 2025

Reference:

WHO Highlights from the Meeting of the Strategic Advisory Group of Experts on Immunization

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Concomitant of IPV and nOPV2 Vaccines Suggested During Polio Outbreaks

Karen McClorey Hackett — Sat, 14 Dec 2024 12:11:55 +0000

Reviewer:

Robert Carlson, MD

The WHO Executive Board recently published a report following its 156th session, which provides an update on progress toward fully implementing and financing the Polio Eradication Strategy and the Polio Transition Framework.

Based on the September 2024 Strategic Advisory Group of Experts on Immunization (SAGE) meeting, the report was published on December 11, 2024.

Within this report, the Polio Oversight Board extended the Strategy by three additional years.

This extension shifts the timeline for eradicating wild poliovirus type 1 to the end of 2027 and the goal for certifying the elimination of circulating vaccine-derived poliovirus type 2 (cVDPV2) to the end of 2029.

Additionally, the Global Polio Eradication Initiative continues to support integration activities across the program in accordance with the Polio Oversight Board-approved integration work plan. The plan focuses on strengthening routine immunization, integrating service delivery in seven priority countries, and campaign-based integration across all polio-affected countries.

These efforts include the emergency response to returnees to Afghanistan, integrated service delivery in Pakistan, and multi-antigen campaigns in 20 countries.

Between September and November 2024, poliovirus in wastewater samples was detected in Germany and the United Kingdom.

In the UK, cVDPV2 was isolated from an environmental sample collected in November from Leeds and from environmental samples collected from London and East Worthing.

In Germany, six additional cVDPV2 isolates were confirmed from environmental samples collected in November from Bonn, Dresden, Duesseldorf, Hamburg, Cologne, and Mainz. All of these detected isolates were linked to the strain originating in Nigeria.

"VDPVs are a major challenge for eradicating polio. These viruses were first noticed during a 2000 outbreak in Hispaniola. Between 2017 and February 2024, VDPV2 has been reported in 49 countries, especially in sub-Saharan Africa, Syria, Afghanistan, Pakistan, and other countries," commented Duellyn Pandis, DNP, APRN, FNP-C.

"High-income and many middle-income countries have eliminated polio with the inactivated polio vaccine (IPV), but achieving similar success in crowded, unsanitary areas remains difficult. Over 40 countries have seen the reintroduction of wild polio or spread of vaccine-derived polio due to low population immunity."

"The best course to prevent infection from polio is with vaccination. The United States uses a killed version of the polio vaccine IPOL produced by Sanofi Aventis. It protects infants (6 weeks of age), children, and adults against poliomyelitis caused by poliovirus Types 1, 2, and 3. If traveling to a country with a known outbreak, ensure the full series of polio vaccines have been completed."

"If it is more than 10 years since the last polio vaccine, an adult booster is indicated," added Pandis, President and CEO of Passport Health - Tampa.

To date, the Global Polio Eradication Initiative has contributed oral polio vaccines (OPV) for ten countries as part of the "Big Catch-Up" initiative, which aims to reduce the number of zero-dose children and increase routine immunization rates.

Among other factors, the SAGE reviewed the global polio epidemiology and expressed support for the ongoing development of the bOPV vaccine cessation policy framework. In some situations, OPVs can mutate and regain virulence, leading to vaccine-derived poliovirus, paralyzing an unvaccinated person.

SAGE also recommended that, where feasible, the concomitant use of IPV and type 2 novel oral polio (nOPV2) be used for initial outbreak response vaccination campaigns.

The nOPV2 vaccine has been 'triple-locked' using genetic engineering to prevent it from becoming harmful and producing a mutation. As a result, nOPV2 is reported to be more genetically stable than previous oral polio vaccines.

As of early December 2024, over 1.1 billion doses of the nOPV2 vaccine have been administered worldwide.

Furthermore, in response to recently confirmed poliovirus detections, a WHO Committee unanimously agreed as of December 3, 2024, that the risk of the international spread of poliovirus remains a Public Health Emergency of International Concern and recommended the extension of Temporary Recommendations for three months into 2025.

This WHO recommendation includes ensuring all visitors to polio-endemic areas are fully vaccinated, and some adults may need a one-time polio vaccine booster.

In the U.S., the IPV vaccine is available at health clinics and pharmacies, but not the nOPV2 vaccine.

Sub Title:

Polio outbreaks decrease following vaccination campaigns in 2024

References:

WHO Polio Report Dec. 11, 2024

Polio Outbreaks Remain a Public Health Emergency of International Concern

ECDC - Wastewater poliovirus detections 2024

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from Pixabay

Polio Outbreaks Remain a Public Health Emergency of International Concern

Karen McClorey Hackett — Mon, 09 Dec 2024 20:44:21 +0000

Reviewer:

Robert Carlson, MD

The World Health Organization (WHO) recently announced that during the 40th meeting of the Emergency Committee under the International Health Regulations on the international spread of poliovirus, data on wild poliovirus (WPV1) and circulating vaccine-derived polioviruses (cVDPV) was reviewed in the context of the global target of interruption and certification of WPV1 eradication by 2027 and interruption and certification of cVDPV2 elimination by 2029.

In summary, the available data indicate that the global transmission of WPV1 is geographically limited to the two WPV1 endemic countries.

However, in 2024, there has been geographical spread and intensifying transmission within the two endemic countries.

As of December 3, 2024, the Committee unanimously agreed that the risk of the international spread of poliovirus remains a Public Health Emergency of International Concern and recommended the extension of Temporary Recommendations for a further three months into 2025.

The WHO Director-General endorsed the Committee's recommendations for countries meeting the definition for 'States infected with WPV1, cVDPV1 or cVDPV3 with potential risk for international spread', 'States infected with cVDPV2 with potential risk for international spread' and for 'States no longer infected by WPV1 or cVDPV, but which remain vulnerable to re-infection by WPV or cVDPV.'

Over the past few years, there have been outstanding examples of poliovirus elimination.

India was once deemed the most challenging country in the world to end polio. But today, India is polio-free, and countries are replicating its success by embracing the power of innovative vaccines.

In 2024, India continues vaccinating millions of children against polio.

The Global Polio Eradication Initiative uses two types of vaccine to stop polio transmission – inactivated polio vaccine (IPV) and oral polio vaccine.

Previously, the U.S. CDC reissued a Level 2 - Practice Enhanced Precautions, Travel Health Advisory identifying 37 countries where poliovirus remains a health risk. The CDC recommends that visitors to these counties speak with a travel vaccine expert about polio immunization options at least one month before departing overseas.

"Educating international travelers about the potential disease risks should be part of a travel consultation with a travel health specialist," commented Beverly Schaefer, RPh.

"International travelers visiting areas with increased risk of polio should get a one-time polio booster dose before traveling,' added Schaefer with Katterman's Sand Point Pharmacy in Seattle, WA.

As of December 9, 2024, IPVs are available at health clinics and pharmacies in the U.S.

Sub Title:

Poliovirus Travel Health Advisory Issued by US CDC

References:

WHO Statement of the fortieth meeting of the Polio IHR Emergency Committee

US CDC - Polio

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GPEI Dec. 2024

The World is Not Polio Free Today

Donald Hackett — Fri, 25 Oct 2024 14:24:56 +0000

Reviewer:

Robert Carlson, MD

Every year, World Polio Day is celebrated on October 24th to raise awareness of the importance of polio vaccination in protecting children.

To ensure a polio-free future for everyone, the World Health Organization (WHO) says efforts must be made to maintain high immunization coverage, implement high-quality surveillance to detect any presence of the poliovirus and prepare responses in the event of an outbreak.

Unfortunately, after the 39th meeting of the IHR Emergency Committee for Polio held in August 2024, the WHO announced that the spread of the poliovirus remained a Public Health Emergency of International Concern and extended the global alert into November 2024.

The revised target date to stop circulating vaccine-derived poliovirus (cVDPV) transmission is now the end of 2026.

Last week, the U.S. Centers for Disease Control and Prevention (CDC) confirmed that cVDPVs can emerge and cause paralysis in areas with low population poliovirus immunity.

For example, the Global Polio Eradication Initiative (GPEI) today announced that polio-endemic Pakistan and Afghanistan reported additional cases last week. And Chad, Niger, and Nigeria reported cVDPV2 cases.

The CDC reported that from January 2023 to June 2024, 672 confirmed polio cases were detected in 39 countries or areas.

Although the number of countries reporting poliovirus outbreaks is approximately the same as last year, as some countries have interrupted transmission, newly infected or reinfected countries report confirmed outbreaks, says the CDC.

"The polio virus spreads primarily through person-to-person contact, mainly via the fecal-oral route, and less commonly through contaminated water or food," Duellyn Pandis, DNP, APRN, FNP-C, informed Vax-Before-Travel News.

"It infects the throat and intestines, leading to flu-like symptoms. It can then travel to the brain and spinal cord, potentially causing paralysis," added Pandis, CEO of PassportHealth Tampa.

To notify international travelers of this health risk, the CDC reissued a Global Polio Alert - Level 2, Practice Enhanced Precautions Travel Health Notice in August 2024, identifying polio outbreaks and poliovirus detections in 37 countries.

In the United States, the CDC says wastewater testing can inform public health action as a component of polio outbreak response. The primary purpose of wastewater surveillance for poliovirus is to prevent cases of paralytic polio by identifying communities at increased risk for poliovirus exposure.

During 2022–2023, the CDC confirmed that seven U.S. jurisdictions (5 states and two cities) participated in prospective or retrospective wastewater testing for poliovirus after a paralytic polio case was identified in New York.

Two distinct vaccine-derived poliovirus type 2 viruses were detected in wastewater from New York State and New York City in 2022, representing two separate virus importation events.

Of those viruses, one resulted in persistent community transmission in multiple New York counties and one paralytic case.

No poliovirus was detected in wastewater tests conducted in participating jurisdictions (Connecticut, New Jersey, Michigan, Illinois, and Chicago, IL). However, New York's neighbors, New Jersey and the Philadelphia vicinity, did not participate in this review.

These testing results highlight the ongoing risk for poliovirus importations into the U.S.

Globally, insufficient access to the newly approved nOPV2 vaccine has led to delays in implementing outbreak responses, impeding efforts to achieve the high population immunity required to stop cVDPV2 transmission.

Whereas nOPV2 is genetically more stable than Sabin strain OPV2 in community circulation, these findings highlight that cVDPVs can develop (breakthrough cases) following nOPV2 vaccination when the timing and quality of vaccination responses are suboptimal.

The WHO says that the prolonged community circulation of the nOPV2 vaccine strain leads to reversion to neurovirulence, seeding new emergencies.

In the U.S., supplies of the inactive polio vaccine (IPV), which reduces poliovirus shedding, are readily available. The IPV has been deployed in the U.S. since 2000 and is generally available at clinics and pharmacies.

Last year, the CDC endorsed an IPV booster dose for people who have completed a primary series of trivalent OPV or IPV when visiting polio-endemic areas.

Sub Title:

World Polio Day 2024 highlights the importance of polio vaccination

References:

WHO - World Polio Day 2024

US CDC - Update on Vaccine-Derived Poliovirus Outbreaks - October 2024

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US CDC - Positive and negative poliovirus test results by MMWR week

Canada Contributes $111 Million to Defeat Polio

Karen McClorey Hackett — Sat, 28 Sep 2024 09:56:54 +0000

For many years, the Canadian government has been a vital supporter of the global polio eradication effort, and this support continues today.

On September 23, 2024, the Government of Canada announced a new contribution of approximately $111,657,485 over the next three years to support the work of the Global Polio Eradication Initiative (GPEI).

This new funding brings Canada's total contributions to the GPEI to about $1 billion.

Dr. Tedros Adhanom Ghebreyesus, the Director-General of the World Health Organization, commented in a press release, "These funds will help the GPEI reach communities with polio vaccines, including some of the world's most marginalized populations, and bring us closer to our goal of eradicating this disease once and for all."

Since the launch of GPEI, polio cases have decreased by more than 99%. However, last week, the GPEI reported new polioviruses cases and positive environmental isolates in the following countries:

Pakistan: four WPV1 cases

Democratic Republic of the Congo: two cVDPV2 cases

Niger: two cVDPV2-positive environmental samples

Nigeria: four cVDPV2 cases

Innovate polio vaccines have stopped the spread of wild poliovirus in all but two countries: Afghanistan and Pakistan. Other countries have experienced outbreaks of poliovirus variants, which can emerge in areas with low immunization rates.

Two types of vaccines are used to help prevent global polio in 2024: oral poliovirus vaccine and inactivated poliovirus vaccine (IPV), which is given as an injection.

In the U.S., IPV is generally available at health clinics and pharmacies.

When traveling to one of the 37 countries reporting polio detections, the U.S. CDC recommends travelers speak with a healthcare provider about polio boosters.

Sub Title:

Polio vaccines available in September 2024

Reference:

GPEI welcomes Canada’s pledge of CAN $151 million

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ECDC polio dashboard Sept. 2024

139th Confirmation of Polio Remains a Global Risk

Donald Hackett — Sat, 07 Sep 2024 17:39:45 +0000

Reviewer:

Robert Carlson, MD

In the United States, most people say that polio has been eradicated for many years. While this assumption may be accurate for U.S. residents, international travelers should have a different perspective.

For the 139th time, the WHO Director-General convened the Emergency Committee under the International Health Regulations (2005) (IHR) on the international spread of poliovirus.

During this July 2024 meeting, the Emergency Committee reviewed the data on wild poliovirus (WPV1) and circulating vaccine-derived polioviruses (cVDPV) in the context of the global targets of interruption and certification of WPV1 eradication by 2026 and interruption and certification of cVDPV2 elimination by 2028.

The Committee unanimously agreed that the risk of the international spread of poliovirus remains a Public Health Emergency of International Concern (PHEIC) and recommended extending Temporary Recommendations for another three months.

Effective on August 12, 2024, the Director-General endorsed the Committee’s recommendations for countries meeting the definition for ‘States infected with WPV1, cVDPV1 or cVDPV3 with potential risk for international spread’, ‘States infected with cVDPV2 with potential risk for international spread’ and for ‘States previously infected by WPV1 or cVDPV within the last 24 months’ and extended the Temporary Recommendations under the IHR to reduce the risk of the international spread of poliovirus.

Furthermore, the WHO wrote that all countries should ensure that residents and longterm visitors of all ages receive bivalent oral or inactivated poliovirus vaccines (IPV) between four weeks and 12 months before international travel.

Ensure that those undertaking urgent travel (within four weeks) who have not received a dose of bOPV or inactivated poliovirus vaccine (IPV) in the previous four weeks to 12 months receive a dose of polio vaccine at least by the time of departure, as this will still provide benefit, particularly for frequent travelers.

An oral vaccine can reduce polio outbreaks, while the injected IPV prevents paralysis, but it does not stop the spreading of the virus.

The fecal-oral route most often spreads the virus, and less than 1% of wild poliovirus infections result in paralysis.

At the point of departure, the international travel of any resident lacking documentation of appropriate polio vaccination from all points of departure, irrespective of the means of road, air, or sea travel, should be restricted.

Following the recent WHO announcement, the U.S. CDC reissued its Level 2—Practice Enhanced Precautions, Travel Health Advisory, which listed 37 countries with poliovirus detections in the past year.

On August 20, 2024, the CDC confirmed polio can be prevented with appropriate vaccinations before visiting endemic countries. Before traveling to any destination listed, adults who previously completed the routine polio vaccine series may receive a single, lifetime booster dose of the polio vaccine.

The IPV has been offered in the U.S. since 2000 and continues to be available at travel clinics and pharmacies in 2024.

Internationally, the novel oral polio vaccine (nOPV2) is being used to stop transmission of cVDPV2, currently the most prevalent form of the variant poliovirus.

Sub Title:

Polio vaccine boosters recommended when visiting poliovirus detected countries

References:

August 2024 Statement of the Thirty-ninth Meeting of the Polio IHR Emergency Committee

US CDC Polio travel advisory Aug. 2024

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ECDC - Countries affected by WPV and/or cVDPV outbreaks, 2024 (as of 20 August 2024).

Polio Cases Surge in July 2024

Karen McClorey Hackett — Sat, 27 Jul 2024 16:33:46 +0000

Reviewer:

Robert Carlson, MD

While efforts to eradicate poliomyelitis have been ongoing for decades, significant progress has been made in reducing polio cases by 99% over the last 30 years.

However, the last steps in eradicating the disease are proving to be the most challenging, as recent data indicates a resurgence of polio in 2024.

According to the latest Global Polio Eradication Initiative (GPEI) report, five countries reported new polio cases this week.

As of July 24, 2024, Pakistan reported a wild poliovirus type 1 (WPV1) case. This is the ninth WPV1 case reported in Pakistan this year.

And vaccine-derived cases were detected in the Democratic Republic of the Congo (1), Ethiopia (5), Somalia (1), and Yemen (11).

Last week, the GPEI reported that Nigeria confirmed one circulating vaccine-derived poliovirus type 2 (cVDPV2) case. There have been 31 cases reported this year and 87 cases reported in 2023.

The GPEI says cVDPV2 is a public health threat that affects 27 countries, including Angola, Liberia, Senegal, Sierra Leone, and South Sudan, located across four World Health Organization (WHO) regions.

Based on the current situation regarding WPV1 and cVDPVs and the reports provided by affected countries, the WHO Director-General determined in April 2024 that poliovirus detections continue to constitute an emergency.

cVDPV cases are associated with oral polio vaccines (OPV) and can cause paralysis among persons in areas with low population immunity to polioviruses.

To address this issue, the novel oral polio vaccine (nOPV2) is being rolled out under the WHO Emergency Use Listing (November 2020). The nOPV2 is reported to be more genetically stable than previous OPVs, with a lower risk of reversion to neurovirulence and less likely to mutate and cause paralysis.

On February 28, 204, the U.S. CDC Advisory Committee on Immunization Practices included an Introduction and Considerations for the Potential Use of nOPV2 as an Outbreak Control Measure.

The nOPV2 vaccine is not yet approved by the U.S. FDA.

As of July 2024, over 1 billion doses of nOPV2 have been administered worldwide, says the GPEI.

However, 14.3 million children were missing out on any vaccination in 2022. To reduce the number of polio cases, these so-called “zero-dose children” also need access to polio vaccines.

The WHO strongly recommends that these children be offered disease-prevention vaccines in 2024.

Sub Title:

One billion nOPV2 polio vaccine doses have been administered in 35 countries

References:

GPEI weekly report

WHO - Poliomyelitis - number of reported cases - 2023

World health statistics 2024

WHO Immunization coverage

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Sunday, July 28, 2024 - 06:00

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GPEI polio case map July 23, 2024

Which Vaccines Are Recommend for France's Summer Olympics

Karen McClorey Hackett — Fri, 12 Jul 2024 21:42:42 +0000

Reviewer:

Robert Carlson, MD

As we approach the Paris 2024 Olympic and Paralympic Games in late July and August, a recent study has looked into the possibility of using wastewater surveillance to detect priority pathogens that can be monitored during these events.

On July 11, 2024, the researchers published a list of 60 important pathogens in Eurosurveillance to be monitored for public health during the 2024 Games.

Six targets suitable for wastewater surveillance were successfully identified: poliovirus, influenza A virus, influenza B virus, mpox virus, SARS-CoV-2 coronavirus, and measles virus.

These viruses are spread differently.... airborne and contact with an infected person.

The researchers stated that the French health authorities were reviewing a proposal for a wastewater sampling strategy. Upon approval, the following steps will involve selecting sampling and partner laboratories to conduct the analyses.

Wastewater surveillance is relatively sensitive in detecting even a small number of cases of a virus and has the potential to provide early detection of virus outbreaks.

Instead of reacting to a disease outbreak, the World Health Organization recommends that international travelers be fully protected against vaccine-preventable diseases caused by these viruses.

France's Ministry of Health wrote on June 20, 2024, that each traveler (to France) is requested to verify their vaccination status and consult their doctor for any request for a new vaccine or vaccination renewal. Depending on your age, place of residence, health conditions, and vaccination status, this vaccination renewal request may include vaccines against measles, whooping cough, tetanus, diphtheria, polio, and any other disease.

The European CDC stated on July 12, 2024, that it will monitor this mass gathering event through epidemic intelligence activities between July 15 and September 13, 2024, in collaboration with Santé Publique France. Weekly updates will be included in the Communicable Disease Threats Report.

The U.S. Centers for Disease Control and Prevention suggest that travelers speak with a healthcare provider about vaccine options before departing to a health-risk environment such as Paris, France.

In the United States, numerous pharmacies and travel clinics offer a variety of travel vaccines.

Sub Title:

Pathogen prioritisation for wastewater surveillance ahead of the Paris 2024 Olympic and Paralympic Games, France

References:

Pathogen prioritisation for wastewater surveillance ahead of the Paris 2024 Olympic and Paralympic Games, France

Olympic and Paralympic Games FAQ - June 2024

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Saturday, July 13, 2024 - 06:00

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by G.C. from Pixabay

Angola Becomes Another Polio Hot-Spot

Donald Hackett — Sat, 25 May 2024 15:40:30 +0000

Reviewer:

Holly Lutmer PharmD

Robert Carlson, MD

The World Health Organization (WHO) Africa recently confirmed that the African country of Angola had been free of wild poliovirus since July 2011 and declared the interruption of polio transmission in November 2015.

Unfortunately, Angola recently reported a concerning development in early 2024.

Four cases of Poliovirus Type 2 have been detected in environmental samples of sewage water collected in two provinces. Additionally, two cases of Acute Flaccid Paralysis (AFP) have been reported in early May 2024.

These AFP cases are the first in Angola since the 2019-2020 outbreak, which recorded 124 cases.

Furthermore, 36 potential AFP cases are awaiting classification by the National Committee of Polio Experts, which may or may not be related to the polio virus.

On May 17, 2024, the WHO indicated that this polio outbreak is not just a concern; it's a call to action. These AFP cases underscore the urgency of the national polio vaccination campaign and the danger of continued poliovirus transmission among children.

Nationwide, the government has identified 5,549,140 children under the age of five in need of polio vaccination. The next-generation nOPV2 vaccine, administered over 1 billion times, is now being offered in Africa.

'Vaccinating our children is not just a public health measure but, more than that, it is a commitment to the progress and prosperity of our country,' said the Secretary of State for Public Health, Dr. Carlos Alberto Pinto de Sousa, said in a press release.

"This is a crucial step in maintaining our polio-free status and ensuring the health and future of our children."

The risk of outbreak spread is high in Angola, with less than 60% of children having immunity to poliovirus types 1, 2, and 3.

The Government of Angola has classified three out of 18 provinces as high-risk. This population group includes children under five years old, unvaccinated individuals, or those who have received fewer doses of polio vaccines, particularly in urban areas and areas with poor water and sanitation infrastructure.

According to the WHO and other organizations, polio remains endemic in two countries, Afghanistan and Pakistan. Until poliovirus transmission is interrupted in these countries, all countries, including the United States, remain at risk of polio importation.

On May 23, 2024, the U.S. CDC confirmed that 34 countries pose oplio risks to international travelers. Before any international travel, make sure you are up to date on your polio vaccines, says the CDC.

In the U.S., polio vaccines are offered at health clinics and pharmacies.

Sub Title:

Polio vaccinations scheduled for over 5 million children in Angola

References:

Angola aims to vaccinate over 5 million children

Reliefweb / International Federation of Red Cross And Red Crescent Societies

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WHO oral polio vaccinations - Angola May 2024

Two Countries Defeat Wild Poliovirus Transmission

Karen McClorey Hackett — Tue, 14 May 2024 20:59:12 +0000

Reviewer:

Robert Carlson, MD

Amongst the 34 countries reporting polio cases in 2024, two African countries confirmed today the closure of the wild poliovirus type 1 (WPV1) outbreak, marking a significant milestone in the fight against polio in the African region.

On May 14, 2024, following thorough assessments in Malawi and Mozambique, an independent Polio Outbreak Response Assessment Team recommended the closure of these WPV1 outbreaks.

The last WPV1 case in the African Region, linked to a strain circulating in Pakistan, was reported in Mozambique's Tete Province in August 2022. A total of nine cases were detected in Mozambique and neighboring Malawi, where the outbreak was declared in February 2022.

In a coordinated response, more than 50 million children in five southern African countries have been vaccinated against the virus.

These countries have administered over 100 million vaccine doses in the most at-risk areas. The strategy to prevent this outbreak from getting out of hand relied on synchronizing and coordinating vaccination plans across five countries and monitoring vaccination activities.

These tactics proved vital in identifying and reaching all eligible children in cross-border areas to avoid the risk of paralysis due to the virus.

"Closing polio outbreaks is possible when national governments, local health workers, community mobilizers, and global partners come together to prioritize a rapid and timely response to protect children from this devastating disease," said Dr. Chris Elias, president of Global Development at the Bill & Melinda Gates Foundation, in a press release.

"Malawi, Mozambique, and the entire Southern-African region are setting the example for what it takes to urgently improve vaccination campaigns and disease surveillance systems."

"Commitments like these will help us achieve a world free of all forms of poliovirus."

Since 1988, the incidence of wild poliovirus has been reduced by more than 99%, from more than 350,000 annual cases in more than 125 endemic countries to four cases in 2024 from two endemic countries (Pakistan and Afghanistan).

In 2023, only 12 cases of WPV1 were detected globally.

However, the U.S. CDC says that some international destinations have a circulating poliovirus. Before traveling to at-risk areas, ensure you are up to date on your polio vaccines.

In 2024, most African polio vaccination campaigns deploy the WHO-approved nOPV2 vaccine.

Since launching in 2021, approximately 1 billion nOPV2 doses have been administered in more than 35 countries.

nOPV2 is a novel oral poliomyelitis vaccine type 2 developed to address the evolving risk of circulating vaccine-derived polio. It has been 'triple-locked' using genetic engineering to prevent it from becoming harmful and producing a gut reaction.

As a result, nOPV2 is reported to be more genetically stable than currently approved oral polio vaccines.

Sub Title:

WPV1 poliovirus eliminated in Malawi and Mozambique

References:

WHO - Timely outbreak response, enhanced surveillance halts wild poliovirus transmission

US CDC - Level 2 - Practice Enhanced Precautions - Polio

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Wednesday, May 15, 2024 - 05:00

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Country reports.org 2024

National Vaccination Day 2024 Launches Today

Karen McClorey Hackett — Sat, 16 Mar 2024 18:33:49 +0000

Reviewer:

Robert Carlson, MD

National Immunization Days (NIDs) are essential to eradicating diseases worldwide. Celebrated annually on March 16th, the goal of NIDs is to identify children who are either not fully immunized or only partially protected and to enhance immunity in those who have already been immunized.

According to the World Health Organization (WHO), vaccination is an effective and safe way of preventing harmful diseases. A vaccine uses the body's natural defenses to build a resistance wall to specific infections and make the vaccinated individual's immune system stronger.

For over 100 years, vaccination has played a crucial role in maintaining public health. Effective results have been seen for decades against diseases like measles, chicken pox, tetanus, rubella, and polio.

The overarching message in 2024 is "Vaccines Work for All."

According to the WHO, this theme underscores the crucial role that safe and effective vaccination plays in safeguarding the health of individuals and communities alike.

The Global Polio Eradication Initiative (GPEI) says National Immunization Days (NID) are conducted in two rounds, one month apart, in India.

The Government of India has observed the day since 1995 to recognize the efforts of frontline healthcare workers.

Because oral polio vaccine does not require a needle and syringe, volunteers with minimal training can serve as vaccinators, increasing the number of vaccinators well beyond the existing trained health staff.

In some countries, three to five years of NIDs are usually required to eradicate polio, especially in those where routine immunization coverage is low, says the GPEI.

NIDs are generally conducted during the cool, dry season because logistics are simplified, immunological response to oral polio vaccine is improved, and the potential damage to the heat-sensitive vaccine is reduced.

Increasingly, neighboring countries are coordinating or "synchronizing" their National Immunization Days.

This ensures that children crossing borders for any reason are identified and immunized. It also allows health teams to cross borders and vaccinate children in pockets of territory otherwise isolated by rivers or mountains or on islands that may be less accessible from the other side.

This approach has been adopted in the United States, with targeted days encouraging people to speak with healthcare providers about the immunization enhancement options.

Sub Title:

National Immunization Days are a pillar of disease eradication

References:

GPEI - National Immunization Days

WHO National Vaccination Day

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WHO 2024

Novel Polio Vaccine Investments Offer Measurable Returns

Donald Hackett — Sat, 24 Feb 2024 17:47:24 +0000

Reviewer:

Robert Carlson, MD

Holly Lutmer PharmD

A recent investment case has shown that a successful polio transition in the WHO Eastern Mediterranean Region can generate a high return on investment.

According to the study, sustaining and integrating polio assets into expanded immunization, surveillance, and emergency response programs can bring economic and social benefits worth an estimated $289.2 billion.

With the current cost of this work being $7.5 billion, it means that for every dollar spent, the return on investment is almost $39.

At the 154th session of the WHO Executive Board, the outgoing WHO Regional Director for the Eastern Mediterranean Region, Dr. Ahmed Al-Mandhari, drew attention to these findings in a press release issued on February 14, 2024, "We have conducted an investment case to mobilize resources for longer-term sustainability of public health functions.... and highlights the economic value and social benefits of sustaining polio assets and integrating them into national health systems."

This report offers clear evidence that national governments, donors, and other stakeholders must now seize the opportunity to use these assets to build strong, equitable, and resilient health systems.

The report includes data from polio transition in Iraq, Libya, Somalia, the Syrian Arab Republic, Sudan, and Yemen, which have been certified as polio-free, and Afghanistan and Pakistan, which are yet to be certified.

For years, the Global Polio Eradication Initiative (GPEI) has provided substantial technical and financial support for vaccination programs. These capacities are necessary to sustain a polio-free world and, at the same time, build resilience and deliver improved health outcomes.

Polio, or poliomyelitis, is a disabling and potentially deadly disease. It is caused by the poliovirus, says the U.S. CDC. The virus spreads from person to person and can infect a person's spinal cord, causing paralysis.

As of February 2024, the GPEI has empowered over 1 billion vaccinations with the type 2 novel oral polio vaccine (nOPV2).

This new polio vaccine has been 'triple-locked' using genetic engineering to prevent it from becoming harmful and producing a gut reaction. As a result, nOPV2 is reported to be more genetically stable than legacy oral polio vaccines.

In the United States, the inactivated polio vaccine (IPV) is the only vaccine administered since 2000. The CDC recommends that children get four doses of polio vaccine.

Furthermore, based on destination, the CDC suggests that international travelers speak with their healthcare provider regarding polio booster options in 2024.

Sub Title:

Economic and social benefits arise from sustaining polio immunizations

References:

WHO: Sustaining polio investments offers a high return

WHO Eastern Mediterranean Region news Feb. 2024

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WHO Africa Polio Vaccinations 2024

1 Billion Novel Polio Vaccinations Administered

Karen McClorey Hackett — Sun, 14 Jan 2024 17:49:50 +0000

Reviewer:

Robert Carlson, MD

The Global Polio Eradication Initiative (GPEI) recently launched a Make Polio History campaign to rally supporters of polio eradication. This effort included the novel oral polio type 2 (nOPV2) vaccine, which was launched in response to poliovirus type 2 outbreaks,

Over the past three years, approximately 1 billion nOPV2 doses have been administered in more than 35 countries worldwide, says the GPEI.

To enhance the use of this new polio vaccine, the World Health Organization (WHO) prequalified the nOPV2 in late 2023.

The WHO's decision came years after nOPV2 became the first vaccine to receive a WHO Emergency Use Listing to protect children worldwide.

The development of nOPV2 builds upon decades of research on oral polio vaccines, wrote PATH on January 9, 2024.

Researchers banded together to test a modified version of the existing type 2 Sabin oral polio vaccine.

"We proposed design modifications that we believed held the potential for creating a more genetically stable vaccine," said Andrew Macadam, Ph.D., a principal scientist at the Medicines and Healthcare Products Regulatory Agency in the U.K. and one of the developers of nOPV2.

"It is gratifying to know that this research culminated in a product that protects millions of children worldwide and helps accelerate the end of a horrible disease."

Since 2015, PATH has served as the convener of the nOPV2 product development consortium —facilitating data-sharing and coordination among partners and providing technical assistance, such as developing assays to assess the stability of vaccine attenuation and supporting evaluation of surveillance data.

PATH's unedited article is available at this link.

PATH partners with public institutions, businesses, grassroots groups, and investors to solve the world's most pressing health challenges.

In the United States, the nOPV2 vaccine is unavailable. In the U.S., the inactivated polio vaccine has been given since 2000.

The U.S. CDC recommends vaccinating all children to protect against polio or poliomyelitis. The IPV is given by a shot in the leg or arm, depending on the patient's age.

Sub Title:

nOPV2 polio vaccine availability expands in 2024

References:

PATH - Emergency use of nOPV2

US CDC polio vaccination

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by Gerd Altmann

Polio Outbreaks Remain Global Health Risk in 2024

Karen McClorey Hackett — Fri, 29 Dec 2023 18:25:09 +0000

Reviewer:

Robert Carlson, MD

The 37th meeting of the World Health Organization (WHO) Emergency Committee under the International Health Regulations on the international spread of poliovirus was convened on December 12, 2023.

The WHO's Committee unanimously agreed that the risk of the international spread of poliovirus remains a Public Health Emergency of International Concern and recommended its extension and Temporary Recommendations for a further three months.

In 2022, the United States was added to this list of countries where polio was identified.

Previously, the WHO and UNICEF announced they are deploying over $1 billion in resources to eradicate polio and other childhood immunizations.

One global partner confirmed its role in this worldwide challenge to stop polio outbreaks.

The Global Polio Eradication Initiative (GPEI) recently reconfirmed it has two goals within its current strategy: to interrupt all remaining transmission of endemic wild poliovirus type 1 (WPV1) and to stop all outbreaks of variant poliovirus type 2 (cVDPV2).

The GPEI wrote on December 18, 2023.... 2023 was a critical year for progressing towards these goals.

Thanks to the novel oral polio vaccine type 2 (nOPV2), strong political commitment, and community-based efforts to reach more children with the vaccine, the number of cases of cVDPV2 continued to decline in 2023.

Nearly 1 billion doses of the nOPV2 vaccine, a comparably safe, effective, but more genetically stable version of the existing type 2 oral polio vaccine, have now been administered across 35 countries, protecting millions of children from illness and paralysis.

Achieving and sustaining a polio-free world has proven more challenging and taken longer than anyone could have imagined.

But making history is never easy. With today's complexities, this (vaccination) program still inspires us to bring about the best in our humanity.

Thank you to all who have contributed to this effort so far and continue to do so. Let us double down and make the dream of a polio-free world a reality, wrote the GPEI.

To notify international travelers of their health risks, the U.S. Centers for Disease Control and Prevention issued an updated Global Polio Alert - Level 2, Practice Enhanced Precautions Travel Health Notice on September 11, 2023, regarding polio outbreaks and poliovirus detections in 31 countries.

In the U.S., the IPV polio vaccine is indicated for active immunization of children and adults to prevent poliomyelitis caused by poliovirus types 1, 2, and 3. The IPV protects against both wild-type polio and the weakened poliovirus strain.

In 2023, booster doses of IPV were recommended for certain adults in the U.S.

Sub Title:

Over 1 billion nOPV2 vaccine doses delivered

References:

New funding to ensure 370 million children receive polio vaccinations

https://www.who.int/news/item/22-12-2023-statement-following-the-thirty-seventh-meeting-of-the-ihr-emergency-committee-for-polio

GPEI – a brief review of 2023 and full focus on 2024

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GPEI Dec. 2023

$59 Million Supports Polio Eradication's Last-Mile in Pakistan

Donald Hackett — Sun, 10 Dec 2023 16:31:16 +0000

Reviewer:

Holly Lutmer PharmD

Robert Carlson, MD

World leaders recently announced new commitments that help implement the Paris Pact principles, combining official development assistance and private investment, and support the objective of achieving polio eradication by 2026.

Confirmed by Bill Gates, co-chair of the Bill & Melinda Gates Foundation, and Remy Rioux, CEO of the Agence Française de Développement (AFD) on December 8, 2023, a €55 million concessional loan, with a €20 million principal buy-down from the Gates Foundation will support Pakistan's national health institutions and the Pakistan Polio Eradication Initiative to recover following impacts from the devastating floods in August 2022.

By supporting the Pakistan Polio Eradication Programme, through the World Health Organization (WHO), in immunization activities, disease surveillance, polio campaign monitoring, and other technical areas, the AFD investment will enhance systems able to target climate-sensitive diseases and their risk sources.

Notably, this funding will also support female polio healthcare workers, whose efforts and experiences are central to Pakistan's success against polio and other diseases.

Since 1994, Pakistan has been fighting to end the crippling poliovirus in the country.

In 2023, Pakistan has reported 5 cases of paralysis from polio. Poliovirus has also been detected in sewage water in 20 districts in the four major provinces, reaffirming that polio continues to pose a threat to children living in poor sanitary conditions with low immunity and poor nutrition.

"Thank you to the Government of France and the Government of Pakistan for their continued leadership in the fight to end polio," commented Mark Suzman, CEO of the Bill & Melinda Gates Foundation, in a press release.

"From France's commitment to the Global Polio Eradication Initiative last year to today's new financing partnership between the French Development Agency and the Government of Pakistan, these additional resources are essential to ensuring no child suffers from this devastating disease again."

Pakistan's national vaccination initiative is driven by trained and dedicated polio workers, the most extensive surveillance network in the world, quality data collection and analysis, behavioral change communication, state-of-the-art laboratories, and some of the best epidemiologists and public health experts in Pakistan and the world.

Globally, polio outbreaks continue in 2023.

The U.S. Centers for Disease Control and Prevention issued an updated Global Polio Alert on September 11, 2023, regarding polio outbreaks and poliovirus detections in 31 countries.

Previously, the WHO confirmed on August 25, 2023, that the spread of the poliovirus remained a Public Health Emergency of International Concern for three additional months.

As of December 2023, various polio vaccines are available in most countries. In the U.S., the IPV vaccine has been offered since 2000.

Sub Title:

Paris Pact objective is global polio eradication by 2026

References:

SUPPORT LAST MILE POLIO ERADICATION IN PAKISTAN AND TO BUILD MORE CLIMATE RESILIENT HEALTH SYSTEMS

The Paris Pact for People and the Planet

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American Association for the Advanced Research