Lauren R Platt1, Concepción F Estívariz2, Roland W Sutter1. 1. Polio Operations and Research, World Health Organization, Geneva, Switzerland. 2. Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia.
Abstract
BACKGROUND: Vaccine-associated paralytic poliomyelitis (VAPP) is a rare adverse event associated with oral poliovirus vaccine (OPV). This review summarizes the epidemiology and provides a global burden estimate. METHODS: A literature review was conducted to abstract the epidemiology and calculate the risk of VAPP. A bootstrap method was applied to calculate global VAPP burden estimates. RESULTS: Trends in VAPP epidemiology varied by country income level. In the low-income country, the majority of cases occurred in individuals who had received >3 doses of OPV (63%), whereas in middle and high-income countries, most cases occurred in recipients after their first OPV dose or unvaccinated contacts (81%). Using all risk estimates, VAPP risk was 4.7 cases per million births (range, 2.4-9.7), leading to a global annual burden estimate of 498 cases (range, 255-1018). If the analysis is limited to estimates from countries that currently use OPV, the VAPP risk is 3.8 cases per million births (range, 2.9-4.7) and a burden of 399 cases (range, 306-490). CONCLUSIONS: Because many high-income countries have replaced OPV with inactivated poliovirus vaccine, the VAPP burden is concentrated in lower-income countries. The planned universal introduction of inactivated poliovirus vaccine is likely to substantially decrease the global VAPP burden by 80%-90%.
BACKGROUND: Vaccine-associated paralytic poliomyelitis (VAPP) is a rare adverse event associated with oral poliovirus vaccine (OPV). This review summarizes the epidemiology and provides a global burden estimate. METHODS: A literature review was conducted to abstract the epidemiology and calculate the risk of VAPP. A bootstrap method was applied to calculate global VAPP burden estimates. RESULTS: Trends in VAPP epidemiology varied by country income level. In the low-income country, the majority of cases occurred in individuals who had received >3 doses of OPV (63%), whereas in middle and high-income countries, most cases occurred in recipients after their first OPV dose or unvaccinated contacts (81%). Using all risk estimates, VAPP risk was 4.7 cases per million births (range, 2.4-9.7), leading to a global annual burden estimate of 498 cases (range, 255-1018). If the analysis is limited to estimates from countries that currently use OPV, the VAPP risk is 3.8 cases per million births (range, 2.9-4.7) and a burden of 399 cases (range, 306-490). CONCLUSIONS: Because many high-income countries have replaced OPV with inactivated poliovirus vaccine, the VAPP burden is concentrated in lower-income countries. The planned universal introduction of inactivated poliovirus vaccine is likely to substantially decrease the global VAPP burden by 80%-90%.
Authors: Jennifer L Konopka-Anstadt; Ray Campagnoli; Annelet Vincent; Jing Shaw; Ling Wei; Nhien T Wynn; Shane E Smithee; Erika Bujaki; Ming Te Yeh; Majid Laassri; Tatiana Zagorodnyaya; Amy J Weiner; Konstantin Chumakov; Raul Andino; Andrew Macadam; Olen Kew; Cara C Burns Journal: NPJ Vaccines Date: 2020-03-20 Impact factor: 7.344
Authors: Michael Famulare; Stewart Chang; Jane Iber; Kun Zhao; Johnson A Adeniji; David Bukbuk; Marycelin Baba; Matthew Behrend; Cara C Burns; M Steven Oberste Journal: J Virol Date: 2015-10-14 Impact factor: 5.103