TechNet-21 - Forum

  1. Ganesh Prasad Mishra
  2. Immunization information systems & coverage monitoring
  3. Wednesday, 11 December 2019

Last Friday (Dec 6), The Star reported the country’s Health Ministry confirming that a three-month-old boy from Tuaran, Sabah, has been infected with vaccine-derived poliovirus type 1 (VDPV1) after being admitted into a hospital’s intensive care unit.

The Star quoted health director-general Dr Noor Hisham Abdullah who said on Sunday (Dec 8): “The patient is currently undergoing treatment in an isolation ward and is in stable condition but needs respiratory support.”

He added that the poliovirus is classified as a circulating vaccine-derived poliovirus type 1 (VDPV1), which originates from a poliovirus that has been weakened by the orally-administered polio vaccine.

The Star reported that Dr Hisham said the weakened virus excretes from the body through faeces.

However, in unsanitary environments, the virus can infect others who have not been immunised against polio and will “thus spread in communities whose polio immunisation rates are less than 95 per cent”.

He warned that if the disease is left uncontrolled, it can genetically mutate until it once again becomes an active virus.

In an article on Monday (Dec 9), The Associated Press (AP) quoted Dr Hisham as saying that vaccination will be stepped up after an investigation in the infant’s home village showed that 25 out of 204 children, aged between two months and 15 years, were not vaccinated against polio.


Accepted Answer Pending Moderation

Dear Ganesh Prasad M

Thanks for sharing the occurrence of a cVDPV case in a 3 month old child after a polio free status of 27 years attributable to <95% coverage.

India is polio free from Feb 2011, certified as polio free in March 2014. NFHS 4: 2015-16 revealed 62% FIC for India and 63% for Karnataka, NFHS 5 will hopefully capture the FIC of ~90% revealed by CES 2018 in 190 IMI districts. India with 1.35 billion population, FIC ranging from <60% to >90% in different areas of the country, IAP schedule still recommending OPV 1st dose at 6 month other than zero OPV, administering both IPV and OPV together as in Govt sector is still a news among the pediatricians of Medical Colleges [evidence: as per the vaccination cards received from private sector in our vaccination clinic] fIPV coverage with 2 doses ~60% which is further accentuated by vaccination by the private sector >30% in the urban areas with no known potency. Though bOPV in the private sector has VVM, operational knowledge about how to read and interpret VVM is too poor. If the benchmark for coverage of primary vaccination is ≥95% for bOPV to prevent occurrence of sporadic case(s), with this low coverage, India can potentially get cVDPV / WPV at any time. As per WHO, containment measures for cVDPV or WPV are being almost same.

To address these issues, GoI launched the most ambitious multimillion $ MI / IMI with special drives. Being special drive, achieving and then sustaining the high RI coverage is a herculean task. There is an urgent need to reiterate the 6th strategic objective of local innovation to implement 5th strategic objective of sustenance of achievement. In this regard there is an urgent and perpetual need of actively involve the private sector adequately and accountably through standardized nation friendly immunization card – the “Combo-Card”. KVG team developed and operating successfully

1) Nation friendly Combo-Card for the private sector to eliminate the ambiguity regarding the vaccination schedule, making their vaccination data compatible with HMIS to avoid spurious low coverage,  

2)  Dedicated Vaccination Clinic in the Medical College for replication in all Medical Colleges to roll-out graduates and post graduates with right operational knowledge to strengthen RI throughout the year & years to come since 2016 and

3) Extended Immunogram to operate RI sessions in All Time Mission Mode in the attached PHCs since 2013, achieved >95% coverage and sustaining the same. 

 Hope the RI stake holders will replicate the success story.

Best wishes


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