India's preparedness for introduction of IPV and switch from tOPV to bOPV

Global Polio Eradication and Endgame Strategic Plan 2013-18 calls for the ultimate withdrawal of oral polio vaccines (OPV) from all immunization programs across the world. The phased globally synchronized withdrawal would begin with type 2 serotype in 2016 through a switch from trivalent OPV (tOPV) to bivalent OPV (bOPV) and is associated with small but real risk of Vaccine Derived Polio Virus (VDPV) outbreaks. To mitigate this risk, efforts across the world, including India, are underway that comprise of Inactivated Polio Vaccine (IPV) introduction, containment of type 2 wild and vaccine strains, securing bOPV supplies, and surveillance and response protocols for any outbreaks after switch. Switch implementation in India is particularly challenging as country has one of the largest cold chain system in world with - 27000 cold chain points from where tOPV will be exchanged with bOPV and disposed in short time frame as any use/storage of tOPV beyond switch will jeopardize the global polio eradication.