OPV birth dose

Thank you sir for the update 

Selon les recommandations récentes de l’OMS (mars 2024) et de l’IMEP, la dose zéro du vaccin oral contre la polio (VPO0), administrée à la naissance, reste essentielle dans les contextes à risque élevé (faible couverture vaccinale, zones difficiles d’accès, épidémies, afflux de réfugiés).

Dans les pays ou régions avec :  (1) Absence de polio depuis ≥10 ans, (2) Couverture VPO3 > 95 %, (3) Introduction d’au moins deux doses de VPI, (4) le VPO0 n’est plus obligatoire, mais peut être utilisé comme dose d’opportunité.

En RDC : Vu les inégalités de couverture vaccinale, le VPO0 doit continuer à être administré au niveau national pour renforcer l’immunité précoce, surtout dans les zones vulnérables.

Priorité : assurer que tous les enfants reçoivent la série complète de VPO et VPI aux âges recommandés.

The current guidance based on the most recent recommendations from the World Health Organization (WHO) and the Global Polio Eradication Initiative (GPEI):

• OPV0 (zero dose) is typically recommended at birth (within the first 2 weeks of life) to provide early protection and prime the immune system, especially in areas where polio transmission is still a risk or where routine immunization coverage is not optimal.
• For countries that have maintained polio-free status for at least ten years, have sustained OPV3 coverage above 95%, and have introduced at least two doses of IPV (inactivated polio vaccine) in their routine schedule, the role of OPV0 changes:
• The OPV0 is NOT considered mandatory in these settings, as per current WHO recommendations.
• However, it may still be offered as an additional opportunity to vaccinate, particularly for children who might miss later doses, or in special circumstances (e.g., high-risk populations, refugee influx, outbreaks).   
• The primary polio vaccination schedule for such countries is considered robust enough (with high coverage of OPV3 and IPV) to ensure population immunity. 
•  The zero dose is mainly an opportunity dose, not a required dose for counting "full vaccination" status in these settings.
• The key is ensuring all children get the primary series of OPV and IPV at the recommended ages.

Reference:

• WHO Position Paper on Polio Vaccines, March 2024 -most recent
• GPEI FAQ on OPV and IPV use

Based on the latest WHO and GPEI recommendations, countries that have maintained polio-free status for at least 10 years, with OPV3 coverage above 95% and at least two doses of IPV in their routine immunization schedules, are not required to administer the OPV zero (birth) dose. OPV0 may still be given as an additional, opportunity dose if feasible, but missing it does not affect a child’s fully immunized status as long as the primary series (OPV1–3 and two IPV doses) is completed. The main focus should be on ensuring high coverage of all routine polio vaccine doses.

In countries with lower immunization coverage or higher risk of polio transmission, the OPV zero dose remains strongly recommended.

Reference:
WHO Position Paper, Polio Vaccines, March 2024; GPEI Vaccine Policy Q&A, 2024.

According to WHO’s Immunization in Practice (2015) manual, in areas where polio is endemic or where there is a high risk of poliovirus importation, an OPV birth dose (zero dose) is recommended to provide early protection.

The decision to continue or discontinue the OPV birth dose should be based on a comprehensive risk assessment and national immunization policy. Countries that have maintained polio-free status, achieved high OPV3 coverage (>95%), and introduced at least two IPV doses may consider adjusting their immunization schedule, provided their surveillance and response capacities remain robust.

Ultimately, this is a context-specific decision that must weigh the current epidemiological risk, population immunity, and the potential for virus reintroduction. Attached is the WHO 2015 doc