Some countries introduced one dose of IPV in 2015, switched from tOPV to bOPV in 2016, and introduced a second dose of IPV in 2021. These countries are at low risk for polio importation or transmission. Can these countries discontinue the use of bOPV and switch to IPV only for routine immunization?
Not yet. Unless a country meets strict WHO risk-grading criteria and receives WHO approval, it should continue to use bOPV in its routine schedule until the globally coordinated withdrawal of bOPV is authorised.
Relevant guidance
- The September 2024 SAGE meeting (doc attached) asked WHO to create a risk-grading framework so a limited number of low-risk countries could apply to move to an IPV-only schedule before worldwide cessation of bOPV.
- Until that framework is final and approved, all countries that switched to bOPV in 2016 are expected to keep bOPV in routine immunisation, together with two IPV doses, to maintain intestinal immunity and guard against cVDPV outbreaks.
- The only programmes already on IPV-only schedules are those that never reintroduced OPV after 2016, for example the United States and most of Western Europe.
Requirements for discontinuing bOPV
1. Very high and stable IPV coverage (at least 95 percent nationally and in every district), using three routine IPV doses plus a booster about 15 months of age or six months after the third dose.
2. Robust AFP and environmental surveillance able to detect a single poliovirus importation.
3. Rapid-response capacity and guaranteed access to emergency bOPV stockpiles within 14 days.
4. Secure laboratory containment of Sabin and wild poliovirus materials.
5. Formal WHO review and approval of the national risk assessment.
Until these conditions are met and certified, countries that introduced one IPV dose in 2015, switched from tOPV to bOPV in 2016, and added a second IPV dose in 2021 must continue the combined bOPV plus IPV schedule, or wait for the global, synchronised cessation of bOPV after WPV1 and cVDPV2 are eliminated. i have attached the September 2024 SAGE meeting report, GPEI polio eradication strategy 2022-2026 and this is a linkedin to my news letter on the hexavalent vaccine, newly introduced in two countries in Africa https://www.linkedin.com/pulse/hexavalent-vaccine-africa-one-shot-six-shields-tambe-vdvbe Thank you.
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