PDF(Pubmed)
Abstract：
Delivering inactivated poliovirus vaccine (IPV) with oral poliovirus vaccine (OPV) in campaigns has been explored to accelerate the control of type 2 circulating vaccine-derived poliovirus (cVDPV) outbreaks. A review of scientific literature suggests that among populations with high prevalence of OPV failure, a booster with IPV after at least two doses of OPV may close remaining humoral and mucosal immunity gaps more effectively than an additional dose of trivalent OPV. However, IPV alone demonstrates minimal advantage on humoral immunity compared with monovalent and bivalent OPV, and cannot provide the intestinal immunity that prevents infection and spread to those individuals not previously exposed to live poliovirus of the same serotype (i.e. type 2 for children born after the switch from trivalent to bivalent OPV in April 2016). A review of operational data from polio campaigns shows that addition of IPV increases the cost and logistic complexity of campaigns. As a result, campaigns in response to an outbreak often target small areas. Large campaigns require a delay to ensure logistics are in place for IPV delivery, and may need implementation in phases that last several weeks. Challenges to delivery of injectable vaccines through house-to-house visits also increases the risk of missing the children who are more likely to benefit from IPV: those with difficult access to routine immunization and other health services. Based upon this information, the Strategic Advisory Group of Experts in immunization (SAGE) recommended in October 2020 the following strategies: provision of a second dose of IPV in routine immunization to reduce the risk and number of paralytic cases in countries at risk of importation or new emergences; and use of type 2 OPV in high-quality campaigns to interrupt transmission and avoid seeding new type 2 cVDPV outbreaks.
摘要：
已探索在运动中使用灭活的脊髓灰质炎病毒疫苗（IPV）和口服脊髓灰质炎病毒疫苗（OPV），以加速控制2型循环疫苗衍生的脊髓灰质炎病毒（cVDPV）暴发。对科学文献的回顾表明，在OPV失败患病率高的人群中，与额外剂量的三价OPV相比,在至少两剂OPV后加强IPV可能更有效地缩小剩余的体液和粘膜免疫缺口.然而,与单价和二价OPV相比，单独的IPV在体液免疫上表现出最小的优势，并且无法提供预防感染和传播给以前未接触过相同血清型活脊髓灰质炎病毒的个体的肠道免疫力（即2016年4月从三价OPV转换为二价OPV后出生的儿童的2型）。对脊髓灰质炎运动的业务数据的审查表明，增加IPV会增加运动的成本和后勤复杂性。因此,应对疫情的运动通常针对小区域。大型活动需要延迟，以确保IPV交付的物流到位，并且可能需要持续数周的分阶段实施。通过挨家挨户访问提供可注射疫苗的挑战也增加了错过更有可能从IPV中受益的儿童的风险：那些难以获得常规免疫和其他卫生服务的儿童。根据这些信息,免疫战略咨询专家小组(SAGE)于2020年10月推荐了以下策略:在常规免疫中提供第二剂IPV,以减少在有输入或新出现的危险的国家出现麻痹病例的风险和数量;在高质量的运动中使用2型OPV,以阻断传播并避免播种新的2型cVDPV暴发.
