我一直是一个强有力的倡导者,多年来,关于IPV控制脊髓灰质炎的优点,以及从环境中最终根除疾病和脊髓灰质炎病毒(BealeAJ.脊髓灰质炎:是时候改变免疫政策了吗?柳叶刀1990;335:839-842)。我也认识到我们在公共卫生领域有如此出色的疫苗Sabin的OPV是多么幸运。Foege博士提出了一种使用两种疫苗的方法:OPV和IPV。EPI计划使用了3或4剂OPV,但是在许多发展中国家,事实证明这不足以提供令人满意的控制。在南美,需要使用10个或更多的剂量来控制疾病。在DTP中使用杀死的脊髓灰质炎疫苗和三剂OPV的组合方法似乎是首选的共识解决方案。这将导致最低限度的,希望,不中断扩大免疫方案的现有方案。几乎可以肯定的是,这将使小儿麻痹症得到控制,并且至少可以根除这种疾病。很明显,越早这样做越好。现在做更便宜,虽然它在短期内需要更多的资金;而且它对世界上的孩子——现在和未来都更好。将IPV放入DTP的额外费用可能约为每门课程一美元,这可能并不比给予六剂量的OPV更昂贵,当考虑到行政总成本时。(抽象截尾250字)
I have been a strong advocate, for many years, for the merits of IPV for the control of
poliomyelitis, and the ultimate eradication of the disease and of poliovirus from the environment (Beale AJ. Poliovaccines: time for a change in immunization policy? Lancet 1990; 335:839-842). I have also recognized how fortunate we are in the Public Health field to have such an excellent vaccine as Sabin\'s OPV. Dr. Foege has argued aloquently and cogently for an approach that uses both vaccines: OPV and IPV. The EPI programme has used 3 or 4 doses of OPV, but in a number of developing countries this has proved inadequate to provide satisfactory control. In South America the use of 10 or more doses has been required to bring the disease under control. A combined approach of using killed poliovaccine combined in DTP and three doses of OPV seems to be the preferred
consensus solution. It would cause the minimum and, hopefully, no disruption of the existing programmes of the EPI. It would almost certainly bring forward the day when
poliomyelitis will be controlled and the disease at least will be eradicated. It is clear that the sooner this is done the better. It is cheaper to do it now, although it requires more funds in the short term; and it is better for the children of the world--present and future. The extra cost of putting IPV into DTP is probably about one US$ per course, which is probably no more expensive than giving six more doses of OPV, when the total costs of administration are considered.(ABSTRACT TRUNCATED AT 250 WORDS)