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Monday, 21st of July 2008 Print

  This article, also available at http://www.ajph.org/cgi/reprint/98/7/1322
 reviews the options before governments and international agencies
 confronted with the risks and benefits of different polio vaccination
 The authors do not support the expensive switch from OPV to IPV, more and
 more accepted in the industrialized world, as a global policy.
  Authors' summary is below' full text on the Internet.
 Good reading.
 The Risks, Costs, and Benefits of Possible Future Global Policies for
 Managing Polioviruses
 Kimberly M. Thompson, ScD, Radboud J. Duintjer Tebbens, PhD, Mark A.
 Pallansch, PhD, Olen M. Kew, PhD, Roland W. Sutter, MD, MPH, R. Bruce
 Aylward, MD, MPH, Margaret Watkins, MPH, BSN, Howard E. Gary, Jr, PhD,
 James Alexander, MD, MEd, Hamid Jafari, MD and Stephen L. Cochi, MD, MPH
 Objectives.We assessed the costs, risks, and benefits of possible future
 major policy decisions on vaccination, surveillance, response plans, and
 containment following global eradication, of wild polioviruses.
 Methods.We developed a decision analytic model to estimate the incremental
 cost-effectiveness ratios and net benefits of risk management options for
 polio for the 20-year period and stratified the world according to income
 level to capture important variability between nations.
 Results.For low-, lower-middle-, and upper-middle-income groups currently
 using oral poliovirus vaccine (OPV), we found that after successful
 eradication of wild polioviruses, OPV cessation would save both costs and
 lives when compared with continued use of OPV without supplemental
 immunization activities. We found cost-effectiveness ratios for switching
 from OPV to inactivated poliovirus vaccine to be higher (i.e., less
 desirable) than other health investment opportunities, depending on the
 actual inactivated poliovirus vaccine costs and assumptions about whether
 supplemental immunization activities with OPV would continue.
 Conclusions.Eradication promises billions of dollars of net benefits,
 although global health policy leaders face difficult choices about future
 policies. Until successful eradication and coordination of posteradication
 policies, health authorities should continue routine polio vaccination and
 supplemental immunization activities.
 July 2008, Vol 98, No. 7 | American Journal of Public Health 1322-1330
 © 2008 American Public Health Association
 Good reading.


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