Fractional-Dose Inactivated Poliovirus Vaccine Campaign — Sindh Province, Pakistan, 2016 https://www.cdc.gov/mmwr/volumes/66/wr/mm6647a4.htm#suggestedcitation Morbidity and Mortality Weekly Report / December 1, 2017 / 66(47);1295–1299 Aslam Pervaiz, MBBS1; Chukwuma Mbaeyi, DDS2; Mirza Amir Baig, MBBS1; Ashley Burman, MPH3; Jamal A. Ahmed, MD4; Sharifa Akter, MBBS5; Fayaz A. Jatoi, MA5; Abdirahman Mahamud, MD3; Rana Jawad Asghar, MD6; Naila Azam, MD7; Muhammad Nadeem Shah, MBBS1; Mumtaz Ali Laghari, MBBS1; Kamaluddin Soomro, MBBS1; Mufti Zubair Wadood, MBBS3; Derek Ehrhardt, MSN, MPH2; Rana M. Safdar, MD4; Noha Farag, MD, PhD2 (View author affiliations) View suggested citation Summary What is already known about this topic? Wild poliovirus type 2 was declared eradicated in September 2015, prompting a synchronized switch from trivalent to bivalent (types 1 and 3) oral poliovirus vaccine in April 2016. Any subsequent isolation of vaccine-derived poliovirus type 2 (VDPV2) following the switch represents a potential public health emergency for which response activities might be warranted. Vaccination options for these activities include the use of monovalent oral poliovirus vaccine type 2 (mOPV2) and/or inactivated poliovirus vaccine (IPV) for polio vaccination campaigns. What is added by this report? Because of the limited global stock of IPV, fractional-dose intradermal IPV (fIPV), which is one fifth of the full intramuscular dose, has been developed and is being used for polio vaccination activities. Several studies have indicated that fIPV is not inferior to full dose IPV, and it has been used successfully for polio response activities in India. In response to a VDPV2 isolate from sewage samples taken from Hyderabad, Pakistan, fIPV was used in a polio vaccination campaign targeting children aged 4–23 months in four districts of Sindh province, Pakistan. Although relatively high coverage (82%) was achieved, operational challenges related to the use of an intradermally injected vaccine were encountered during the campaign. What are the implications for public health practice? Given current recommendations in favor of mOPV2 use for VDPV2 response activities, countries should weigh the potential benefits of using fIPV against the operational challenges associated with its use. If countries determine that fIPV use is warranted, meticulous planning and preparation should precede such activities to ensure judicious use of the limited global stock of IPV.

Tuesday, 30th of January 2018

Fractional-Dose Inactivated Poliovirus Vaccine Campaign — Sindh Province, Pakistan, 2016

https://www.cdc.gov/mmwr/volumes/66/wr/mm6647a4.htm#suggestedcitation

Morbidity and Mortality Weekly Report / December 1, 2017 / 66(47);1295–1299

Aslam Pervaiz, MBBS¹; Chukwuma Mbaeyi, DDS²; Mirza Amir Baig, MBBS¹; Ashley Burman, MPH³; Jamal A. Ahmed, MD⁴; Sharifa Akter, MBBS⁵; Fayaz A. Jatoi, MA⁵; Abdirahman Mahamud, MD³; Rana Jawad Asghar, MD⁶; Naila Azam, MD⁷; Muhammad Nadeem Shah, MBBS¹; Mumtaz Ali Laghari, MBBS¹; Kamaluddin Soomro, MBBS¹; Mufti Zubair Wadood, MBBS³; Derek Ehrhardt, MSN, MPH²; Rana M. Safdar, MD⁴; Noha Farag, MD, PhD² (View author affiliations)

View suggested citation

Summary

What is already known about this topic?

Wild poliovirus type 2 was declared eradicated in September 2015, prompting a synchronized switch from trivalent to bivalent (types 1 and 3) oral poliovirus vaccine in April 2016. Any subsequent isolation of vaccine-derived poliovirus type 2 (VDPV2) following the switch represents a potential public health emergency for which response activities might be warranted. Vaccination options for these activities include the use of monovalent oral poliovirus vaccine type 2 (mOPV2) and/or inactivated poliovirus vaccine (IPV) for polio vaccination campaigns.

What is added by this report?

Because of the limited global stock of IPV, fractional-dose intradermal IPV (fIPV), which is one fifth of the full intramuscular dose, has been developed and is being used for polio vaccination activities. Several studies have indicated that fIPV is not inferior to full dose IPV, and it has been used successfully for polio response activities in India. In response to a VDPV2 isolate from sewage samples taken from Hyderabad, Pakistan, fIPV was used in a polio vaccination campaign targeting children aged 4–23 months in four districts of Sindh province, Pakistan. Although relatively high coverage (82%) was achieved, operational challenges related to the use of an intradermally injected vaccine were encountered during the campaign.

What are the implications for public health practice?

Given current recommendations in favor of mOPV2 use for VDPV2 response activities, countries should weigh the potential benefits of using fIPV against the operational challenges associated with its use. If countries determine that fIPV use is warranted, meticulous planning and preparation should precede such activities to ensure judicious use of the limited global stock of IPV.

https://www.cdc.gov/mmwr/volumes/66/wr/mm6647a4.htm#suggestedcitation

Morbidity and Mortality Weekly Report / December 1, 2017 / 66(47);1295–1299