Retrospective analysis of a local cessation of vaccination against poliomyelitis: a possible scenario for the future
Retrospective analysis of a local cessation of vaccination against poliomyelitis: a possible scenario for the future
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DOI：
10.1128/jvi.77.23.12460-12465.2003
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发表时间：
2003-12-01
影响因子：
5.4
通讯作者：
Agol, VI
中科院分区：
文献类型：
--
作者：
Korotkova, EA;Park, R;Agol, VI
要在全球根除小儿麻痹症，就必须对免疫做法进行重大改革。其中一个拟议方案包括停止口服脊髓灰质炎病毒活疫苗接种，并建立脊髓灰质炎病毒储备，以备脊髓灰质炎病毒重新进入流通时应急。我们在这里描述了一个回顾性分析，在1963年至1966年在前苏联的白俄罗斯共和国的一个地区停止使用口服脊髓灰质炎疫苗。在此期间，疫苗衍生脊髓灰质炎病毒的独立谱系在该地区广泛传播和演变。这些谱系中的一些似乎起源于在基本上没有接种疫苗的这段时间里向社区中的40名儿童提供的口服脊髓灰质炎疫苗。这些数据表明，当地停止口服脊髓灰质炎疫苗接种和建议使用口服脊髓灰质炎疫苗控制疫苗接种后脊髓灰质炎病毒可能重新出现的风险非常高。在评估全球同步停用口服脊髓灰质炎疫苗的风险时，还应考虑此处记录的非免疫人群中非衍生病毒的高传播性，以及已知存在口服脊髓灰质炎疫苗长期排泄物。
The global eradication of poliomyelitis will require substantial changes in immunization practices. One of the proposed scenarios includes cessation of vaccination with live oral poliovirus vaccine (OPV) and the creation of an OPV stockpile for emergency response in case of the reintroduction of poliovirus into circulation. We describe here a retrospective analysis of the cessation of OPV usage in a region of the Byelorussian Republic of the former Soviet Union in 1963 to 1966. During this period, a widespread circulation and evolution of independent lineages of vaccine-derived polioviruses took place in the region. Some of these lineages appeared to originate from OPV given to 40 children in the community during this period of essentially no vaccinations. The data demonstrate very high risks associated with both the local cessation of OPV vaccination and the proposed use of OPV to control a possible reemergence of poliovirus in the postvaccination period. The high transmissibility of Off-derived viruses in nonimmune population, documented here, and the known existence of long-term OPV excretors should be also considered in assessing risks of the synchronized global cessation of OPV usage.