Vaccination Strategies after Elimination of Poliomyelitis

消除脊髓灰质炎后的疫苗接种策略

• 批准号: 7454235
• 负责人: Yvonne A. Maldonado
• 金额: $ 50.03万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-07-01 至 2012-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7454235
• 关键词: Address; Affect; Age-Months; Antibodies; Area; B-Lymphocytes; Blood Circulation; Child; Chronic; Condition; Count; Data; Developed Countries; Developing Countries; Development; Disease Outbreaks; Dose; Enrollment; Feces; Frequencies; Functional disorder; Genome; Goals; HIV; Household; Human poliovirus; Immune; Individual; Infant; Infection; Intestines; Life; Measures; Mucosal Immunity; Nutritional status; Oral; Paralysed; Perinatal; Point Mutation; Policies; Poliomyelitis; Poliovirus Vaccines; Polioviruses; Population; Prevalence; RNA; Reverse Transcription; Risk; Role; Sampling; Seroprevalences; Serotyping; Specimen; Testing; Time; Treatment Protocols; Vaccination; Vaccines; Virulent; Virus Diseases; Virus Shedding; World Health; World Health Organization; Zimbabwe; base; design; genome sequencing; immune function; immunogenicity; killings; mutant; neurovirulence; transmission process; vaccination strategy; vaccine development

DESCRIPTION (provided by applicant): The global eradication of poliomyelitis, a goal set by the World Health Assembly in 1988, may likely be achieved within the next five years. Cases of poliomyelitis have decreased dramatically in the last 20 years, from an estimated 350,000 cases in 1988 to under 1300 in 2004 - a greater than 99% reduction. However, the recent discovery of circulating virulent vaccine derived polioviruses (VDPV), capable of causing paralytic poliomyelitis, threatens eradication. In addition, well-known point mutations of the three Sabin serotypes are associated with development of vaccine-associated paralytic poliomyelitis (VAPP). Thus, global cessation of oral polio vaccine (OPV) use as soon as eradication occurs is a high priority. Understanding the dynamics of circulation of OPV, and especially of VDPV and VAPP, and the impact of human immunodeficiency virus (HIV) infection on viral shedding and on the immunogenicity of inactivated polio vaccine (IPV), is critical for the development of post-eradication vaccination policies. Information about the immunogenicity of IPV regimens is important to assess whether IPV can be used to control potential post-eradication outbreaks in areas of high HIV prevalence. There is a lack of critical data, especially among immunodeficient individuals who may shed more VAPP and VDPV for longer periods than those with normal immune function, to evaluate post-eradication vaccination options being considered by the World Health Organization. We propose to provide data, in a timely fashion, to evaluate the shedding and transmission of OPV, VAPP and VDPV by healthy and immunodeficient populations given OPV in a developing country, and to assess the immunogenicity and mucosal immunity of IPV regimens in healthy and immunodeficient infants living in poor sanitary conditions, which may affect IPV immunogenicity. The proposed studies will be carried among HIV- infected and uninfected infants living in Chitungwiza, Zimbabwe, with an HIV seroprevalence of 20%, to address specific gaps in designing polio vaccination strategies for developing areas of the world. Lay description. Paralytic poliomyelitis (polio) may soon be eradicated. However, polio caused by the live polio vaccine can occur and may threaten efforts to eradicated polio. We propose strategies to identify the effect of HIV infection on polio eradication strategies in a developing country and to study the use of a killed polio vaccine in eradication of poliomyelitis worldwide.

描述（由申请人提供）：世界卫生大会于 1988 年制定的目标是在全球范围内根除脊髓灰质炎，这一目标很可能在未来五年内实现。过去 20 年里，脊髓灰质炎病例急剧减少，从 1988 年估计的 35 万例减少到 2004 年的不足 1,300 例，减少了 99% 以上。然而，最近发现的循环毒力疫苗衍生脊髓灰质炎病毒（VDPV）能够引起麻痹性脊髓灰质炎，有可能被消灭。此外，众所周知，三种 Sabin 血清型的点突变与疫苗相关麻痹性脊髓灰质炎 (VAPP) 的发生有关。因此，根除脊髓灰质炎后立即在全球范围内停止使用口服脊髓灰质炎疫苗（OPV）是当务之急。了解 OPV，尤其是 VDPV 和 VAPP 的循环动态，以及人类免疫缺陷病毒 (HIV) 感染对病毒脱落和灭活脊髓灰质炎疫苗 (IPV) 免疫原性的影响，对于制定根除后疫苗接种政策至关重要。有关 IPV 方案的免疫原性的信息对于评估 IPV 是否可用于控制 HIV 高流行地区潜在的根除后疫情爆发非常重要。目前缺乏关键数据来评估世界卫生组织正在考虑的根除后​​疫苗接种方案，尤其是在免疫缺陷个体中，这些个体可能比免疫功能正常的个体在更长时间内排出更多的 VAPP 和 VDPV。我们建议及时提供数据，以评估发展中国家接受 OPV 的健康和免疫缺陷人群中 OPV、VAPP 和 VDPV 的脱落和传播情况，并评估生活在卫生条件较差的健康和免疫缺陷婴儿中 IPV 方案的免疫原性和粘膜免疫，这可能会影响 IPV 的免疫原性。拟议的研究将在生活在津巴布韦 Chitungwiza（HIV 血清阳性率为 20%）的 HIV 感染和未感染婴儿中进行，以解决世界发展中地区在设计脊髓灰质炎疫苗接种策略方面的具体差距。平铺说明。麻痹性脊髓灰质炎（脊髓灰质炎）可能很快就会被根除。然而，由脊髓灰质炎活疫苗引起的脊髓灰质炎可能会发生，并可能威胁到根除脊髓灰质炎的努力。我们提出了一些策略，以确定艾滋病毒感染对发展中国家根除脊髓灰质炎策略的影响，并研究使用灭活脊髓灰质炎疫苗来根除全世界的脊髓灰质炎。