Guidance for Assessment of Poliovirus Vaccination Status and Vaccination of Children Who Have Received Poliovirus Vaccine Outside the United States.

Abstract

In 1988, the World Health Assembly resolved to eradicate poliomyelitis (polio). Since then, wild poliovirus (WPV) cases have declined by >99.9%, from an estimated 350,000 cases of polio each year to 74 cases in two countries in 2015 (1). This decrease was achieved primarily through the use of trivalent oral poliovirus vaccine (tOPV), which contains types 1, 2, and 3 live, attenuated polioviruses. Since 2000, the United States has exclusively used inactivated polio vaccine (IPV), which contains all three poliovirus types (2,3). In 2013, the World Health Organization (WHO) set a target of a polio-free world by 2018 (4). Of the three WPV types, type 2 was declared eradicated in September 2015. To remove the risk for infection with circulating type 2 vaccine-derived polioviruses (cVDPV), which can lead to paralysis similar to that caused by WPV, all OPV-using countries simultaneously switched in April 2016 from tOPV to bivalent OPV (bOPV), which contains only types 1 and 3 polioviruses (5). This report summarizes current Advisory Committee on Immunization Practices (ACIP) recommendations for poliovirus vaccination and provides CDC guidance, in the context of the switch from tOPV to bOPV, regarding assessment of vaccination status and vaccination of children who might have received poliovirus vaccine outside the United States, to ensure that children living in the United States (including immigrants and refugees) are protected against all three poliovirus types. This guidance is not new policy and does not change the recommendations of ACIP for poliovirus vaccination in the United States. Children living in the United States who might have received poliovirus vaccination outside the United States should meet ACIP recommendations for poliovirus vaccination, which require protection against all three poliovirus types by age-appropriate vaccination with IPV or tOPV. In the absence of vaccination records indicating receipt of these vaccines, only vaccination or revaccination in accordance with the age-appropriate U.S. IPV schedule is recommended. Serology to assess immunity for children with no or questionable documentation of poliovirus vaccination will no longer be an available option and therefore is no longer recommended, because of increasingly limited availability of antibody testing against type 2 poliovirus.

• Authors: Mona Marin, Manisha Patel, Steve Oberste, Mark A Pallansch
• Journal: MMWR. Morbidity and mortality weekly report (MMWR Morb Mortal Wkly Rep) Vol. 66 Issue 1 Pg. 23-25 (Jan 13 2017) ISSN: 1545-861X [Electronic] United States
• PMID: 28081056 (Publication Type: Journal Article)

Chemical References

• Poliovirus Vaccine, Inactivated
• Poliovirus Vaccine, Oral

Topics

• Advisory Committees
• Centers for Disease Control and Prevention, U.S.
• Child, Preschool
• Disease Eradication
• Drug Substitution
• Global Health
• Humans
• Immunization (standards)
• Immunization Schedule
• Infant
• Poliomyelitis (epidemiology, prevention & control)
• Poliovirus Vaccine, Inactivated (administration & dosage)
• Poliovirus Vaccine, Oral (administration & dosage)
• United States