Vaccination against polio should not be stopped
The striking 50-year-long decline in the incidence of poliomyelitis has stalled in the past seven years, which has led to calls for an urgent re-assessment of eradication and post-eradication campaign strategies. The current plan of eliminating the circulation of wild poliovirus so that further immunization will be unnecessary does not take into account recent scientific data and political realities that limit the likelihood that this strategy can sustain prevention of the disease. It is crucially important that high levels of population immunity are maintained against polio in the foreseeable future.
The evidence summarized above strongly suggests that any strategy that renders human populations vulnerable to infection by poliovirus is associated with an unacceptable risk. Therefore, the goal of the polio-eradication programme should be to achieve the widest-possible vaccination coverage. We may have no other choice than to continue immunization against a non-existing disease to prevent ourselves from becoming hostages to the threat of the devastating return of poliomyelitis. The short-term choice between OPV and IPV should depend on local conditions. The combination of IPV with other routine immunizations against important paediatric infections will be optimal in the long term.
Continued research on poliovirus should be encouraged and should focus on the improvement of the existing IPV. These improvements would include cost reduction, bundled delivery with other vaccines for children and boosting its ability to induce local immunity. In addition, the development of fundamentally new vaccines, as well as efficacious anti-polio drugs, should be explored. Such efforts could radically change vaccination policy decisions and eventually lead to the true eradication of poliomyelitis.
Nature Reviews Microbiology 5, 952-958 (December 2007)
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Tags: Biology, Health, Medicine, Microbiology, Science, Vaccines, Virology
