Injectable polio vaccine may be introduced

Published June 4, 2013
The file image shows a health worker in the field for anti-polio campaign. – AP Photo
The file image shows a health worker in the field for anti-polio campaign. – AP Photo

LAHORE, June 3: In a major development, the injectable/inactivated polio vaccine (IPV) is likely to be introduced for the first time in Pakistan to help overcome the crippling disease more effectively, Dawn has learnt.

The IPV is said to be highly effective in preventing paralytic disease caused by all three types of poliovirus and is currently being used by a majority of the polio-free developed and advanced countries.

The inactivated poliovirus vaccine is injected into a muscle or under the skin and is usually given by a healthcare professional in a hospital, clinic, or provider’s office.

Pakistan is one of the three polio-endemic countries which have been using oral polio vaccine (OPV) since the disease has hit the country.

The Polio Eradication and Endgame Strategic Plan 2013-18 of Global Polio Eradication Initiative (GPEI) had hinted at the new scheme in its April 2013 report of introducing IPV for the first time in three polio endemic countries -- Pakistan, Afghanistan and Nigeria.

“The polio programme in Pakistan is collaborating with the Aga Khan University, Karachi, to pilot the use of IPV with OPV in 2013 as an additional tool to rapidly build an immune response in children who have not been easily reached through regular polio campaigns or routine immunization”, the report said.

It says Pakistan will investigate the operational feasibility of using IPV with OPV in campaigns in the areas of Fata and Balochistan where difficult access and management issues have prevented the programme from building immunity to the levels needed to interrupt transmission.

These efforts will be combined with other health promotion activities and the mobilization of pediatricians to address other health concerns of families.

The Independent Monitoring Board (IMB) in its report released in the last week of May 2013 also said, “A trial in Pakistan, planned for later this year, needs to answer all of the immunological, operational and communications questions once and for all”.

The report said the discussion of this idea had been circulated because there were no operational trial data to test the hypotheses advanced in support of, and against, the concept.

“The programme needs to have a clear and evidence-based plan on this by the end of 2013,” the IMB report says.

‘The introduction of new IPV options for managing long-term poliovirus risks and potentially accelerating wild poliovirus eradication’ in all the member states is one of the five major elements of the Polio Eradication and Endgame Strategic Plan 2013-18. The member states have been asked to prepare them for complete shift from OPV to the IPV in 2015.

“Introduction of new vaccines is a major development in the management of poliovirus risk”, the plan said.

It said lessons learned in the introduction of new vaccines in low and middle income countries over the past decade (e.g. of haemophilus influenza type b, pneumococcal orrotavirus vaccines) will be beneficial to IPV introduction.

Countries will need to perform proper planning and preparation building upon existing checklists for cold chain, logistics and vaccine management, healthcare worker training and supervision, waste management, injection safety and adverse events following immunization (AEFI) monitoring.

“The GPEI partners, particularly WHO and Unicef, in conjunction with the GAVI Alliance and other immunization partners will assist countries to prepare for the introduction of IPV,” the report says.

Relevant support activities will include training of health worker communications development, cold-chain management and development of vaccine management strategies.

Quoting a report of the WHO regarding advantages of this vaccine, a senior representative of the body says as IPV is not a ‘live’ vaccine, it carries no risk of vaccine-associated polio paralysis. He says the IPV triggers an excellent protective immune response in most people.

He says the IPV is over five times more expensive than oral polio vaccine and administering of the vaccine requires rather trained health workers and sterile injection equipment and procedures.

“IPV is one of the safest vaccines in use. No serious systemic adverse reactions have been shown to follow vaccination,” he said.

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