National Institute for Communicable Diseases/National Health Laboratory Service, Private Bag X4, Sandringham 2131, South Africa.
Vaccine. 2012 Sep 7;30 Suppl 3:C35-7. doi: 10.1016/j.vaccine.2012.02.056.
South Africa is currently the only country on the African continent using inactivated polio vaccine (IPV) for routine immunization in a sequential schedule in combination with oral polio vaccine (OPV). IPV is a component of an injectable pentavalent vaccine introduced nationwide in April 2009 and administered according to EPI schedule at 6, 10 and 14 weeks with a booster dose at 18 months. OPV is administered at birth and together with the first IPV dose at 6 weeks, which stimulates gut immune system producing a memory IgA response (OPV), followed by IPV to minimize the risk of vaccine associated paralytic polio (VAPP). OPV is also given to all children under 5 years of age as part of regular mass immunizations campaigns. The decision to incorporate IPV into the routine schedule was not based on cost-effectiveness, which it is not. Other factors were taken into account: Firstly, the sequence benefits from the initial mucosal contact with live(vaccine) virus which promotes the IgA response from subsequent IPV, as well as herd immunity from OPV, together with the safety of IPV. Secondly, given the widespread and increasing use of IPV in the developed world, public acceptance of vaccination in general is enhanced in South Africa which is classified as an upper middle income developing country. Thirdly, to address equity concerns because of the growing use of IPV in the private sector. Fourthly, the advent of combination vaccines facilitated the incorporation of IPV into the EPI schedule.
南非目前是非洲大陆唯一在常规免疫中序贯使用灭活脊髓灰质炎疫苗（IPV）的国家，与口服脊髓灰质炎疫苗（OPV）联合使用。IPV 是 2009 年 4 月在全国范围内推出的一种五价注射疫苗的组成部分，按照 EPI 时间表在 6、10 和 14 周时进行接种，在 18 个月时进行加强针接种。OPV 在出生时接种，并与第 6 周时的第一针 IPV 同时接种，这会刺激肠道免疫系统产生记忆 IgA 反应（OPV），然后接种 IPV 以最大程度降低疫苗相关麻痹性脊髓灰质炎（VAPP）的风险。OPV 也会作为常规大规模免疫接种活动的一部分，用于所有 5 岁以下儿童。将 IPV 纳入常规免疫接种时间表的决定并非基于成本效益，因为它并非如此。还考虑了其他因素：首先，该顺序得益于与活（疫苗）病毒的初始粘膜接触，这促进了随后 IPV 的 IgA 反应，以及 OPV 的群体免疫力，以及 IPV 的安全性。其次，鉴于 IPV 在发达国家的广泛使用和不断增加，南非对疫苗接种的公众接受度普遍提高，南非被归类为中上收入发展中国家。第三，为了解决由于私营部门越来越多地使用 IPV 而引起的公平性问题。第四，联合疫苗的出现促进了 IPV 纳入 EPI 时间表。
