Salmerón García Francisco, Portela Moreira Agustín, Soler Soneira Marta, López Hernández Susana, Chamorro Somoza Díaz-Sarmiento María, Pérez González Isabel, Rubio Gómez María Isabel, Pérez González Alicia, Sagredo Rodríguez Ana, Ruiz Antúnez Sol, Timón Jiménez Marcos, Frutos Cabanillas Gloria
División de Productos Biológicos y Biotecnología, Departamento de Medicamentos de Uso Humano, Agencia Española de Medicamentos y Productos Sanitarios (AEMPS), Madrid, España.
Rev Esp Salud Publica. 2013 Sep-Oct;87(5):497-505. doi: 10.4321/S1135-57272013000500008.
Vaccination against polio generates herd immunity (both with the attenuated (OPV) and inactivated (IPV) vaccines) and this will allow the eradication of the disease. The OPV vaccine produces 2-4 polio cases per cohort of one million children and therefore IPV is used in countries that can afford its cost (about 15 times more expensive than OPV). In 1988 the World Health Assembly established the polio eradication goal as "interruption of wild poliovirus transmission". If the elimination of wild poliovirus were achieved, the use of OPV will produce annually between 250 and 500 cases of polio in the world. From 1999, it was clear that eradication would require ending of immunization with OPV. On the 25th of January, 2013 it is approved the plan for the eradication and containment of all polioviruses, wild or not, so that no child suffers paralytic poliomyelitis. The most important landmarks include the lack of wild polio cases after 2014, the introduction of at least one dose of IPV in all immunization programs and to cease the type 2 OPV vaccination by the end of 2016 and to stop the use of the oral bivalent vaccine in 2019. To achieve all this, a complex scientific work and economic solidarity will be required.
脊髓灰质炎疫苗接种可产生群体免疫(减毒活疫苗(OPV)和灭活疫苗(IPV)均可),这将有助于根除该疾病。OPV疫苗每百万儿童队列中会导致2 - 4例脊髓灰质炎病例,因此,在有能力承担其成本的国家(成本约为OPV的15倍)会使用IPV。1988年,世界卫生大会将根除脊髓灰质炎的目标设定为“阻断野生脊髓灰质炎病毒传播”。如果实现野生脊髓灰质炎病毒的消除,使用OPV每年将在全球导致250至500例脊髓灰质炎病例。从1999年起,很明显根除脊髓灰质炎需要停止使用OPV进行免疫接种。2013年1月25日,根除和控制所有脊髓灰质炎病毒(无论是否为野生病毒)的计划获得批准,以使没有儿童患麻痹性脊髓灰质炎。最重要的节点包括2014年后无野生脊髓灰质炎病例、在所有免疫规划中引入至少一剂IPV、在2016年底前停止2型OPV疫苗接种以及在2019年停止使用口服二价疫苗。要实现所有这些目标,将需要复杂的科学工作和经济团结。