Pervaiz Aslam, Mbaeyi Chukwuma, Baig Mirza Amir, Burman Ashley, Ahmed Jamal A, Akter Sharifa, Jatoi Fayaz A, Mahamud Abdirahman, Asghar Rana Jawad, Azam Naila, Shah Muhammad Nadeem, Laghari Mumtaz Ali, Soomro Kamaluddin, Wadood Mufti Zubair, Ehrhardt Derek, Safdar Rana M, Farag Noha
MMWR Morb Mortal Wkly Rep. 2017 Dec 1;66(47):1295-1299. doi: 10.15585/mmwr.mm6647a4.
Following the declaration of eradication of wild poliovirus (WPV) type 2 in September 2015, trivalent oral poliovirus vaccine (tOPV) was withdrawn globally to reduce the risk for type 2 vaccine-derived poliovirus (VDPV2) transmission; all countries implemented a synchronized switch to bivalent OPV (type 1 and 3) in April 2016 (1,2). Any isolation of VDPV2 after the switch is to be treated as a potential public health emergency and might indicate the need for supplementary immunization activities (3,4). On August 9, 2016, VDPV2 was isolated from a sewage sample taken from an environmental surveillance site in Hyderabad, Sindh province, Pakistan. Possible vaccination activities in response to VDPV2 isolation include the use of injectable inactivated polio vaccine (IPV), which poses no risk for vaccine-derived poliovirus transmission. Fractional-dose, intradermal IPV (fIPV), one fifth of the standard intramuscular dose, has been developed to more efficiently manage limited IPV supplies. fIPV has been shown in some studies to be noninferior to full-dose IPV (5,6) and was used successfully in response to a similar detection of a single VDPV2 isolate from sewage in India (7). Injectable fIPV was used for response activities in Hyderabad and three neighboring districts. This report describes the findings of an assessment of preparatory activities and subsequent implementation of the fIPV campaign. Despite achieving high coverage (>80%), several operational challenges were noted. The lessons learned from this campaign could help to guide the planning and implementation of future fIPV vaccination activities.
2015年9月宣布根除野生脊灰病毒2型之后，全球停用了三价口服脊灰病毒疫苗（tOPV），以降低2型疫苗衍生脊灰病毒（VDPV2）传播风险；所有国家于2016年4月同步改用二价OPV（1型和3型）（1,2）。改用疫苗后，任何VDPV2的分离株都应被视为潜在的公共卫生紧急情况，可能表明需要开展补充免疫活动（3,4）。2016年8月9日，在巴基斯坦信德省海得拉巴德一个环境监测点采集的污水样本中分离出VDPV2。针对VDPV2分离株可能采取的疫苗接种活动包括使用注射用灭活脊灰疫苗（IPV），其不存在疫苗衍生脊灰病毒传播风险。已研发出标准肌内注射剂量五分之一的分剂量皮内IPV（fIPV），以便更有效地管理有限的IPV供应。一些研究表明，fIPV不劣于全剂量IPV（5,6），并且在应对印度污水中类似的单个VDPV2分离株检测时成功使用过（7）。在海得拉巴德及三个相邻地区开展应对活动时使用了注射用fIPV。本报告描述了对fIPV活动的筹备工作及后续实施情况进行评估的结果。尽管覆盖率很高（>80%），但仍发现了一些操作方面的挑战。从本次活动中吸取的经验教训有助于指导未来fIPV疫苗接种活动的规划和实施。
