Arbo Antonio, Falleiros-Arlant Luiza Helena, López Eduardo L, Brea Del Castillo José, Martínez de Cuellar Celia, Moreno Gabriela, Rolón Roger, Cerda Javier, Eguiazú Salim
aff1, Paraguay.
aff2, Brazil.
Rev Chilena Infectol. 2019 Feb;36(1):83-90. doi: 10.4067/S0716-10182019000100083.
Given that the last notified case of poliomyelitis due to wild poliovirus type 2 was in 1999, in 2012, the Strategic Advisory Group of Experts on Immunization (SAGE) of the World Health Organization (WHO) recommended the withdrawal of the type 2 component of oral polio vaccine (OPV) and the introduction of a bivalent OPV (bOPV) in all countries by 2016. WHO recommended also that the withdrawal should be preceded by the introduction of at least one dose of inactivated poliovirus vaccine (IPV) in routine immunization schedules. The introduction of IPV prior to the change of the bOPV in 2016 to trivalent OPV (tOPV) was based on the concept of ensuring that a substantial proportion of the population would be protected against type 2 polio after the removal of the type 2 OPV. However, the world's two producers of IPV (Bilthoven Biologicals and Sanofi) have faced problems in the production of this vaccine and therefore reported a reduction of the global supply of IPV. In response to the potential shortage of IPV, at a meeting held on March 10 2017, the SAGE and Technical Advisory Group (TAG) of the Pan American Health Organization (PAHO) urged the countries in the Latin American region to replace the routine administration of the full doses of inactivated polio vaccine (IPV-C) in the immunization schedule (administered by intramuscular route), administering a fraction of the full dose in two intradermal shots (IPV-f). The possibility of this strategy was analyzed by opinion leaders convened by the Paraguayan Society of Pediatrics with the support of the Latin American Society of Pediatric Infectious Diseases (SLIPE) and Latin American Association of Pediatrics (ALAPE). This document presents the results of the discussion.
鉴于最后一例由野生2型脊髓灰质炎病毒引起的脊髓灰质炎病例发生在1999年，2012年，世界卫生组织（WHO）免疫战略咨询专家组（SAGE）建议停用口服脊髓灰质炎疫苗（OPV）中的2型成分，并在2016年前在所有国家引入二价口服脊髓灰质炎疫苗（bOPV）。WHO还建议，在停用之前，应在常规免疫程序中至少引入一剂灭活脊髓灰质炎病毒疫苗（IPV）。在2016年将bOPV更换为三价口服脊髓灰质炎疫苗（tOPV）之前引入IPV，是基于这样一种理念，即确保在去除2型OPV后，大部分人群能够获得针对2型脊髓灰质炎的保护。然而，全球两家IPV生产商（荷兰比尔特霍芬生物制品公司和赛诺菲）在该疫苗生产方面遇到问题，因此报告称IPV全球供应量减少。为应对IPV可能出现的短缺，在2017年3月10日举行的一次会议上，泛美卫生组织（PAHO）的SAGE和技术咨询小组（TAG）敦促拉丁美洲地区各国在免疫程序中，将常规接种的全剂量灭活脊髓灰质炎疫苗（IPV-C，通过肌肉注射给药），改为分两次皮内注射全剂量的一部分（IPV-f）。巴拉圭亚儿科学会在拉丁美洲儿科传染病学会（SLIPE）和拉丁美洲儿科学会（ALAPE）的支持下召集了意见领袖，对这一策略的可行性进行了分析。本文介绍了讨论结果。
