Facultad de Medicina, Universidad Metropolitana de Santos, São Paulo, Brasil.
Facultad de Ciencias Médicas, Universidad Nacional La Plata, Buenos Aires, Argentina.
Rev Chilena Infectol. 2020 Dec;37(6):701-709. doi: 10.4067/S0716-10182020000600701.
Oral poliovirus vaccine (OPV) has been instrumental in controlling the polio epidemic, and stands out for its safety, efficacy, ease of oral administration, and low cost. However, despite these advantages, as it is a live attenuated virus vaccine, there is the possibility of mutations that confer neurovirulence. Therefore, surveillance for acute flaccid paralysis (AFP) is important, whether associated with live vaccines (VAPP) or vaccine-derived viruses (VDPV). In this review we present important data from Latin America in recent years, where data on VDPV of community transmission, of ambiguous origin and associated with immunodeficiencies are reviewed. Due to the presence of VDPV, it is important to strengthen the epidemiological surveillance system for AFP, with data much lower than those recommended in recent years in the Americas. Additionally, it is essential to improve vaccination coverage to reduce the number of infants at risk of acquiring poliomyelitis. Consequently, we present the vaccination coverage rates with the inactivated vaccine against poliovirus (IPV) in the region and analyze the vaccination programs against poliomyelitis in accordance with the recommendations of the Latin American Society of Pediatric Infectious Diseases (SLIPE; minimum 3 doses of IPV) and the WHO Strategic Advisory Expert Group (SAGE) on Immunization (minimum 2 doses of IPV). The study concludes with recommendations from the authors for the change from OPV to exclusive use of IPV, to increase vaccination coverage and to strengthen surveillance for AFP in the region.
口服脊髓灰质炎疫苗（OPV）在控制脊髓灰质炎疫情方面发挥了重要作用，其安全性、有效性、口服给药的便利性和低成本尤为突出。然而，尽管具有这些优势，但由于它是一种减毒活病毒疫苗，存在突变获得神经毒力的可能性。因此，急性弛缓性麻痹（AFP）的监测非常重要，无论是与活疫苗（VAPP）还是疫苗衍生病毒（VDPV）相关。在本次综述中，我们呈现了近年来拉丁美洲的重要数据，其中包括社区传播、来源不明和与免疫缺陷相关的 VDPV 的数据。由于存在 VDPV，加强 AFP 的流行病学监测系统非常重要，而该地区的监测数据远低于近年来美洲的推荐值。此外，提高疫苗接种覆盖率以减少感染脊髓灰质炎风险的婴儿数量至关重要。因此，我们呈现了该地区针对脊髓灰质炎的灭活疫苗（IPV）的接种覆盖率，并根据拉丁美洲儿科学会感染性疾病分会（SLIPE；至少 3 剂 IPV）和世界卫生组织免疫战略咨询专家组（SAGE）的建议分析了脊髓灰质炎免疫接种计划（至少 2 剂 IPV）。该研究根据作者的建议得出结论，建议从 OPV 转变为仅使用 IPV，以提高疫苗接种覆盖率并加强该地区 AFP 的监测。
