The Bill & Melinda Gates Foundation, Seattle, Washington, USA.
National Primary Health Care Development Agency, Abuja, Nigeria.
J Infect Dis. 2024 Mar 14;229(3):805-812. doi: 10.1093/infdis/jiad222.
Novel oral poliovirus vaccine (OPV) type 2 (nOPV2) has been made available for outbreak response under an emergency use listing authorization based on supportive clinical trial data. Since 2021 more than 350 million doses of nOPV2 were used for control of a large outbreak of circulating vaccine-derived poliovirus type 2 (cVDPV2) in Nigeria.
Using a bayesian time-series susceptible-infectious-recovered model, we evaluate the field effectiveness of nOPV2 immunization campaigns in Nigeria compared with campaigns using monovalent OPV type 2 (mOPV2).
We found that both nOPV2 and mOPV2 campaigns were highly effective in reducing transmission of cVDPV2, on average reducing the susceptible population by 42% (95% confidence interval, 28-54%) and 38% (20-51%) per campaign, respectively, which were indistinguishable from each other in this analysis (relative effect, 1.1 [.7-1.9]). Impact was found to vary across areas and between immunization campaigns.
These results are consistent with the comparable individual immunogenicity of nOPV2 and mOPV2 found in clinical trials but also suggest that outbreak response campaigns may have small impacts in some areas requiring more campaigns than are suggested in current outbreak response procedures.
新型口服脊髓灰质炎疫苗(nOPV2)已根据支持性临床试验数据获得紧急使用清单授权,可用于应对疫情。自 2021 年以来,尼日利亚已使用超过 3.5 亿剂 nOPV2 来控制循环疫苗衍生脊髓灰质炎病毒 2 型(cVDPV2)的大规模暴发。
我们使用贝叶斯时间序列易感-感染-恢复模型,评估 nOPV2 免疫接种活动在尼日利亚的现场效果,与使用单价脊髓灰质炎疫苗 2 型(mOPV2)的活动进行比较。
我们发现,nOPV2 和 mOPV2 活动在降低 cVDPV2 传播方面都非常有效,每次活动平均使易感人群减少 42%(95%置信区间,28-54%)和 38%(20-51%),在这项分析中彼此之间无显著差异(相对效果,1.1[0.7-1.9])。结果发现,影响在不同地区和免疫接种活动之间存在差异。
这些结果与临床试验中发现的 nOPV2 和 mOPV2 相当的个体免疫原性一致,但也表明疫情应对活动在某些地区可能影响较小,需要比当前疫情应对程序建议的更多活动。