Costa Clemens Sue Ann, Santos Gustavo Mendes Lima, Gonzalez Isabela, Clemens Ralf
Department of Paediatrics Oxford University Oxford United Kingdom Department of Paediatrics, Oxford University, Oxford, United Kingdom.
International Vaccine Institute Seoul Republic of Korea International Vaccine Institute, Seoul, Republic of Korea.
Rev Panam Salud Publica. 2023 Jul 3;47:e99. doi: 10.26633/RPSP.2023.99. eCollection 2023.
Poliovirus infection causes paralysis in up to 1 in 200 infected persons. The use of safe and effective inactivated poliovirus vaccines and live attenuated oral poliovirus vaccines (OPVs) means that only two pockets of wild-type poliovirus type 1 remain, in Afghanistan and Pakistan. However, OPVs can revert to virulence, causing outbreaks of circulating vaccine-derived poliovirus (cVDPV). During 2020-2022, cVDPV type 2 (cVDPV2) was responsible for 97-99% of poliomyelitis cases, mainly in Africa. Between January and August 2022, cVDPV2 was detected in sewage samples in Israel, the United Kingdom and the United States of America, where a case of acute flaccid paralysis caused by cVDPV2 also occurred. The Pan American Health Organization has warned that Brazil, the Dominican Republic, Haiti and Peru are at very high risk for the reintroduction of poliovirus and an additional eight countries in Latin America are at high risk, following dropping vaccination rates (average 80% coverage in 2022). Sabin type 2 monovalent OPV has been used to control VDPV2 outbreaks, but its use could also lead to outbreaks. To address this issue, a more genetically stable, novel OPV2 (nOPV2) was developed against cVDPV2 and in 2020 was granted World Health Organization Emergency Use Listing. Rolling out a novel vaccine under the Emergency Use Listing in mass settings to contain outbreaks requires unique local regulatory and operational preparedness.
脊髓灰质炎病毒感染会导致每200名感染者中就有1人出现瘫痪。安全有效的灭活脊髓灰质炎病毒疫苗和减毒活口服脊髓灰质炎病毒疫苗（OPV）的使用意味着仅在阿富汗和巴基斯坦还存在两个I型野生脊髓灰质炎病毒疫源地。然而，OPV可能会恢复毒力，引发循环疫苗衍生脊髓灰质炎病毒（cVDPV）疫情。在2020 - 2022年期间，2型cVDPV（cVDPV2）导致了97% - 99%的脊髓灰质炎病例，主要发生在非洲。2022年1月至8月期间，在以色列、英国和美国的污水样本中检测到了cVDPV2，在这些国家还出现了1例由cVDPV2引起的急性弛缓性麻痹病例。泛美卫生组织警告称，由于疫苗接种率下降（2022年平均覆盖率为80%），巴西、多米尼加共和国、海地和秘鲁重新引入脊髓灰质炎病毒的风险非常高，拉丁美洲还有另外8个国家也面临高风险。2型单价OPV（Sabin）已被用于控制VDPV2疫情，但使用它也可能导致疫情爆发。为解决这一问题，针对cVDPV2研发了一种基因更稳定的新型OPV2（nOPV2），并于2020年获得了世界卫生组织紧急使用清单。在大规模环境中根据紧急使用清单推出新型疫苗以控制疫情需要独特的当地监管和业务准备。
