The epidemiology of poliomyelitis, the poliovaccines and the present state of the WHO campaign for world-wide eradication of the polioviruses until the year 2000 are reviewed. In a second part, the recommendations of the "Ständige Impfkommission (STIKO, immunization task force)" from 1994 for Germany concerning poliovaccination are discussed. In contrast to the industrialized countries, the oral vaccination of infants in protection rates. After changes in vaccination strategy including mass vaccination days, the eradication campaign has succeeded in a considerable number of developing nations. However, because of limited financial resources and organizational difficulties the year 2000 goal for global eradication of polioviruses will hardly be met. The vaccination strategy of the STIKO continues to rely essentially on the trivalent oral poliovirus vaccine. The enhanced-potency inactivated polio vaccine is recommended for immunodeficient and all HIV-positive vaccinees as well as vaccinees with immunodeficient or HIV-positive contacts. Combined use of oral live vaccine and inactivated poliovirus vaccine induces an excellent local and systemic immunity. A combined vaccination strategy should be of particular interest in situations where other strategies fail.
本文回顾了脊髓灰质炎的流行病学、脊髓灰质炎疫苗以及世界卫生组织在2000年前全球根除脊髓灰质炎病毒运动的现状。第二部分讨论了德国“常设免疫委员会(STIKO,免疫工作组)”1994年关于脊髓灰质炎疫苗接种的建议。与工业化国家不同,发展中国家婴儿口服疫苗的保护率较低。在改变疫苗接种策略(包括大规模疫苗接种日)后,根除运动在许多发展中国家取得了成功。然而,由于财政资源有限和组织困难,2000年全球根除脊髓灰质炎病毒的目标很难实现。STIKO的疫苗接种策略仍然主要依赖三价口服脊髓灰质炎病毒疫苗。对于免疫缺陷者、所有HIV阳性接种者以及有免疫缺陷或HIV阳性接触者的接种者,建议使用增强效力的灭活脊髓灰质炎疫苗。口服活疫苗和灭活脊髓灰质炎病毒疫苗联合使用可诱导良好的局部和全身免疫。在其他策略失败的情况下,联合疫苗接种策略应特别受到关注。