title: Modeling the potential role of inactivated poliovirus vaccine to manage the risks of oral poliovirus vaccine cessation.
abstract: BACKGROUND
  The Global Polio Eradication Initiative plans to stop all oral poliovirus vaccine (OPV) after wild poliovirus eradication, starting with serotype 2. Stakeholders continue to discuss the role of using inactivated poliovirus vaccine (IPV) to manage the risks of circulating vaccine-derived polioviruses (cVDPVs) during the end game.
  
  
  METHODS
  We use a poliovirus transmission and OPV evolution model to explore the impact of various routine immunization policies involving IPV on population immunity dynamics and the probability and magnitude of cVDPV emergences following OPV cessation.
  
  
  RESULTS
  Adding a single IPV dose to an OPV-only routine immunization schedule at or just before OPV cessation produces very limited impact on the probability of cVDPV emergences and the number of expected polio cases in settings in which we expect cVDPVs in the absence of IPV use. The highest-cost option of switching to a 3-dose IPV schedule only marginally decreases cVDPV risks. Discontinuing supplemental immunization activities while introducing IPV prior to OPV cessation leads to an increase in cVDPV risks.
  
  
  CONCLUSIONS
  Introducing a dose of IPV in countries currently using OPV only for routine immunization offers protection from paralysis to successfully vaccinated recipients, but it does little to protect high-risk populations from cVDPV risks.
authors.affiliation: Kid Risk, Inc.
authors.forename: Radboud J
authors.initials: RJ
authors.lastname: Duintjer Tebbens
authors.affiliation: Kid Risk, Inc, College of Medicine, University of Central Florida, Orlando.
authors.forename: Kimberly M
authors.initials: KM
authors.lastname: Thompson
mesh_terms: D003198:Computer Simulation; D060740:Disease Eradication / Q000379:methods*; D006801:Humans; D011051:Poliomyelitis / Q000276:immunology / Q000517:prevention & control*; D011054:Poliovirus Vaccine, Inactivated / Q000008:administration & dosage* / Q000276:immunology*; D011055:Poliovirus Vaccine, Oral / Q000008:administration & dosage* / Q000009:adverse effects / Q000276:immunology*; D014611:Vaccination / Q000379:methods*
chemical_list: D011054:Poliovirus Vaccine, Inactivated; D011055:Poliovirus Vaccine, Oral
keywords: disease outbreaks; dynamic modeling; eradication; inactivated poliovirus vaccine; oral poliovirus vaccine; polio