title: The polio endgame: rationale behind the change in immunisation.
abstract: The decades long effort to eradicate polio is nearing the final stages and oral polio vaccine (OPV) is much to thank for this success. As cases of wild poliovirus continue to dwindle, cases of paralysis associated with OPV itself have become a concern. As type-2 poliovirus (one of three) has been certified eradicated and a large proportion of OPV-related paralysis is caused by the type-2 component of OPV, the World Health Assembly endorsed the phased withdrawal of OPV and the introduction of inactivated polio vaccine (IPV) into routine immunisation schedules as a crucial step in the polio endgame plan. The rapid pace of IPV scale-up and uptake required adequate supply, planning, advocacy, training and operational readiness. Similarly, the synchronised switch from trivalent OPV (all three types) to bivalent OPV (types 1 and 3) involved an unprecedented level of global coordination and country commitment. The important shift in vaccination policy seen through global IPV introduction and OPV withdrawal represents an historical milestone reached in the polio eradication effort.
authors.affiliation: Department of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia, USA.
authors.forename: Julie
authors.identifier: 0000-0001-9816-9645
authors.initials: J
authors.lastname: Garon
authors.affiliation: Center for Vaccine Equity, Task Force for Global Health, Decatur, Georgia, USA.
authors.forename: Manish
authors.initials: M
authors.lastname: Patel
mesh_terms: D002648:Child; D004059:Diffusion of Innovation; D060740:Disease Eradication; D057915:Drug Substitution; D014943:Global Health; D006285:Health Planning; D006801:Humans; D007114:Immunization / Q000379:methods; D011051:Poliomyelitis / Q000517:prevention & control*; D011054:Poliovirus Vaccine, Inactivated; D011055:Poliovirus Vaccine, Oral
chemical_list: D011054:Poliovirus Vaccine, Inactivated; D011055:Poliovirus Vaccine, Oral
keywords: endgame; eradication; inactivated polio vaccine; oral polio vaccine; poliomyelitis