Mass Vaccination Campaigns for Polio Eradication: An Essential Strategy for Success

  • R. W. Sutter
  • C. Maher

Abstract

Effective vaccines against poliomyelitis became available in the mid-1950s and early 1960s. Mass campaigns were an integral part of early control efforts. Thereafter, polio vaccines were used largely in routine childhood programs. The resolution in 1988 to eradicate polio globally led to the development of appropriate strategies to achieve this goal, including mass vaccination campaigns (i.e., national immunization days, sub-national immunization days and mop-up activities), to achieve the highest possible coverage in the shortest possible time. Unlike other vaccines, mass campaign use of oral poliovirus vaccine enhances the immunogenicity of this vaccine, primarily due to: (1) the decrease in the prevalence of other enteroviruses that potentially interfere with seroconversion; and (2) the secondary spread of vaccine virus from vaccinees to close contacts, resulting in seroconversion of some unvaccinated contacts. To reach the highest possible coverage, detailed planning, meticulous execution, careful supervision and standardized monitoring are critical. A number of innovative approaches to improve the quality and/or coverage have become the ‘standard’ of supplemental immunization activities. These mass campaigns have led to dramatic decreases in the incidence of polio. This chapter reviews the scientific, operational and programmatic data on mass campaign use of polio vaccines, and summarize the lessons learnt from implementing the mass vaccination strategies used to eradicate poliomyelitis globally.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Sutter RW, Kew OM, Cochi SL (2003) Poliovirus vaccine-live. In: Plotkin SA, Orenstein WA (eds), 4th edn. Vaccines. W.B. Saunders Company, Philadelphia, 25:651–705.Google Scholar
  2. 2.
    Majiyagbe J (2004) The volunteers’ contribution to polio eradication. Bull WHO 82:2PubMedGoogle Scholar
  3. 3.
    World Health Assembly (1988) Polio eradication by the year 2000. Resolutions of the 41th World Health Assembly. Geneva: World Health Organization, 1988 (WHA resolution no. 41.28)Google Scholar
  4. 4.
    Hull H, Ward NA, Hull B, Milstien JB, de Quadros C (1994) Paralytic poliomyelitis: seasoned strategies, disappearing disease. Lancet 343:1331–1337PubMedCrossRefGoogle Scholar
  5. 5.
    Smith J (1990) Patenting the Sun. Polio and the Salk Vaccine. William Morrow & Company, New YorkGoogle Scholar
  6. 6.
    Chumakov MP, Voroshilova MK, Drozdov SG, et al. (1961) Some results of the work on mass immunization in the Soviet Union with live poliovirus vaccine prepared from Sabin strains. Bull WHO 25:79–91PubMedGoogle Scholar
  7. 7.
    Agol VI, Drozdov SG (1993) Russian contribution to OPV. Biologicals 21:321–325PubMedCrossRefGoogle Scholar
  8. 8.
    Sabin AB (1985) Oral poliovirus vaccine: history of its development and use and current challenge to eliminate poliomyelitis from the world. J Infect Dis 151:420–436PubMedGoogle Scholar
  9. 9.
    Sabin AB (1984) Strategies for elimination of poliomyelitis in different parts of the world with use of oral poliovirus vaccine. Rev Infect Dis 6(Suppl 2):S391–S396PubMedGoogle Scholar
  10. 10.
    Robertson HE, Acker MS, Dillenberg HO, et al. (1962) Community-wide use of a “balanced” trivalent oral poliovirus vaccine (Sabin): a report of the 1961 trial at Prince Albert, Saskatchewan. Can Public Health J 53:179–191Google Scholar
  11. 11.
    CDC. Poliomyelitis Prevention in the United States (1997) Introduction of a sequential vaccination schedule of inactivated poliovirus vaccine followed by oral poliovirus vaccine. Updated Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep 46(RR-3)Google Scholar
  12. 12.
    CDC (2000) Poliomyelitis Prevention in the United States. Updated Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep 49(RR-5)Google Scholar
  13. 13.
    Ofusu-Amahh S, Kratzer JH, Nicholas DD (1977) Is poliomyelitis a serious problem in developing countries?-lameness in Ghanaian schools. Brit Med J i:1012–1014CrossRefGoogle Scholar
  14. 14.
    Bernier RH (1984) Some observations on poliomyelitis lameness surveys. Rev Infect Dis 6(Suppl.2):S371–S375PubMedGoogle Scholar
  15. 15.
    Cruz RR (1984) Cuba:mass polio vaccination program, 1962–1982. Rev Infect Dis 6(Suppl.2):S408–S412Google Scholar
  16. 16.
    Mas Lago P, Ramon Bravo J, Andrus JK, Comellas MM, Galindo MA, de Quadros CA, Bell E (1994) Lessons from Cuba: mass campaign administration of trivalent oral poliovirus vaccine and seroprevalence of poliovirus neutralizing antibodies. Bull WHO 72:221–225PubMedGoogle Scholar
  17. 17.
    Mas Lago P (1999) Eradication of poliomyelitis in Cuba: a historical perspective. Bull WHO 77:681–687PubMedGoogle Scholar
  18. 18.
    Henderson RH (1984) The Expanded Programme on Immunization of the World Health Organization. Rev Infect Dis 6(Suppl.2):S475–S479PubMedGoogle Scholar
  19. 19.
    Grant JP (1991) Reaching the unreached: a miracle in the making. Asia Pac J Public Health 5:154–162PubMedGoogle Scholar
  20. 20.
    Murray C, Kreuser J, Whang W (1994) Cost-effectiveness analysis and policy choices: investing in health systems. Bull WHO 72:663–674PubMedGoogle Scholar
  21. 21.
    Vaccine and Biologicals Department (2003) WHO vaccine-preventable diseases: Monitoring system. 2003 global summary. Geneva: World Health Organization, (WHO/V&B/03.20)Google Scholar
  22. 22.
    McBean AM, Thoms ML, Albrecht P, et al. (1988) Serologic response to oral polio vaccine and enhanced-potency inactivated polio vaccine. Am J Epidemiol 128:615–628PubMedGoogle Scholar
  23. 23.
    Faden H, Modlin JF, Thoms ML, McBean AM, Ferdon MB, Ogra PL (1990). Comparative evaluation of immunization with live attenuated and enhanced-potency inactivated trivalent poliovirus vaccines in childhood: systemic and local immune responses. J Infect Dis 162:1291–1297PubMedGoogle Scholar
  24. 24.
    Patriarca PA, Wright PF, John TJ (1991) Factors affecting the immunogenicity of oral poliovirus vaccine in developing countries: review. Rev Infect Dis 13:926–939PubMedGoogle Scholar
  25. 25.
    Domök I, Balayan MS, Fayinka OA, Skrtic N, Soneji AD, Harland PS (1974) Factors affecting the efficacy of live poliovirus vaccine in warm climates. Efficacy of type 1 Sabin vaccine administered together with antihuman gamma-globulin horse serum to breast-fed and artificially fed infants in Uganda. Bull WHO 51:333–347PubMedGoogle Scholar
  26. 26.
    Expanded Program on Immunization (1989) Global Advisory Group (1988). Wkly Epidemiol Rec 64:5–10Google Scholar
  27. 27.
    Rezapkin GV, Norwood LP, Taffs RE, et al. (1995) Microevaluation of type 3 Sabin strain of poliovirus in cell cultures and its implications for oral poliovirus vaccine quality control. Virology 211:377–384PubMedCrossRefGoogle Scholar
  28. 28.
    Nathanson N, Horn SD (1992) Neurovirulence tests of type 3 oral poliovirus vaccine manufactured by Lederle Laboratories, 1964–1988. Vaccine 10:469–474PubMedCrossRefGoogle Scholar
  29. 29.
    Patriarca PA, Laender F, Palmeira G, et al. (1988) Randomized trial of alternative formulations of orla poliovaccine in Brazil. Lancet i:429–433CrossRefGoogle Scholar
  30. 30.
    Patriarca PA, Linkins RW, Sutter RW, Orenstein WA (1993) Optimal schedule for the administration of oral poliovirus vaccine. In Kurstak E (ed). Measles and poliomyelitis-vaccines and immunization. Springer, New York, Chapter 24 pp 303–313Google Scholar
  31. 31.
    Milstien JB, Lemon SM, Wright PF (1997) Development of a more thermostable poliovirus vaccine. J Infect Dis 175(Suppl.1):S247–S253PubMedGoogle Scholar
  32. 32.
    Anonymous (1996) Vaccine vial monitors take guesswork out of immunization. Vaccine Immun News 1:7–8Google Scholar
  33. 33.
    Heymann DL, Murphy K, Brigaud M, et al. (1987) Oral poliovirus vaccine in tropical Africa: greater impact on incidence of paralytic disease than expected from coverage surveys and seroconversion rates. Bull WHO 65:495–501PubMedGoogle Scholar
  34. 34.
    Olivé J-M, Risi JB Jr, de Quadros CA (1977) National immunization days: Experience in Latin America. J Infect Dis 175(Suppl.1):S189–S193Google Scholar
  35. 35.
    Bilous J, Maher C, Tangermann RH, Aylward RB, et al. (1997) The experience of countries in the Western Pacific Region in conducting national immunization days for polio eradication. J Infect Dis 175(Suppl.1):S194–S197PubMedGoogle Scholar
  36. 36.
    Tangermann RH; Hull HF, Jafari H, Nkowane B, Everts H, Aylward BR (2000) Eradication of poliomyelitis in countries affected by conflict. Bull WHO 78:330–338PubMedGoogle Scholar
  37. 37.
    CDC (1999) Progress toward poliomyelitis eradication during armed conflict-Somalia and Southern Sudan, January 1998–June 1999. MMWR Morb Mortal Wkly Rep 48:633–637Google Scholar
  38. 38.
    Benyesh-Melnick M, Melnick JL, Rawls WE, et al. (1967) Studies on the immongenicity, communicability, and genetic stability of oral poliovaccine administered during the winter. Am J Epidemiol 86:112–136PubMedGoogle Scholar
  39. 39.
    Risi JB (1984) The control of poliomyelitis in Brazil. Rev Infect Dis 6(Suppl 2):S400–S403Google Scholar
  40. 40.
    Hinman AR, Foege WH, de Quadros CA, Patriarca PA, Orenstein WA, Brink EW (1987) The case for global eradication of poliomyelitis. Bull WHO 65:835–840PubMedGoogle Scholar
  41. 41.
    Birmingham ME, Aylward BR, Cochi SL, Hull HF (1977) National immunization days: State of the art. J Infect Dis 175(Suppl.1):S183–S188Google Scholar
  42. 42.
    Benyesh-Melnick M, Melnick JL, Rawls WE, et al. (1967) Studies on the immongenicity, communicability, and genetic stability of oral poliovaccine administered during the winter. Am J Epidemiol 86:112–136PubMedGoogle Scholar
  43. 43.
    Chen RT, Hausinger S, Dajani AS, et al. (1996) Seroprevalence of antibody against poliovirus in innercity preschool children: implications for vaccination policy in the United States. JAMA 275:1639–1645PubMedCrossRefGoogle Scholar
  44. 44.
    Ramsey ME, Begg NT, Ghandi J, Brown D (1994) Antibody response and viral excretion after live polio vaccine or a combined schedule of live and inactivated polio vaccines. Pediatr Infect Dis J 13:1117–1121Google Scholar
  45. 45.
    Richardson G, Linkins RW, Eames MA, Wood DJ, Minor PD, Patriarca PA (1995) Immunogenicity of oral polio vaccine administered in mass campaigns versus routine immunization programs. Bull WHO 73:769–777PubMedGoogle Scholar
  46. 46.
    WHO Collaborative Study Group on Oral and Inactivated Poliovirus Vaccines (1997) Combined immunization of infants with oral and inactivated poliovirus vaccines: Results of a randomized trial in the Gambia, Oman, and Thailand. J Infect Dis 175(Suppl.1):S215–S227Google Scholar
  47. 47.
    Reichler MR, Kharabshah S, Rhodes P, Otoum H, BLoch S, Majid MA, et al. (1997) Increased immunogenicity of oral poliovirus vaccine administered inmass vaccination campaigns compared with the routine vaccination programin Jordan. J Infect Dis 175(Suppl.1):S198–S204PubMedGoogle Scholar
  48. 48.
    Deming MS, Linkins RW, Jaiteh KO, Hull HF (1997) The clinical efficacy of trivalent oral polio vaccine in The Gambia by season of vaccine administration. J Infect Dis 175(Suppl.1):S254–S257PubMedGoogle Scholar
  49. 49.
    Posey DL, Linkins RW, Couto Oliveira MJ, Monteiro D, Patriarca PA (1997) The effect of diarrea on oral poliovirus vaccine failure in Brazil. J Infect Dis 175(Suppl.1):S258–S263PubMedGoogle Scholar
  50. 50.
    Terry L (1962) The Association of Cases of Poliomyelitis with the Use of Type 3 Oral Poliomyelitis Vaccines. US Department of Health, Education and Welfare, Washington DCGoogle Scholar
  51. 51.
    Anonymous (1964) Oral poliomyelitis vaccine. Report of the Special Advisory Committee on Oral Poliomyelitis Vaccines to the Surgeon General of the Public Health Service. JAMA 190:161–163Google Scholar
  52. 52.
    Henderson DA, Witte JJ, Morris L, Langmuir AD (1964) Paralytic disease associated with oral polio vaccines. JAMA 190:41–48PubMedGoogle Scholar
  53. 53.
    Andrus JA, Strebel PM, de Quadros CA, Olive JM (1995) Risk of vaccine-associated paralytic poliomyelitis in the America, 1989–1991. Bull WHO 73:33–40PubMedGoogle Scholar
  54. 54.
    Kohler KA, Banerjee K, Hlady WG, Andrus JK, Sutter RW (2002) Vaccineassociated paralytic poliomyelitis in India, 1999: decreased risk despite massive use of oral polio vaccine. Bull WHO 80:210–216PubMedGoogle Scholar
  55. 55.
    Kohler KA, Banerjee K, Sutter RW (2002) Further clarity on vaccine-associated paralytic polio in India (letter). Bull WHO 80:987PubMedGoogle Scholar
  56. 56.
    Schonberger LB, McGowan JE Jr, Gregg MB (1976) Vaccine-associated poliomyelitis in the United States, 1961–1972. Am J Epidemiol 104:202–211PubMedGoogle Scholar
  57. 57.
    Nkowane BM, Wassilak SGF, Orenstein WA, et al. (1987) Vaccine-associated paralytic poliomyelitis: United States, 1973 through 1984. JAMA 257:1335–1340PubMedCrossRefGoogle Scholar
  58. 58.
    Strebel PM, Sutter RW, Cochi SL, Biellik RJ, Brink EW, Kew OM, Pallansch MA, Orenstein WA, Hinman AR (1992) Epidemiology of poliomyelitis in the United States:One decade after the last reported case of indigenouswild virus-associated disease. Clin Infect Dis 14:568–579PubMedGoogle Scholar
  59. 59.
    Alexander LN, Seward JF, Santibanez TA, Pallansch MA, Kew OM, Prevots DR, Strebel PM, Cono J, Wharton M, Orenstein WA, Sutter RW (2004) Vaccine policy changes and epidemiology of poliomyelitis in the United States. JAMA 292:1696–1701PubMedCrossRefGoogle Scholar
  60. 60.
    Sutter RW, Prevots DR (1994) Vaccine-associated paralytic poliomyelitis among immunodeficient persons. Infect Med 11:426,429–430, 435–438Google Scholar
  61. 61.
    de Quadros CA, Andrus JK, Olive J-M, Da Silveira CM, Eikhof RM, Carrasco P, Fitzsimmons JW, Pinheiro FP (1991) Eradication of poliomyelitis: progress in the Americas. Pediatr Infect Dis J 10:222–229PubMedCrossRefGoogle Scholar
  62. 62.
    Wright PF, Kim-Farley RJ, de Quadros CA, Robertson SE, Scott RM, Ward NA, Henderson RH (1992) Strategies for the global eradication of poliomyelitis by the year 2000. N Engl J Med 325:1774–1779CrossRefGoogle Scholar
  63. 63.
    Olivé J-M, Risi JB Jr, de Quadros CA (1977) National immunization days: Experience in Latin America. J Infect Dis 175(Suppl.1):S189–S193Google Scholar
  64. 64.
    Bilous J, Maher C, Tangermann RH, Aylward RB, et al. (1997) The experience of countries in the Western Pacific Region in conducting national immunization days for polio eradication. J Infect Dis 175(Suppl.1):S194–S197PubMedGoogle Scholar
  65. 65.
    WHO (1996) Expanded Program on Immunization. Field Guide for Supplementary Activities Aimed at Achieving Polio Eradication. World Health Organization, Geneva (WHO document WHO/EPI/GEN/95.01 REV.1)Google Scholar
  66. 66.
    Pan American Health Organization (1985) Director announces campaign to eradicate poliomyelitis from the Americas by 1990. Bull Pan American Health Org 19:213–215Google Scholar
  67. 67.
    CDC (1994) Certification of polio eradication-the Americas, 1994. MMWRMorb Mortal Wkly Rep 43:720–722Google Scholar
  68. 68.
    CDC (2001) Certification of polio eradication-Western Pacific Region, 2000. MMWR Morbid Mortal Wkly Rep 50:1–3Google Scholar
  69. 69.
    WHO (2002) Certification of poliomyelitis eradication, European Region, June 2002. Wkly Epidemiol Rec 77:221–223Google Scholar
  70. 70.
    WHO (2004) Progress towards global poliomyelitis eradication: preparation for the oral poliovirus vaccine cessation era. Wkly Epidemiol Rec 79:349–355Google Scholar
  71. 71.
    WHO (2004) Conclusions and recommendations of the Ad Hoc Advisory Committee on Poliomyelitis Eradication, Geneva, 21–22 September 2004. Wkly Epidemiol Rec 79:401–407Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2006

Authors and Affiliations

  • R. W. Sutter
    • 1
  • C. Maher
    • 1
  1. 1.Polio Eradication InitiativeWorld Health OrganizationGenevaSwitzerland

Personalised recommendations