Risks associated with the use of live-attenuated vaccine poliovirus strains and the strategies for control and eradication of paralytic poliomyelitis

Abstract

The Global Polio Eradication Initiative was launched in 1988 with the aim to eliminate paralytic poliomyelitis. Two effective vaccines are available: inactivated polio vaccine (IPV) and oral polio vaccine (OPV). Since 1964, OPV has been used instead of IPV in most countries due to several economic and biological advantages. However, in rare cases, the live-attenuated Sabin strains of OPV revert to neurovirulence and cause vaccine-associated paralytic poliomyelitis in vaccinees or lead to emergence of vaccine-derived poliovirus strains. Attenuating mutations and recombination events have been associated with the reversion of vaccine strains to neurovirulence. The substitution of OPV with an improved new-generation IPV and the availability of new specific drugs against polioviruses are considered as future strategies for outbreak control and the eradication of paralytic poliomyelitis worldwide.

Keywords::

• immunization schedules
• inactivated polio vaccine
• mutations
• neurovirulence
• oral polio vaccine
• recombination
• vaccine-associated paralytic poliomyelitis
• vaccine-derived polioviruses

Financial & competing interests disclosure

This work was supported by research grants of the Postgraduate Program ‘Applications of Molecular Biology-Genetics. Diagnostic Biomarkers,’ code 3817, of the University of Thessaly, School of Health Sciences, Department of Biochemistry and Biotechnology, Larissa, Greece. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.