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  • Title: Safety of oral poliomyelitis vaccine: results of a WHO enquiry.
    Author: Esteves K.
    Journal: Bull World Health Organ; 1988; 66(6):739-46. PubMed ID: 3266113.
    Abstract:
    The date received from the 13 countries participating in the World Health Organization (WHO) collaborative study to obtain information on the possible risks associated with the use of oral poliomyelitis vaccine (OPV) and on measures to reduce these risks if they were shown to exist are reported for 1980-84. The data largely confirm earlier patterns and particularly those for 1975-79. 4 countries with a total population of 39 million were free from cases of acute persistent spinal paralysis (APSP) all through 1980-84; 8 countries with a population of 485 million had a low incidence of the disease; and 1 country with a population of 22.6 million continued to experience more cases than any of the others. From a total population of 547 million (1983 estimate), a total of 395 cases of APSP fulfilled the criteria for inclusion in the study, representing an annual average rate of 0.14 cases/1,000,000 population in the 5-year period. 305 of the cases were reported from 1 country. The annual rate in this country was 90 times higher than that of the other countries in the study. 10 countries used oral vaccine; 3 of them administered 20 million doses, and the remaining 7 reported the distribution of 193 million doses. Different approaches were used in the 4 countries that did not report any cases during the 1980-84 period; all these approaches were shown to be effective. Country No. 1 used mono-, bi-, and trivalent oral poliovaccines administered in short-term campaigns. Country No. 2 had a combined vaccination schedule of 3 doses of inactivated poliovaccine followed by 3 doses of oral vaccine administered throughout the year. Countries No. 6 and 12 relied exclusively on inactivated poliovaccine. Of the 8 countries reporting 90 cases of APSP during 1980-84, 6 relied exclusively on OPV. In these 6 countries, based on an estimated overall vaccine acceptance rate of 67% in the 1980-84 period, nearly 24 million children would have completed the full course of primary vaccination within their 1st 2 years of life. There were 32 recipient cases among this child population of 24 million. In sum, the primary conclusion of this study, which extended over a 15-year period, is that oral poliovaccine continues to be one of the safest vaccines in use. The risk of vaccine associated, in all but 1 participating country, was less than 1/1,000,000 vaccinees, cases due to type 3 virus being the most common in both vaccine recipients and contacts. Type 2 occurred more often in contacts than in vaccinees, and type 1 was rarely implicated.
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