Globally Polio eradication is not yet achieved !

James Khangenbam *

Pulse polio immunization programme underway at Moreh Primary Health Centre with ADC, Moreh Robert Kshetrimayum on February 22 2015 :: Pix - HL

Globally Polio eradication is not yet achieved. Despite India's success in aiming to eradicate polio, risks for re-introduction of the disease remain, particularly through importation from endemic countries such as Nigeria, Afghanistan and Pakistan. Nigeria is on the way to becoming polio free with no polio case reported for the past 12 months. One of the strategies to prevent re-emergence of Polio is to strengthen routine immunization coverage and further boost the immunity against poliovirus by providing children with IPV.

The goal of a polio free world

In May 2013, the World Health Organisation (WHO) recommended the inclusion of one dose of the Inactivated Poliovirus Vaccine (IPV) into the Routine Immunization Schedules worldwide. This recommendation was made under a plan to achieve and sustain a polio free world. Under this, IPV would be given in addition to the existing Oral Polio Vaccine (OPV), in order to boost population immunity.

Introducing IPV in India

In line with India's commitment to the Polio Endgame Strategic Plan (2013 – 2018), the Ministry of Health and Family Welfare, Government of India plans to introduce one dose of IPV into the routine immunization programmes by 2015.

When to get IPV

Currently, children under two years of age in India receive a birth dose of OPV in institutional delivery, 3 doses at six, ten and fourteen weeks and one booster dose at one and a half years as part of routine immunization. OPV is also administered during periodic polio vaccine campaigns that target all children under five years of age.

A single dose of IPV injection is to be administered to children with the third dose of OPV at 14 weeks. In delayed cases, the child can be given IPV upto one year of age along with third dose of OPV. IPV will be introduced in a phased manner throughout all states and union territories of India, from November 2015 onwards, in addition to the OPV.

How is IPV different from OPV?

The OPV is a live attenuated vaccine that is taken orally as drops. OPV is given under the national immunization schedules at birth (in institutional deliveries) and six, ten and fourteen weeks of age with one booster at one and a half years of age and is also given during polio campaign to all children under 5 years of age. OPV remains the main preventive measure against polio.

The IPV vaccine on the other hand is an inactivated or killed vaccine and is given through an injection. Given in addition to the third dose of OPV at the age of 14 weeks, IPV strengthens the immune system and provides further protection from Polio.

Following immunization with IPV, it is essential that parents continue to immunize their children with OPV every time it is offered.

What are the benefits of IPV?

IPV serves the dual purpose of quickly boosting child's immunity to polio, thus overall population immunity and helps in preventing any possible polio outbreak in the country.

Vaccinating each child in India and across the world remains a priority. The poliovirus is an extremely tenacious virus and can re –emerge and re – infect if there is any complacency regarding polio vaccination campaigns. Given the threat of importation of the poliovirus from neighbouring polio endemic countries such as Pakistan and Afghanistan, it is important to maintain very high population immunity. IPV along with third dose of OPV boosts polio immunity and will prevent re-introduction of poliovirus.

How safe is IPV introduction?

IPV is an extremely safe and effective vaccine and has been used successfully in many countries for several decades. In India too, it has been used for the past many years by the private doctors. IPV protects children against all three forms of poliovirus, and when used in combination with other vaccines.

As with other vaccines, minor local reactions such as redness and tenderness may occur following IPV.IPV can be safely administered to children with immune deficiency or prematurely born infants (i.e <37 weeks gestation) at the recommended age along with other routine vaccinations. IPV is administered intramuscularly and can be given along with other inject able vaccines such as DPT, Hepatitis – B and Pentavalent vaccine. Most middle and high income countries have been safely using multiple injections for more than a decade.

Why is Polio Immunization important?

The Poliovirus causes permanent paralysis in the arms and legs and often leads to death. The poliovirus enters the body through mouth, often when one eats food or drinks water contaminated with faecal matter from an infected person. The virus multiplies in the intestines before invading the nervous system and causing paralysis or death.

The virus usually affects children under 5 years of age. Preventing polio using vaccination is the only way to defeat the disease. There is no cure, and no other effective way besides vaccination to prevent the disease. There is no cure, and no other effective way besides vaccination to prevent the disease from spreading.

Progress in Polio Eradication

Just thirty years ago, polio continued to cause disability and death among thousands of children across the world. The Global Polio Eradication Initiative (GPEI), launched in 1988, aimed to eradicate this disease through a series of polio immunization campaigns and through high routine immunization coverage. As a result, the incidence of polio worldwide has been reduced by more than 99 %. India too has achieved tremendous success in polio eradication.

As late as 2009, India would be the last country to eliminate polio. The last case of Wild Poliovirus (type 1) in India was on 13th January 2011 in Howrah, West Bengal. India was certified Polio Free on 27th March 2014.

(Extract from Regional Media Workshop for IPV & Penta valent introduction in 7 NE States held on 29th September 2015 at Indian Institute of Bank Management Khanapara, Guwahati)