Polio Endgame: IAPCOI perspectives

Vipin M. Vashishtha, MDConvener, IAPCOI

vipinipsita@gmail.com

Individual protection:

• Does end game have ANY significance to IAPCOI recommendations?

• What impact does endgame has on our recommendations on polio vaccination?

• Should we respect the government/GPEI policies on end game?

Public use:

• What level of involvement is desired?– Only advocacy for initiating process of devising

consultations?– Preparing a document for ideal way to approach

‘end game’?– Drafting & presenting a detailed document on

indigenous ‘post-eradication polio immunization’ policy?

Public use: ‘End game’

Issues on broader IPV use:• What ought to be our recommendations on?– When to start: Before ‘switch’ Vs at ‘switch’? – Number of dosage: 1 or 2 or more?– To whom : limited Vs universal?– What preparation: Sabin Vs Salk? Adjuvanted Vs

non-adjuvanted? Stand-alone Vs combination?– What route: fractional dose (ID) Vs full dose IM?

Public use: Post-eradication polio immunization strategy

Options:• No IPV; surveillance & response• Population priming only• Immunity for ONE year• Immunity for entire childhood

Post-eradication polio immunization strategy

• If universal IPV option is chosen, when IPV should be incorporated in RI?

• Prior to OPV cessation• At the time of OPV cessation

Post-eradication polio immunization strategy

• If universal IPV option is chosen, how IPV should be incorporated in RI?

• Gradual introduction, staggered approach • Simultaneous all over the country

Post-eradication polio immunization strategy

• If universal IPV option is chosen, how long IPV should be continued?

• Indefinite• Finite (5 years ?)

Other issues:

• How long AFP surveillance to continue?• How to discontinue OPV? – Global Vs regional Vs national synchronization?

• How to deal with future outbreaks of cVDPVs after OPV cessation?

Factors influencing future demand, supply & cost of IPV

Issues related to wider use of IPV

Strategic issues Technical issues