Poliovirus vaccination options for achieving eradication and securing the endgame

• 2012 had the lowest number of polio cases in the lowest number of countries.
• Outbreaks of vaccine-derived poliovirus have increased and are mostly due to type 2.
• Use of inactivated poliovirus vaccine in routine immunization is recommended before withdrawal of type 2 oral vaccine.
• Inactivated poliovirus vaccine will enhance the effectiveness and decrease the risks of oral poliovirus vaccines.

In 1988, the World Health Assembly resolved to globally eradicate poliomyelitis. As part of a four-pronged strategy with establishment of enhanced surveillance, institution of national immunization days, strengthening routine immunization, and carrying-out mopping-up activities, oral poliovirus vaccine (OPV) was selected as the vaccine-of-choice for eradication. Massive OPV use decreased the number of polio-endemic countries from >125 countries in 1988 to only 3 in 2012 and led to a >99.9% decrease in polio incidence in the corresponding period. In this communication, we will discuss polio vaccination options to accelerate eradication, to mitigate the risks during the planned withdrawal of type 2 OPV, and to secure eradication for future generations.