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The polio endgame: rationale behind the change in immunisation
  1. Julie Garon1,
  2. Manish Patel2
  1. 1Department of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia, USA
  2. 2Center for Vaccine Equity, Task Force for Global Health, Decatur, Georgia, USA
  1. Correspondence to Julie Garon, Department of Infectious Diseases, Emory University School of Medicine, 1462 Clifton Rd NE, Suite 446, Atlanta, GA 30322, USA; julie.garon{at}


The decades long effort to eradicate polio is nearing the final stages and oral polio vaccine (OPV) is much to thank for this success. As cases of wild poliovirus continue to dwindle, cases of paralysis associated with OPV itself have become a concern. As type-2 poliovirus (one of three) has been certified eradicated and a large proportion of OPV-related paralysis is caused by the type-2 component of OPV, the World Health Assembly endorsed the phased withdrawal of OPV and the introduction of inactivated polio vaccine (IPV) into routine immunisation schedules as a crucial step in the polio endgame plan. The rapid pace of IPV scale-up and uptake required adequate supply, planning, advocacy, training and operational readiness. Similarly, the synchronised switch from trivalent OPV (all three types) to bivalent OPV (types 1 and 3) involved an unprecedented level of global coordination and country commitment. The important shift in vaccination policy seen through global IPV introduction and OPV withdrawal represents an historical milestone reached in the polio eradication effort.

  • poliomyelitis
  • oral polio vaccine
  • inactivated polio vaccine
  • eradication
  • endgame

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  • Twitter Follow Julie Garon @JulieRGaron

  • Contributors JG drafted the paper with input from MP. JG and MP contributed to writing and revision of the submitted manuscript.

  • Funding JG and MP are supported by the Bill and Melinda Gates Foundation under grant OPP1095024. The authors have no other relevant affiliations or financial involvement with any organisation or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; externally peer reviewed.

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