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J Infect Dis. 2014 Nov 1;210 Suppl 1:S347-52. doi: 10.1093/infdis/jiu060.

Switch from oral to inactivated poliovirus vaccine in Yogyakarta Province, Indonesia: summary of coverage, immunity, and environmental surveillance.

Author information

1
National Institute of Health and Research Development.
2
Yogyakarta Provincial Health Office.
3
National Polio Laboratory Biofarma, Bandung, Indonesia.
4
Ministry of Health, Jakarta.
5
Provincial Health Laboratory.
6
Department of Child Health, Faculty of Medicine, Gadjah Mada University, Yogyakarta.
7
World Health Organization, Country Office, Jakarta.
8
National Institute for Health and Welfare, Helsinki, Finland.
9
World Health Organization, Geneva, Switzerland.
10
Centers for Disease Control and Prevention, Atlanta, Georgia.

Abstract

BACKGROUND:

Inactivated poliovirus vaccine (IPV) is rarely used in tropical developing countries. To generate additional scientific information, especially on the possible emergence of vaccine-derived polioviruses (VDPVs) in an IPV-only environment, we initiated an IPV introduction project in Yogyakarta, an Indonesian province. In this report, we present the coverage, immunity, and VDPV surveillance results.

METHODS:

In Yogyakarta, we established environmental surveillance starting in 2004; and conducted routine immunization coverage and seroprevalence surveys before and after a September 2007 switch from oral poliovirus vaccine (OPV) to IPV, using standard coverage and serosurvey methods. Rates and types of polioviruses found in sewage samples were analyzed, and all poliovirus isolates after the switch were sequenced.

RESULTS:

Vaccination coverage (>95%) and immunity (approximately 100%) did not change substantially before and after the IPV switch. No VDPVs were detected. Before the switch, 58% of environmental samples contained Sabin poliovirus; starting 6 weeks after the switch, Sabin polioviruses were rarely isolated, and if they were, genetic sequencing suggested recent introductions.

CONCLUSIONS:

This project demonstrated that under almost ideal conditions (good hygiene, maintenance of universally high IPV coverage, and corresponding high immunity against polioviruses), no emergence and circulation of VDPV could be detected in a tropical developing country setting.

KEYWORDS:

immunization; polio; poliovirus circulation

PMID:
25316854
DOI:
10.1093/infdis/jiu060
[Indexed for MEDLINE]

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