Lower immunity to poliomyelitis viruses in Australian young adults not eligible for inactivated polio vaccine | Vaccine.
[Pay to View Full Text] [Received 2 September 2019, Revised 23 January 2020, Accepted 27 January 2020, Available online 7 February 2020] [In Press, Corrected Proof]
There are limited long-term data on seroprevalence of neutralising antibody (nAb) to the three poliovirus serotypes following the switch from oral polio vaccine (OPV) to inactivated polio vaccine (IPV). In Australia, combination vaccines containing IPV replaced OPV in late 2005. Using serum and plasma specimens collected during 2012 and 2013, we compared prevalence of nAb to poliovirus type 1 (PV1), type 2 (PV2) and type 3 (PV3) in birth cohorts with differing IPV and OPV eligibility from an Australian population-based sample. In the total sample of 1673 persons aged 12 months to 99 years, 85% had nAb against PV1, 83% PV2 and 67% PV3. In the cohort 12 to <18 years (eligible for 4 OPV doses, last dose 8–14 years prior), a significantly lower proportion had nAb than in the 7 to <12 year cohort (eligible for 3 OPV doses and an IPV booster, last dose 3–8 years prior) for all poliovirus types: [PV1: 87.1% vs. 95.9% (P = 0.01), PV2: 80.4% vs. 92.9% (P = 0.003) and PV3: 38.1% vs. 84.0% (P < 0.0001)]. These data suggest individual-level immunity may be better maintained when an OPV primary schedule is boosted by IPV, and support inclusion of an IPV booster in travel recommendations for young adults who previously received only OPV.
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Pakistan: Drops, injectibles, or both? And other routine queries on polio vaccine answered | DAWN.
[February 12, 2020] Zofeen T. Ebrahim writes:
Public health expert and an epidemiologist specialising in disease control and eradication, Dr Rana Muhammad Safdar, was recently reappointed National Coordinator for Polio Eradication. His work in reducing polio cases from 306 in 2014 to just eight in 2018 has been widely commended. Recently, he took some time out to respond to the routine queries that parents have regarding the polio vaccine.
Q: Why are there two different types of polio vaccines? Does my child need both?
RMS: The two different types of polio vaccines namely OPV (Oral Polio Vaccine) and IPV (Inactivated Polio Vaccine) are given orally and through an intramuscular injection respectively.
OPV is good for inducing gut immunity (intestinal/surface) as well as humoural (blood) immunity. IPV is better than OPV in terms of quick boosting of humoural immunity which safeguards the individual child against paralysis. However, it doesn’t help in strengthening intestinal immunity like OPV does. As OPV blocks the receptors in the intestines and wild polio virus (WPV) that paralyses the child cannot harbour there to increase in number, it not only helps in promoting immunity of the individual child (both humoural and intestinal) but also helps prevent other children from being attacked by WPV.
Q: Is IPV safe? Does IPV have any side effects?
RMS: Overall, polio vaccine is quite safe in both forms. The only issue with IPV can be the slight pain from the injection or any side effect due to wrongly administering the injection, that is, if it's not given by a trained person and/or in hygienic conditions.
Q: I have given several doses of OPV to my child, so does he/she still needs it every time a polio worker comes knocking?
RMS: The number of campaigns in an area are decided based on the current risk by the technical team of experts. And that current risk depends on several factors. Since giving OPV not only saves the child but also helps in protecting others and in eradicating the crippling disease, it is imperative to give your child OPV drops every time the teams come to your home.
Q: I only want my child to receive one polio vaccine, IPV or OPV, but not both. Is there any evidence that multiple injections of vaccines may increase the risk for adverse events?
RMS: Polio vaccine is the safest vaccine on earth. There are no side effects. IPV is given to have an early boost of the personal immunity and we give only one dose of IPV normally in routine. However, OPV should be repeatedly given to further strengthen the immunity, as well as provide the extra level of gut/intestinal immunity. Only one dose of IPV cannot completely safeguard the child from paralysis and/or harbouring the virus in the intestine which multiplies several folds to reach millions (in number) and affect the same child and/or other children. Hence, administration of at least one dose of IPV and then repeated doses of OPV is suggested and advised.
Q: Aren’t multiple injections painful for the child?
RMS: As the needle is a pointed object, it definitely causes some pain. However, for the use of anything, its indications and side effects are weighed. So, the indications and benefits of vaccines are too many and hence shouldn’t be avoided just because of the slight pain caused by the injection process. Leaving children exposed to different pathogens (disease causing agents) just because of a small duration of pain is not a wise idea at all.
Q: If my child receives multiple injections in the same visit, will the vaccines be as effective if given alone? Can multiple vaccines given at once overwhelm a child’s immune system?
RMS: Vaccines given at the same time are as effective as when given alone. Studies show the same, and for reasons, different antigens (vaccines) are given at the same time. It also saves the time of the parents by decreasing the number of visits as well as decreases the pain of the children because of multiple injections. For instance, five different vaccines are given in just one injection known as Pentavalent (for Diphtheria, Pertussis, Tetanus, Hepatitis B, H. Influenza).
So don’t worry about any side effects (except fever and pain with some injectable vaccines) and opt for the vaccinations as advised by experts for the children's overall health.
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Republic of Congo steps up polio vaccination in border region | World Health Organization via ReliefWeb.
[11 Feb 2020]
[Published on 11 Feb 2020 —View Original]
Ouesso, (Congo), 11 February 2020 - Under a sultry and showery sky, small teams fanned out across villages in Sangha, a department in the far north of Republic of the Congo, vaccinating children against wild poliovirus in the country's latest campaign to boost immunization and suppress the risk of cross-border transmission.
Sangha borders Cameroon and Central African Republic, where circulating vaccine-associated poliovirus was detected in 2019. Vaccinator Yvonne Komba and her team visited over 16 villages and vaccinated more than 30 children on the third and last day of the campaign. Unlike years past, Ms Komba recounted, communities are more receptive to vaccinations thanks largely to public health education and regular immunization campaigns.
"Parents are now conscious about the dangers of failing to vaccinate children against polio," said Ms Komba, but pointed out that at times they have worked with village leaders when some families refuse to have their children immunized.
Mother of two Christelle Bangondo readily brought her children for vaccination when Ms Komba's team came to her village, saying she trusted vaccines after a previous immunization against diphtheria, tetanus and whooping cough made her children less prone to coughing.
Low immunization risks.
Congo's last major wild polio outbreak was in 2010. The poliovirus type 1 (there are three types) epidemic infected more than 180 people and killed 85, mostly in the Atlantic port city of Pointe Noire in an outbreak found to be linked to one that was going on in neighbouring Angola. The majority of the infections and deaths were in people over 15 years.
No outbreak of such scale has since occurred in Congo. The country has stepped up polio control measures, but the rate of vaccination was still below 80% in 2019, although up from 68% the year before. Low immunization coverage and poor sanitation puts Congo at risk of circulating vaccine-derived poliovirus
In such settings the virus excreted by children after oral polio vaccination can be transmitted, leading to genetic changes and emergence of circulating vaccine-derived poliovirus. When enough people in a community are immunized, the virus is deprived of susceptible hosts and will die out. High levels of vaccination coverage must be maintained to stop transmission and prevent outbreaks. The virus can easily be imported into a polio-free country and can spread rapidly amongst unimmunized populations. So far Congo has not had a vaccine-derived poliovirus case.
The vaccination drive in Sangha targeting more than 24 000 children was the second in 2019. A countrywide one was held six months earlier. Two campaigns are planned in 2020. The mass immunizations are in addition to routine vaccinations.
Dr Edouard Ndinga, who heads the polio programme at World Health Organization in Congo, noted that the country's current polio vaccination rate "does not ensure full immunity for all children."
Weak public health system, inadequate personnel, logistical challenges and difficulty in reaching some localities are among the impediments to comprehensive polio vaccination efforts in Congo.
Polio has no cure. It can only be prevented. The polio vaccine can protect a child for life.
At the end of the campaign in Sangha, more than 19 000 children were vaccinated. Some far-flung localities were, however, not reached due to logistical difficulties. "The response by the communities during the vaccination campaign was impressive," said Dr Rene Malhela, director of the public health department in Sangha. A few months before the vaccination drive, four suspected polio cases were reported in Sangha, but they turned out negative, Dr Malhela said, pointing out that educating the population, disease surveillance and vaccinations have helped curb the virus.
"It's been more than 20 years since we had a child paralysed by polio. Vaccinations have made a huge impact. said Dr Malhela.
The world has made major progress towards wild polio eradication. In October 2019, an independent expert commission certified wild poliovirus type 3 as eradicated. Type 2 has been eradicated.
This year, Africa is on the cusp of a monumental public health success. With no cases of wild polio virus type 1 reported since August 2016, the region is on track to be certified to have eradicated wild polioviruses in 2020.
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Pakistan: Polio drive aims to immunise 2.3m children across Karachi | The Express Tribune.
[February 11, 2020]
KARACHI: The recent spike in polio cases is a result of problems created against the polio vaccine in Khyber-Pakhtunkhwa, which brought immunisation drives to a standstill last year, claimed Sindh Chief Minister Syed Murad Ali Shah.
He was talking to the media after inaugurating a seven-day vaccination campaign by administering polio drops to children at Rural Health Centre, Baldia, on Monday.
“The increase of 30 cases in 2019 is the result of that stalemate [last year]; otherwise, we had come close to controlling polio and had only one case in 2017,” he stated, adding that five new cases had already been detected in 2020. “This is a painful development for me because I have been making efforts to eradicate the disease, but negative results have come up,” he deplored.
Shah said that there should have been a meeting of the National Polio Eradication Taskforce under the prime minister in November, but it could not be arranged. “Now, our strategy has changed to involve local bodies, civil society and parents to save our future generations from the crippling disease,” he explained.
“This is the question of our children – parents must decide where they want a healthy future for them or disability for their entire life,” he stated, urging parents across Pakistan to be responsible and make sure their children are immunised against polio.
The CM said that 2.3 million children would be targeted for immunisation in the week-long campaign, while another campaign would be launched in the remaining districts of Sindh on February 17, targeting 6.7 million children. He encouraged parents to take their children to hospitals for vaccination if they missed it during this round of campaigns.
He thanked the 13,000 workers participating in the polio drive, as well as the law enforcement personnel who are providing security for them. “All this is being done for the betterment of our children,” he said, adding that this campaign would be followed by more drives in March and April.
“Karachi happens to be the hub for local, national and trans-national population interactions in the country and, in turn, becomes the amplifier of not only local but also imported virus transmission. Nonetheless, our frontline workers are resilient,” an Emergency Operation Centre official told The Express Tribune.
Responding to a question, the chief minister said that local government bodies had to start a drive against stray dogs, in light of a rising number of dog attacks being reported. “I have given them special instructions to start a special drive and save people, particularly children, from dog bites,” he stated.
On the same day, it was revealed that the Sindh local government department has set up the 1093 helpline to receive public complaints such as those pertaining to stray dogs, water supply and sewerage across Sindh.
Local government secretary Roshan Ali Shaikh, in a meeting on Monday, said that the complaints would be forwarded to the relevant district and town authorities for immediate action.
Meanwhile, Sindh chief secretary Syed Mumtaz Ali Shah, who was chairing the meeting, directed officials to ensure the availability of anti-rabies vaccines and anti-snake venom at hospitals. He also ordered them to set up isolation wards in hospital, in view of the global coronavirus outbreak.
The meeting also reviewed the polio campaign, anti-encroachment drives, stray dog attacks and prices and hoarding of essential commodities.
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Infographic: Polio Snapshot Afghanistan (December 2019) | World Health Organization, UN Children's Fund via ReliefWeb.
[11 Feb 2020] [Published on 31 Dec 2019]
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Polio Eradication Initiative senior leadership from Afghanistan and the region assessed the programme activities in Kandahar.
A joint mission led by the Senior advisor to the Minister / National Focal Point for Polio Eradication Dr. Hedayatullah Stanekzai, WHO Director for PEI across the WHO Eastern Mediterranean Region, Dr. Syed Hamid Jafari, Afghanistan/Pakistan Polio Hub Coordinator Dr. Joanna Nikulin, WHO Representative in Afghanistan Dr. Richard Peeperkorn, and WHO Polio Team Leader for Afghanistan Dr. Zubair Wadood Mufti visited Kandahar to assess the programme.
Afghanistan as a country in general and the southern region as the polio transmission engine in particular present numerous challenges, where insecurity and inaccessibility are atop. While reviewing the situation in the southern region at the Emergency Operation Centre,
Dr. Stanekzai urged the teams, including polio and EPI teams to synergistically work toward the goal of polio eradication.
In addition to an emphasis on more female workers for enhanced access, and focusing on population on the move, Dr. Hamid Jafri, emphasized that campaigns’ quality improvement in large and accessible population centres of Kandahar and Lashkargah was vital. Such focus, Dr. Jafari insisted, would stop poliovirus transmission in the southern region and Afghanistan.
Mr. Jafari says, “We are definitely up against a lot of challenges in Afghanistan and Pakistan, however, at the end of the day it is not a task too complicated. What we need is undivided attention of all parties involved and eventually support of the mothers and fathers who have children aged under five.” The delegation also met the Governor of Kandahar seeking his support and personal patronage for polio programme, and made field visits to meet the vaccination teams, their supervisors and observed the surveillance system for polioviruses. The delegation had in-depth discussions with the field staff to better understand the challenges and discuss the possible solutions and way forward.
UNICEF Ethiopia Humanitarian Situation Report No. 12 – Reporting Period: January to December 2019 | UN Children's Fund via ReliefWeb.
[11 Feb 2020] [Published on 31 Dec 2019]
• Over 4.89 million children required humanitarian assistance in the year 2019. Displacements due to inter-ethnic conflicts, food insecurity triggered by natural and man-made crises, and disease outbreaks drove humanitarian needs.
• UNICEF supported over 1.41 million children with WASH Non-Food-Items (NFIs); 731,044 children were vaccinated against measles (of which 11,044 were newly arrived refugee children); 315,467 children were treated for Severe Acute Malnutrition (SAM), including 4,017 refugee children; 263,894 children including 134,586 girls were given access to education; 99,681 children were provided with psychosocial support and 117,164 women and children received information on Gender-Based Violence (GBV) - how it can be prevented and how survivors can access support and services.
• UNICEF’s programme implementation was affected by restricted access to communities due to insecurity, underfunding to deliver the planned services, interruption to service delivery due to a return campaign led by the Government, and limited partner presence in critical geographical areas.
Situation in Numbers 4.89 million
# of children in need of humanitarian assistance
people in need
(HRP October 20192)
Internally displaced people (IDPs) – (DTM Round 193)
# registered refugees
(UNHCR December 2019)
Situation Overview & Humanitarian Needs.
In 2019, conflict-induced displacement, climatic shocks, and the lack of recovery from previous years have continued to drive humanitarian needs. Ethiopia is home to 735,204 refugees, of whom 415,3901 are children. New monthly arrivals in 2019 varied from 6,000 to 11,000, with more than three-quarters of arrivals from Eritrea.
In April, the number of internally displaced persons, driven by conflict and drought, peaked at 3.1 million (2.5 million were conflict-induced and 600,000 were climate-induced; 61 per cent were children). Internally displaced people, especially those living in collective sites, had limited access to basic services, lacked opportunities to rebuild livelihoods, and faced protection risks amid wider security concerns. Family separations, breakdown of support networks, disease outbreaks, and interrupted access to food in 2019, worsened existing vulnerabilities to acute malnutrition. Poor or no access to primary health services, inadequate water and sanitation facilities, and poor health-seeking and hygiene practices put displaced children at a higher risk of contracting preventable diseases in crowded collective sites. Following the March launch of the Government’s Plan to address internal displacements in Ethiopia, over 2.1 million conflict-induced IDPs had been returned, integrated or relocated by May2. Nevertheless, 1.6 million IDPs3, including 850,000 children, are still officially displaced and will require humanitarian assistance in 2020. Likewise, many of those returned remained displaced, without access to basic services and recovery support, and in communities experiencing on-going or renewed insecurity.
New displacements are active and remain a threat to existing caseloads as the potential for conflicts over scarce natural resources and unresolved regional border issues remain.
Erratic and below-normal spring belg/gu/genna rainfall resulted in water and pasture shortages and poor livestock conditions and contributed to deteriorating food and nutrition security in the lowlands. Food insecurity affected over eight million people. In 2020, food security is expected to worsen to Crisis (IPC 34) between February and June in Belg-dependent and pastoralist areas affecting 4.2 million children, of whom 444,000 are expected to be affected by SAM, and three million pregnant and lactating women and children are expected to be affected by Moderate Acute Malnutrition (MAM).
Floods in Afar, Amhara, Benishangul-Gumuz, Gambella, Oromia, Southern Nations Nationalities and People’s Region (SNNP), Somali and Tigray contributed to displacements and the loss of livestock and crops affecting 795,000 people.
In the Somali Region, unseasonal and extended heavy rainfall resulted in floods that severely damaged infrastructure and disrupted people’s livelihoods.
Ethiopia remains vulnerable to outbreaks of epidemic prone diseases. Cholera is a major public health risk and 2,565 cases were reported in 2019 in Addis Ababa, Afar, Amhara, Dire Dawa, Harari, Oromia, SNNP, Somali and Tigray regions. While reported cases were lower than in previous years, predisposing factors remain, with communities remaining vulnerable. Other epidemics reported in 2019 include measles, vaccine derived polio virus type 2, malaria and chikungunya.
With Ethiopia endorsing the amended Refugee Proclamation in January 20195, it is imperative that interventions are designed to not only respond to immediate humanitarian needs but establish, longer-term durable solutions for refugee integration within host communities. Similarly, Ethiopia’s commitment to ratification of the Kampala Convention and consequent national legislation would ensure better protection of IDP rights in Ethiopian domestic law and policy.
A Durable Solutions Initiative for IDPs was launched in December 2019 and intends to link humanitarian and development interventions for longer-term sustainable gains. Similarly, a Multi-Year Resilience Strategy will be implemented from 2020-2025 to improve outcomes for 12 drought-prone zones in Ethiopia’s north-east that have received multi-year assistance for both chronic poverty and food insecurity.
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Malaysia: Education, Health Departments to administer polio vaccine at kindergartens |
[FEBRUARY 11, 2020]
Shafie (right) with Mistirine during their meeting at the Sabah Administrative Centre yesterday.
KOTA KINABALU: The State Education Department will work together with the Health Department for the administration of the oral polio vaccine at kindergartens.
Its director, Dr Mistirine Radin, said that she is not sure how it is going to be planned, adding that she had just returned to work and had just begun to go through all her mails.
Nevertheless, she said that she had already received the letter from the Health Department concerning the issue.
This is the follow-up of the announcement made by Deputy Health Minister Dr Lee Boon Chye that all children below five years old in Sabah including undocumented and non-citizens would be given oral polio vaccine at the end of last year.
The announcement was made after a three-month-old baby in Tuaran was reported to have contracted polio.
Since the discovery, two more cases of polio had been discovered in Sabah.
Mistirine told reporters on the issue after meeting with Chief Minister Datuk Seri Panglima Mohd Shafie Apdal to discuss about the upcoming state-level Teachers’ Day celebration which is scheduled from April 9 to 17.
The event is to take place at the ITCC in Penampang as the district education office will be the host this year.
Mistirine also told reporters on the bully case involving seven secondary school students which allegedly took place outside a school compound.
She said her department would cooperate with the police on the case.
Police have arrested seven Form Four students for allegedly assaulting their schoolmate at a public park in Taman Nelly in Inanam on Saturday after the 15-year-old victim lodged a police report. .
Police have started investigating the case under Section 148 of the Penal Code for rioting with a weapon.
A video of the attack on Feb 5 has been shared widely on social media.
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