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Live or inactivated poliomyelitis vaccine: An analysis of benefits and risks

Author

Listed:
  • Hinman, A.R.
  • Koplan, J.P.
  • Orenstein, W.A.
  • Brink, E.W.
  • Nkowane, B.M.

Abstract

Using decision analysis we evaluated the benefits and risks of continued primary reliance on oral poliomyelitis vaccine (OPV) compared to use of inactivated poliovirus vaccine (IPV). We followed a hypothetical cohort of 3.5 million children from birth to age 30 assuming 95 per cent coverage with 98 per cent effective vaccine. Primary reliance on IPV would result in more cases of paralytic poliomyelitis as well as more susceptibles remaining in the population than would be expected with continuing OPV use (74.1 vs 10.0 cases and 5.9 per cent vs 1.1 per cent susceptibles, respectively). However, with OPV use, most cases of paralysis seen would be associated with the vaccine. Our analysis supports a continuation of current US policy primary reliance on OPV but the conclusion is heavily dependent on assumptions of risk of exposure to wild virus in the United States. Major declines in risk of exposure to wild virus could alter the balance significantly.

Suggested Citation

  • Hinman, A.R. & Koplan, J.P. & Orenstein, W.A. & Brink, E.W. & Nkowane, B.M., 1988. "Live or inactivated poliomyelitis vaccine: An analysis of benefits and risks," American Journal of Public Health, American Public Health Association, vol. 78(3), pages 291-295.
    • Handle: RePEc:aph:ajpbhl:1988:78:3:291-295_2
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    Cited by:

    1. Frank A. Sonnenberg & Mark H. Eckman, 1991. "Health Outcomes Research and Its Interfaces with Medical Decision Making," Medical Decision Making, , vol. 11(4_suppl), pages 15-31, December.
    2. Kimberly M. Thompson & Radboud J. Duintjer Tebbens, 2006. "Retrospective Cost‐Effectiveness Analyses for Polio Vaccination in the United States," Risk Analysis, John Wiley & Sons, vol. 26(6), pages 1423-1440, December.
    3. Raisa B. Deber & Vivek Goel, 1990. "Using Explicit Decision Rules to Manage Issues of Justice, Risk, and Ethics in Decision Analysis," Medical Decision Making, , vol. 10(3), pages 181-194, August.

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