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Review and Assessment of Poliovirus Immunity and Transmission: Synthesis of Knowledge Gaps and Identification of Research Needs

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  • Radboud J. Duintjer Tebbens
  • Mark A. Pallansch
  • Konstantin M. Chumakov
  • Neal A. Halsey
  • Tapani Hovi
  • Philip D. Minor
  • John F. Modlin
  • Peter A. Patriarca
  • Roland W. Sutter
  • Peter F. Wright
  • Steven G.F. Wassilak
  • Stephen L. Cochi
  • Jong‐Hoon Kim
  • Kimberly M. Thompson

Abstract

With the intensifying global efforts to eradicate wild polioviruses, policymakers face complex decisions related to achieving eradication and managing posteradication risks. These decisions and the expanding use of inactivated poliovirus vaccine (IPV) trigger renewed interest in poliovirus immunity, particularly the role of mucosal immunity in the transmission of polioviruses. Sustained high population immunity to poliovirus transmission represents a key prerequisite to eradication, but poliovirus immunity and transmission remain poorly understood despite decades of studies. In April 2010, the U.S. Centers for Disease Control and Prevention convened an international group of experts on poliovirus immunology and virology to review the literature relevant for modeling poliovirus transmission, develop a consensus about related uncertainties, and identify research needs. This article synthesizes the quantitative assessments and research needs identified during the process. Limitations in the evidence from oral poliovirus vaccine (OPV) challenge studies and other relevant data led to differences in expert assessments, indicating the need for additional data, particularly in several priority areas for research: (1) the ability of IPV‐induced immunity to prevent or reduce excretion and affect transmission, (2) the impact of waning immunity on the probability and extent of poliovirus excretion, (3) the relationship between the concentration of poliovirus excreted and infectiousness to others in different settings, and (4) the relative role of fecal‐oral versus oropharyngeal transmission. This assessment of current knowledge supports the immediate conduct of additional studies to address the gaps.

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  • Radboud J. Duintjer Tebbens & Mark A. Pallansch & Konstantin M. Chumakov & Neal A. Halsey & Tapani Hovi & Philip D. Minor & John F. Modlin & Peter A. Patriarca & Roland W. Sutter & Peter F. Wright & S, 2013. "Review and Assessment of Poliovirus Immunity and Transmission: Synthesis of Knowledge Gaps and Identification of Research Needs," Risk Analysis, John Wiley & Sons, vol. 33(4), pages 606-646, April.
  • Handle: RePEc:wly:riskan:v:33:y:2013:i:4:p:606-646
    DOI: 10.1111/risa.12031
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    1. Kimberly M. Thompson & Mark A. Pallansch & Radboud J. Duintjer Tebbens & Steve G. Wassilak & Stephen L. Cochi, 2013. "Modeling Population Immunity to Support Efforts to End the Transmission of Live Polioviruses," Risk Analysis, John Wiley & Sons, vol. 33(4), pages 647-663, April.
    2. Radboud J. Duintjer Tebbens & Mark A. Pallansch & Dominika A. Kalkowska & Steven G. F. Wassilak & Stephen L. Cochi & Kimberly M. Thompson, 2013. "Characterizing Poliovirus Transmission and Evolution: Insights from Modeling Experiences with Wild and Vaccine‐Related Polioviruses," Risk Analysis, John Wiley & Sons, vol. 33(4), pages 703-749, April.
    3. Kimberly M. Thompson & Dominika A. Kalkowska, 2021. "Potential Future Use, Costs, and Value of Poliovirus Vaccines," Risk Analysis, John Wiley & Sons, vol. 41(2), pages 349-363, February.
    4. Radboud J. Duintjer Tebbens & Kimberly M. Thompson, 2018. "Using integrated modeling to support the global eradication of vaccine‐preventable diseases," System Dynamics Review, System Dynamics Society, vol. 34(1-2), pages 78-120, January.
    5. Dominika A. Kalkowska & Kimberly M. Thompson, 2021. "Health and Economic Outcomes Associated with Polio Vaccine Policy Options: 2019–2029," Risk Analysis, John Wiley & Sons, vol. 41(2), pages 364-375, February.
    6. Radboud J. Duintjer Tebbens & Mark A. Pallansch & Konstantin M. Chumakov & Neal A. Halsey & Tapani Hovi & Philip D. Minor & John F. Modlin & Peter A. Patriarca & Roland W. Sutter & Peter F. Wright & S, 2013. "Expert Review on Poliovirus Immunity and Transmission," Risk Analysis, John Wiley & Sons, vol. 33(4), pages 544-605, April.
    7. Radboud J. Duintjer Tebbens & Kimberly M. Thompson, 2019. "Evaluation of Proactive and Reactive Strategies for Polio Eradication Activities in Pakistan and Afghanistan," Risk Analysis, John Wiley & Sons, vol. 39(2), pages 389-401, February.
    8. Kimberly M. Thompson & Mark A. Pallansch & Radboud J. Duintjer Tebbens & Steve G. Wassilak & Jong‐Hoon Kim & Stephen L. Cochi, 2013. "Preeradication Vaccine Policy Options for Poliovirus Infection and Disease Control," Risk Analysis, John Wiley & Sons, vol. 33(4), pages 516-543, April.
    9. Kimberly M. Thompson, 2013. "Modeling Poliovirus Risks and the Legacy of Polio Eradication," Risk Analysis, John Wiley & Sons, vol. 33(4), pages 505-515, April.
    10. Dominika A. Kalkowska & Radboud J. Duintjer Tebbens & Mark A. Pallansch & Kimberly M. Thompson, 2019. "Modeling Undetected Live Poliovirus Circulation After Apparent Interruption of Transmission: Pakistan and Afghanistan," Risk Analysis, John Wiley & Sons, vol. 39(2), pages 402-413, February.
    11. Dominika A. Kalkowska & Mark A. Pallansch & Amanda Wilkinson & Ananda S. Bandyopadhyay & Jennifer L. Konopka‐Anstadt & Cara C. Burns & M. Steven Oberste & Steven G. F. Wassilak & Kamran Badizadegan & , 2021. "Updated Characterization of Outbreak Response Strategies for 2019–2029: Impacts of Using a Novel Type 2 Oral Poliovirus Vaccine Strain," Risk Analysis, John Wiley & Sons, vol. 41(2), pages 329-348, February.
    12. Dominika A. Kalkowska & Mark A. Pallansch & Steven G. F. Wassilak & Stephen L. Cochi & Kimberly M. Thompson, 2021. "Global Transmission of Live Polioviruses: Updated Dynamic Modeling of the Polio Endgame," Risk Analysis, John Wiley & Sons, vol. 41(2), pages 248-265, February.
    13. Radboud J. Duintjer Tebbens & Mark A. Pallansch & Stephen L. Cochi & Derek T. Ehrhardt & Noha H. Farag & Stephen C. Hadler & Lee M. Hampton & Maureen Martinez & Steve G.F. Wassilak & Kimberly M. Thomp, 2018. "Modeling Poliovirus Transmission in Pakistan and Afghanistan to Inform Vaccination Strategies in Undervaccinated Subpopulations," Risk Analysis, John Wiley & Sons, vol. 38(8), pages 1701-1717, August.

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