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Oral Poliovirus Vaccine Evolution and Insights Relevant to Modeling the Risks of Circulating Vaccine‐Derived Polioviruses (cVDPVs)

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  • Radboud J. Duintjer Tebbens
  • Mark A. Pallansch
  • Jong‐Hoon Kim
  • Cara C. Burns
  • Olen M. Kew
  • M. Steven Oberste
  • Ousmane M. Diop
  • Steven G.F. Wassilak
  • Stephen L. Cochi
  • Kimberly M. Thompson

Abstract

The live, attenuated oral poliovirus vaccine (OPV) provides a powerful tool for controlling and stopping the transmission of wild polioviruses (WPVs), although the risks of vaccine‐associated paralytic polio (VAPP) and circulating vaccine‐derived poliovirus (cVDPV) outbreaks exist as long as OPV remains in use. Understanding the dynamics of cVDPV emergence and outbreaks as a function of population immunity and other risk factors may help to improve risk management and the development of strategies to respond to possible outbreaks. We performed a comprehensive review of the literature related to the process of OPV evolution and information available from actual experiences with cVDPV outbreaks. Only a relatively small fraction of poliovirus infections cause symptoms, which makes direct observation of the trajectory of OPV evolution within a population impractical and leads to significant uncertainty. Despite a large global surveillance system, the existing genetic sequence data largely provide information about transmitted virulent polioviruses that caused acute flaccid paralysis, and essentially no data track the changes that occur in OPV sequences as the viruses transmit largely asymptomatically through real populations with suboptimal immunity. We updated estimates of cVDPV risks based on actual experiences and identified the many limitations in the existing data on poliovirus transmission and immunity and OPV virus evolution that complicate modeling. Modelers should explore the space of potential model formulations and inputs consistent with the available evidence and future studies should seek to improve our understanding of the OPV virus evolution process to provide better information for policymakers working to manage cVDPV risks.

Suggested Citation

  • Radboud J. Duintjer Tebbens & Mark A. Pallansch & Jong‐Hoon Kim & Cara C. Burns & Olen M. Kew & M. Steven Oberste & Ousmane M. Diop & Steven G.F. Wassilak & Stephen L. Cochi & Kimberly M. Thompson, 2013. "Oral Poliovirus Vaccine Evolution and Insights Relevant to Modeling the Risks of Circulating Vaccine‐Derived Polioviruses (cVDPVs)," Risk Analysis, John Wiley & Sons, vol. 33(4), pages 680-702, April.
    • Handle: RePEc:wly:riskan:v:33:y:2013:i:4:p:680-702
    DOI: 10.1111/risa.12022
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    References listed on IDEAS

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    1. 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.
    2. Thompson, K.M. & Duintjer Tebbens, R.J. & Pallansch, M.A. & Kew, O.M. & Sutter, R.W. & Aylward, R.B. & Watkins, M. & Gary Jr., H.E. & Alexander, J. & Jafari, H. & Cochi, S.L., 2008. "The risks, costs, and benefits of possible future global policies for managing polioviruses," American Journal of Public Health, American Public Health Association, vol. 98(7), pages 1322-1330.
    3. 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.
    4. Marco Vignuzzi & Jeffrey K. Stone & Jamie J. Arnold & Craig E. Cameron & Raul Andino, 2006. "Quasispecies diversity determines pathogenesis through cooperative interactions in a viral population," Nature, Nature, vol. 439(7074), pages 344-348, January.
    5. Radboud J. Duintjer Tebbens & Mark A. Pallansch & Olen M. Kew & Victor M. Cáceres & Hamid Jafari & Stephen L. Cochi & Roland W. Sutter & R. Bruce Aylward & Kimberly M. Thompson, 2006. "Risks of Paralytic Disease Due to Wild or Vaccine‐Derived Poliovirus After Eradication," Risk Analysis, John Wiley & Sons, vol. 26(6), pages 1471-1505, December.
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    1. Kimberly M. Thompson & Dominika A. Kalkowska, 2021. "Reflections on Modeling Poliovirus Transmission and the Polio Eradication Endgame," Risk Analysis, John Wiley & Sons, vol. 41(2), pages 229-247, February.
    2. Dominika A. Kalkowska & Mark A. Pallansch & Stephen L. Cochi & Stephanie D. Kovacs & Steven G. F. Wassilak & Kimberly M. Thompson, 2021. "Updated Characterization of Post‐OPV Cessation Risks: Lessons from 2019 Serotype 2 Outbreaks and Implications for the Probability of OPV Restart," Risk Analysis, John Wiley & Sons, vol. 41(2), pages 320-328, February.
    3. 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.
    4. 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.
    5. 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.
    6. Kamran Badizadegan & Dominika A. Kalkowska & Kimberly M. Thompson, 2023. "Health Economic Analysis of Antiviral Drugs in the Global Polio Eradication Endgame," Medical Decision Making, , vol. 43(7-8), pages 850-862, October.
    7. 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.
    8. 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.
    9. 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.
    10. 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.
    11. Michael Famulare, 2015. "Has Wild Poliovirus Been Eliminated from Nigeria?," PLOS ONE, Public Library of Science, vol. 10(8), pages 1-13, August.
    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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