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A Health Economic Analysis for Oral Poliovirus Vaccine to Prevent COVID‐19 in the United States

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  • Kimberly M. Thompson
  • Dominika A. Kalkowska
  • Kamran Badizadegan

Abstract

COVID‐19 led to a recent high‐profile proposal to reintroduce oral poliovirus vaccine (OPV) in the United States (U.S.), initially in clinical trials, but potentially for widespread and repeated use. We explore logistical challenges related to U.S. OPV administration in 2020, review the literature related to nonspecific effects of OPV to induce innate immunity, and model the health and economic implications of the proposal. The costs of reintroducing a single OPV dose to 331 million Americans would exceed $4.4 billion. Giving a dose of bivalent OPV to the entire U.S. population would lead to an expected 40 identifiable cases of vaccine‐associated paralytic polio, with young Americans at the highest risk. Reintroducing any OPV use in the U.S. poses a risk of restarting transmission of OPV‐related viruses and could lead to new infections in immunocompromised individuals with B‐cell related primary immunodeficiencies that could lead to later cases of paralysis. Due to the lack of a currently licensed OPV in the U.S., the decision to administer OPV to Americans for nonspecific immunological effects would require purchasing limited global OPV supplies that could impact polio eradication efforts. Health economic modeling suggests no role for reintroducing OPV into the U.S. with respect to responding to COVID‐19. Countries that currently use OPV experience fundamentally different risks, costs, and benefits than the U.S. Successful global polio eradication will depend on sufficient OPV supplies, achieving and maintaining high OPV coverage in OPV‐using countries, and effective global OPV cessation and containment in all countries, including the U.S.

Suggested Citation

  • Kimberly M. Thompson & Dominika A. Kalkowska & Kamran Badizadegan, 2021. "A Health Economic Analysis for Oral Poliovirus Vaccine to Prevent COVID‐19 in the United States," Risk Analysis, John Wiley & Sons, vol. 41(2), pages 376-386, February.
    • Handle: RePEc:wly:riskan:v:41:y:2021:i:2:p:376-386
    DOI: 10.1111/risa.13614
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    References listed on IDEAS

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    1. 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.
    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. 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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    Cited by:

    1. Qazi, Abroon & Simsekler, Mecit Can Emre, 2023. "Nexus between drivers of COVID-19 and country risks," Socio-Economic Planning Sciences, Elsevier, vol. 85(C).

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