Over 80 million children immunized as Africa trailblazes novel polio vaccine

CONGO – More than 80 million children have been vaccinated with the novel oral polio vaccine type 2 (nOPV2) in six countries in Africa, the world’s first region to rollout of the vaccine just months after the World Health Organization (WHO) gave it Emergency Use Listing status in November 2020.

Nigeria became the first country in the world to use nOPV2 to tackle an outbreak in March 2021, vaccinating 7 million children in six states.

By September, Benin, Congo, Liberia, Niger and Sierra Leone had also rolled out the vaccine. Africa was certified free of wild polio in August 2020, but outbreaks of circulating vaccine-derived polio type 2 are still being reported.

The nOPV2 brings significant advantages in tackling polio outbreaks and Nigeria has worked closely with the global polio partners to rollout the vaccine. With swift outbreak response and effective tools and measures, our path to ending all forms of polio once and for all is clearer,” said Dr Tunji Funsho, chair of Rotary’s National PolioPlus Committee, Nigeria.

The nOPV2 is a modified form of the monovalent oral polio vaccine designed to be more genetically stable and less likely to, in under-immunized populations, revert to a form that can cause permanent paralysis in children from vaccine-derived poliovirus.

Given the urgent public health need to address vaccine-derived polio globally, nOPV2 became the first vaccine to receive authorization for use under Emergency Use Listing (EUL).

Over the last three years the African region has seen a growing number of circulating vaccine-derived type 2 poliovirus outbreaks, from an initial three countries (Angola, Democratic Republic of the Congo and Kenya) in 2019 to more than 20 in 2021.

While there has been steady progress towards eradication of all forms of polio in the region, the growing number of outbreaks is concerning and requires a swift and robust immunization response. The nOPV2 plays an effective role in stopping these outbreaks.

WHO in Africa has worked with countries to improve vaccine safety monitoring systems. Countries eligible for outbreak response and needing support were prioritized, with the Rapid Response Team from the WHO Regional Office for Africa assisting.

Based on an independent review of the preliminary safety and genetic stability data collected and analysed by African Member States, the WHO Strategic Advisory Group of Experts in October 2021 recommended broader use of nOPV2. The move to the wider use phase will enable faster deployment of nOPV2 in the field.

The key changes during the transition to wider rollout include reducing the requirements and restrictions. For instance, in broader deployment the vaccine can be used in integrated campaigns, meaning it can be delivered with other vaccines or nonvaccine interventions such as vitamin A administration.

The requirements countries need to meet to use the vaccine have now been reduced to 16 from 25. This is particularly important given that rapid outbreak response is crucial to successfully stopping the circulation of the virus.

During this wider-use phase, Ethiopia, Mauritania, Nigeria, The Gambia, Senegal and Uganda will roll out campaigns targeting a total of approximately 30 million children, increasing the number of African children with effective polio protection.

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