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Preeradication Vaccine Policy Options for Poliovirus Infection and Disease Control

机译：脊髓灰质炎病毒感染和疾病控制的根除前疫苗政策选项

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摘要

With the circulation of wild poliovirus (WPV) types 1 and 3 continuing more than a decade after the original goal of eradicating all three types of WPVs by 2000, policymakers consider many immunization options as they strive to stop transmission in the remaining endemic and outbreak areas and prevent reintroductions of live polioviruses into nonendemic areas. While polio vaccination choices may appear simple, our analysis of current options shows remarkable complexity. We offer important context for current and future polio vaccine decisions and policy analyses by developing decision trees that clearly identify potential options currently used by countries as they evaluate national polio vaccine choices. Based on a comprehensive review of the literature we (1) identify the current vaccination options that national health leaders consider for polio vaccination, (2) characterize current practices and factors that appear to influence national and international choices, and (3) assess the evidence of vaccine effectiveness considering sources of variability between countries and uncertainties associated with limitations of the data. With low numbers of cases occurring globally, the management of polio risks might seem like a relatively low priority, but stopping live poliovirus circulation requires making proactive and intentional choices to manage population immunity in the remaining endemic areas and to prevent reestablishment in nonendemic areas. Our analysis shows remarkable variability in the current national polio vaccine product choices and schedules, with combination vaccine options containing inactivated poliovirus vaccine and different formulations of oral poliovirus vaccine making choices increasingly difficult for national health leaders.
机译：在最初的目标是到2000年消灭所有三种类型的WPV之后，野生1型和3型脊髓灰质炎病毒（WPV）的传播持续了十多年，决策者考虑了许多免疫选择，因为他们努力阻止在其余地方性流行病和暴发地区的传播并防止活脊髓灰质炎病毒重新引入非流行地区。虽然小儿麻痹症疫苗接种的选择可能看起来很简单，但我们对当前选择的分析显示出惊人的复杂性。我们通过制定决策树，为当前和未来的脊髓灰质炎疫苗决策和政策分析提供重要背景，这些决策树清楚地确定了各国在评估国家脊髓灰质炎疫苗选择时当前使用的潜在选择。在对文献进行全面审查的基础上，我们（1）确定国家卫生领导者考虑用于脊髓灰质炎疫苗接种的当前疫苗接种方案；（2）表征可能影响国家和国际选择的当前实践和因素，以及（3）评估证据考虑国家间差异的来源以及与数据局限性相关的不确定性，评估疫苗的有效性。由于全球发生的病例较少，对脊髓灰质炎风险的管理似乎没有那么优先，但要阻止脊髓灰质炎病毒的实时传播，就必须做出积极主动的选择，以管理其余流行地区的人群免疫力，并防止在非流行地区重新建立免疫力。我们的分析表明，当前的国家脊髓灰质炎疫苗产品选择和时间表存在巨大差异，包含灭活脊髓灰质炎病毒疫苗和口服脊髓灰质炎病毒疫苗不同配方的组合疫苗选择对国家卫生领导者的选择越来越困难。

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  • 来源
    《Risk analysis》 |2013年第4期|516-543|共28页
  • 作者

    Kimberly M. Thompson; Mark A. Pallansch; Radboud J. Duintjer Tebbens; Steve G. Wassilak; Jong-Hoon Kim; Stephen L. Cochi;

  • 作者单位

    Kid Risk, Inc., 10524 Moss Park Rd., Ste. 204-364, Orlando, FL, USA,University of Central Florida, College of Medicine, Orlando, FL, USA;

    Centers for Disease Control and Prevention National Center for Immunization and Respiratory Diseases, Division of Viral Diseases, Atlanta, GA, USA;

    Kid Risk, Inc., 10524 Moss Park Rd., Ste. 204-364, Orlando, FL, USA;

    Centers for Disease Control and Prevention National Center for Immunization and Respiratory Diseases, Global Immunization Division, Atlanta, GA, USA;

    Kid Risk, Inc., 10524 Moss Park Rd., Ste. 204-364, Orlando, FL, USA;

    Centers for Disease Control and Prevention National Center for Immunization and Respiratory Diseases, Global Immunization Division, Atlanta, GA, USA;

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  • 原文格式 PDF
  • 正文语种 eng
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  • 关键词

    policy options; poliovirus; vaccination;

    机译：政策选择;脊髓灰质炎病毒;预防接种;

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