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. 2024 Mar 14;229(3):805-812.
doi: 10.1093/infdis/jiad222.

Impact of Supplementary Immunization Activities using Novel Oral Polio Vaccine Type 2 during a Large outbreak of Circulating Vaccine-Derived Poliovirus in Nigeria

Arend Voorman  1 , Hil Lyons  1 , Faisal Shuaib  2 , Usman S Adamu  2 , Charles Korir  3 , Tesfaye Erbeto  3 , Ananda S Bandyopadhyay  1 , Samuel Okiror  1
Affiliations

Impact of Supplementary Immunization Activities using Novel Oral Polio Vaccine Type 2 during a Large outbreak of Circulating Vaccine-Derived Poliovirus in Nigeria

Arend Voorman et al. J Infect Dis. .

Abstract

Background: Novel oral poliovirus vaccine (OPV) type 2 (nOPV2) has been made available for outbreak response under an emergency use listing authorization based on supportive clinical trial data. Since 2021 more than 350 million doses of nOPV2 were used for control of a large outbreak of circulating vaccine-derived poliovirus type 2 (cVDPV2) in Nigeria.

Methods: Using a bayesian time-series susceptible-infectious-recovered model, we evaluate the field effectiveness of nOPV2 immunization campaigns in Nigeria compared with campaigns using monovalent OPV type 2 (mOPV2).

Results: We found that both nOPV2 and mOPV2 campaigns were highly effective in reducing transmission of cVDPV2, on average reducing the susceptible population by 42% (95% confidence interval, 28-54%) and 38% (20-51%) per campaign, respectively, which were indistinguishable from each other in this analysis (relative effect, 1.1 [.7-1.9]). Impact was found to vary across areas and between immunization campaigns.

Conclusions: These results are consistent with the comparable individual immunogenicity of nOPV2 and mOPV2 found in clinical trials but also suggest that outbreak response campaigns may have small impacts in some areas requiring more campaigns than are suggested in current outbreak response procedures.

Keywords: Nigeria; mass vaccination; oral poliovirus vaccine; poliovirus; susceptible infected recovered models.

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Conflict of interest statement

Potential conflicts of interest. A. V., H. L., A. S. B., and S. O. are employed by the Bill & Melinda Gates Foundation. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

Figures

Figure 1.
Figure 1.
Circulating vaccine-derived poliovirus type 2 (cVDPV2) cases and supplementary immunization activities (SIAs), from 2016 to June 2022. Top, cVDPV2 cases (bars), environmental surveillance detections (rug plot), and SIAs as percentage of the population targeted. Bottom, Geographic distribution of cVDPV2 cases for years where there were cases. Abbreviations: IPV, inactivated poliovirus vaccine; mOPV2, monovalent OPV type 2; nOPV2, novel OPV type 2.
Figure 2.
Figure 2.
Posterior estimates of paralysis incidence (A), positive environmental surveillance (ES) samples (B) and susceptible fraction (C) at the national level. A, B, Black dots represent the observed data where greater than zero; dark bands, 95% posterior mean; and light bands, 95% posterior prediction intervals. Abbreviation: SIAs, supplementary immunization activities.
Figure 3.
Figure 3.
Estimated supplementary immunization activity (SIA) effectiveness (right) and estimated basic reproduction number (R0) (left), by state.
Figure 4.
Figure 4.
Sensitivity analyses. Left, Estimated supplementary immunization activity (SIA) impact for novel oral poliovirus (OPV) type 2 (nOPV2) and monovalent OPV type 2 (mOPV2). Right, Relative impact of nOPV2 compared with mOPV2. Abbreviations: ES, environmental surveillance; IPV, inactivated poliovirus vaccine.
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