Vaccinology of poliomyelitis

Abstract

Vaccinology requires not only an understanding of the fundamental properties of the immune system and specific immunogens, but also the application of basic knowledge to develop effective immunization programmes for particular social, political, and environmental conditions. Two problems exist in the use of oral, live poliovirus vaccine: the occurrence of vaccine-associated paralytic poliomyelitis and the uncertain antibody response in tropical climates. These difficulties can be overcome by the use of killed poliovirus vaccine formulated to be effective with a single dose. Application of basic principles can bring poliomyelitis fully under control in all parts of the world.

PIP: Application of basic knowledge about the manipulation of viral antigens, the immune response of individuals, and the response of populations to vaccination programs can be used to solve remaining problems in the control of paralytic poliomyelitis. In areas of the world where poliomyelitis is well controlled but live virus-associated paralytic poliomyelitis continues to occur, routine use of killed poliovirus vaccine will prevent the occurrence of vaccine virus-associated disease as well as maintain control of wild virus disease. This will led to eradication of both the attenuated and wild polioviruses circulating in the population. In areas where poliomyelitis is endemic, killed poliovirus vaccine administered parenterally can control the disease effectively, avoiding the problem of intestinal inhibitors that interfere with the establishment of immunity after administration of live poliovirus vaccine. The potency of killed poliovirus vaccine can be adjusted to provide any desired immune response. It is possible to use a combined DPT-polio vaccine in multiple doses, or a poliovirus vaccine that provides effective immunity after a single dose. Studies are in process to determine the antigen content that would induce immunity with a single dose given within a few days after birth.