Recommendations of 2nd National Consultative Meeting of Indian Academy of Pediatrics (IAP) on polio eradication and improvement of routine immunization.

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dc.contributor.author,en_US
dc.contributor.author,en_US
dc.contributor.authorVashishtha, Vipin Men_US
dc.contributor.authorKalra, Ajayen_US
dc.contributor.authorJohn, T Jacoben_US
dc.contributor.authorThacker, Naveenen_US
dc.contributor.authorAgarwal, R Ken_US
dc.date.accessioned2008-05-03en_US
dc.date.accessioned2009-05-27T06:12:29Z
dc.date.available2008-05-03en_US
dc.date.available2009-05-27T06:12:29Z
dc.date.issued2008-05-03en_US
dc.description47 references.en_US
dc.description.abstractJUSTIFICATION: Persistence of intense wild poliovirus (WPV) transmission, particularly type 3 in northern India necessitated the Indian Academy of Pediatrics (IAP) to convene a National Consultative Meeting to review its earlier recommendations on polio eradication and improvement of routine immunization. PROCESS: More than thirty experts were invited and intense deliberations were held over two days to draw consensus statements on various issues related with polio eradication. OBJECTIVES: To review the ongoing strategy, identify the existing challenges, and suggest modifications to the current strategy for eradication of poliomyelitis in India. RECOMMENDATIONS: IAP reiterates its support to ongoing efforts on polio eradication but demand some flexibility in the strategy. The immediate challenges identified include persistent WPV type 1 transmission in Uttar Pradesh (UP) and Bihar, intense type 3 transmission also in UP and Bihar, and maintaining polio-free status of all other states. Circulating vaccine derived poliovirus (cVDPV), particularly type 2, was identified as a great future threat. Neglect of routine immunization (RI), poor efficacy of oral polio vaccine (OPV), operational issues, and inadequate uptake of OPV in the 2 endemic states are the main reasons of failure to interrupt transmission of WPV 1 and 3. However, for the first time in history the intensity of WPV 1 circulation is very low in western UP. IAP suggests that high-quality, uniform and consistent performance of supplementary immunization activities (SIAs) in all districts of western UP, particularly using mOPV1(monovalent OPV1) should be maintained to avoid reestablishment of circulation of type 1 poliovirus. A judicious mix of mOPV1 and mOPV3, given sequentially or even simultaneously (after validating the efficacies) will be necessary to address the upsurge of WPV3. Re-establishing routine immunization should be the foremost priority. IAP strongly recommends to Government of India (GOI) to take urgent measures to attain coverage of a minimum of 90% against all UIP antigens in all the states by the end of 2008. In view of the need to simultaneously raise immunity levels to protect against WPVs 1, 3 and cVDPV2, IPV may be given immediate consideration as an additional tool. IPV will be essential in the postWPVeradication phase; it can play a useful role even in the current WPV eradication phase. IAP urges the GOI to urgently sort out various issues associated with implementation of the proposal to use IPV. More transparency is needed on cases of vaccine associated paralytic poliomyelitis (VAPP). Further improvement in stool collection rates is also warranted to minimize the tally of compatible cases. IAP urges the social mobilization network to address the issues of waning interest and shifting focus and negative media coverage. Alternate tactics like reduced numbers of SIAs applied in the low transmission season, along with IPVDTP combination vaccine in RI can also be considered. IAP believes it will be risky to stop vaccination against poliomyelitis in postWPV eradication phase. The best option is to gradually introduce IPV starting now, so that a switch to IPV following high-performance national immunization days (NIDs) can be made to ensure sustained high immunity against all polioviruses, wild and vaccine derived. IAP requests the global polio eradication initiative (GPEI) to continue relevant research to inform on various aspects related to polio eradication, defined as zero incidence of any poliovirus infection. IAP also urges GOI to take immediate measures for improvement of environmental sanitation.en_US
dc.identifier.citation, , Vashishtha VM, Kalra A, John TJ, Thacker N, Agarwal RK. Recommendations of 2nd National Consultative Meeting of Indian Academy of Pediatrics (IAP) on polio eradication and improvement of routine immunization. Indian Pediatrics. 2008 May; 45(5): 367-78en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/15497
dc.language.isoengen_US
dc.source.urihttps://indianpediatrics.neten_US
dc.subject.meshChild, Preschoolen_US
dc.subject.meshHealth Planning --organization & administrationen_US
dc.subject.meshHumansen_US
dc.subject.meshImmunization Programs --organization & administrationen_US
dc.subject.meshIndiaen_US
dc.subject.meshInfanten_US
dc.subject.meshInfant, Newbornen_US
dc.subject.meshPatient Acceptance of Health Careen_US
dc.subject.meshPediatricsen_US
dc.subject.meshPoliomyelitis --prevention & controlen_US
dc.subject.meshPoliovirus Vaccines --adverse effectsen_US
dc.subject.meshResearchen_US
dc.subject.meshSocieties, Medicalen_US
dc.titleRecommendations of 2nd National Consultative Meeting of Indian Academy of Pediatrics (IAP) on polio eradication and improvement of routine immunization.en_US
dc.typeConsensus Development Conferenceen_US
dc.typeJournal Articleen_US
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