Global epidemiology of vaccine-derived poliovirus 2016–2021: A descriptive analysis and retrospective case-control study

Yi An Lai; Xin Chen; Mohana Kunasekaran; Bayzidur Rahman; Chandini Raina MacIntyre

EClinicalMedicine (Aug 2022)

Global epidemiology of vaccine-derived poliovirus 2016–2021: A descriptive analysis and retrospective case-control study

Yi An Lai,
Xin Chen,
Mohana Kunasekaran,
Bayzidur Rahman,
Chandini Raina MacIntyre

Affiliations

Yi An Lai: Biosecurity Program, The Kirby Institute, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia; Corresponding author at: Biosecurity Program, The Kirby Institute, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia.
Xin Chen: Biosecurity Program, The Kirby Institute, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
Mohana Kunasekaran: Biosecurity Program, The Kirby Institute, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
Bayzidur Rahman: The Kirby Institute, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
Chandini Raina MacIntyre: Biosecurity Program, The Kirby Institute, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia; School of Population Health, University of New South Wales, Sydney, NSW, Australia

Journal volume & issue: Vol. 50
p. 101508

Abstract

Read online

Summary: Background: Vaccine derived poliovirus (VDPV) remains a major barrier to polio eradication, and recent growing emergences are concerning. This paper presents the global epidemiology of circulating VDPV (cVDPV) by exploring associations between demographic and socioeconomic factors with its recent rise. Methods: Data on reported cVDPV cases and isolates between January 1 2016 and June 30 2021 were compiled from EPIWATCH, an open-source observatory for outbreak scanning and analysis, the World Health Organisation (WHO) and ProMed, and analysed descriptively. Reports containing cVDPV case information were included while duplicates and defective links were excluded. Data collection occurred from April 5 2021 to July 16 2021. To identify factors associated with cVDPV, a retrospective case-control study comparing socioeconomic profiles of countries which reported cVDPV with those that did not was undertaken with weighted logistic regression analysis. Findings: cVDPV caused by serotype 2 poliovirus was the predominant strain (95%) of 1818 total human cVDPV cases reported. Of 40 countries reporting cVDPV cases or isolates, 22 (55%) had polio vaccination coverages below 80%. Low vaccination coverage (Adjusted OR = 83·41, 95% CI: [5·01, 1387·71], p = 0·0020) was found to be associated with increased odds of reporting cVDPV after adjusting for confounding effects of GDP per capita, female adult literacy rates, maternal mortality rate, and Global Peace Index. Interpretation: Our findings reinforce the importance of maintaining high levels of vaccination, as risk of re-emergence rises when immunity wanes. Interventions to increase vaccination and standards of living in developing countries, coupled with robust surveillance are required if humanity hopes to eradicate polio in the near future. Funding: This research was supported by the MRFF 2021 Frontier Health and Medical Research Grant (ID RFRHPI000280), Department of Health, the Australian Government.

Published in EClinicalMedicine

ISSN: 2589-5370 (Online)
Publisher: Elsevier
Country of publisher: United Kingdom
LCC subjects: Medicine: Medicine (General)
Website: https://www.thelancet.com/journals/eclinm/home

About the journal

Abstract

Keywords