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WHO approves first ever vaccine for emergency use to address polio outbreaks

Bio Farma's polio vaccine 'nOPV2' is the first ever vaccine listed under WHO emergency use. This paves the way for potential listing of COVID-19 vaccines too.

The World Health Organization (WHO) on Friday listed a vaccine produced by Indonesia's Bio Farma for emergency use against polio. The nOPV2 vaccine is aimed at addressing the rising cases of a vaccine-derived polio strain in several African and East Mediterranean countries as well as the Western Pacific and South-East Asia regions, the WHO said in a statement.

The emergency use listing, or EUL, allows yet-to-be licensed medicines, vaccines and diagnostics available faster during public health emergencies, such as polio and COVID.

The nOPV2 is the first such listing for a vaccine and paves the way for potential listing of COVID-19 vaccines. Numerous COVID-19 diagnostics have also received emergency use listing.

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Vaccine-derived polio viruses

According to WHO, the world has made incredible progress toward polio eradication, reducing polio cases by 99.9% in the last 30 years. But the continuing outbreaks due to vaccine-derived polio viruses (cVDPVs) are proving to the most difficult step to ending this disease.

The WHO said cVDPVs can occur if the weakened strain of the polio virus contained in the oral polio vaccine (OPV) circulates among under-immunized populations for a long time. If enough children are not immunized against polio, the weakened virus can pass between individuals and over time genetically revert to a form that can cause paralysis it explained.

Currently, type 2 cVDPVs are the most prevalent form of the vaccine-derived virus.

Polio cases around the world

The Global Polio Eradication Initiative (GPEI), led by national governments and the WHO, has been monitoring the disease situation globally since the last three decades. The cases of wild poliovirus have decreased by over 99.9 per cent as a result of vaccination efforts made around the world, according to the WHO.

There are three variants of the poliovirus, numbered 1 to 3. A country is declared polio-free, when wild transmission of all these three kinds are stopped. For eradication, cases of both wild and vaccine-derived polio infection must be reduced to zero.

In 2019, polio outbreaks were recorded in the Philippines, Malaysia, Ghana, Myanmar, China, Cameroon, Indonesia and Iran. These were mostly caused by vaccine-derived viruses.

As per the US Centers for Disease Control and Prevention (CDC), as of October 7, 2020 there were more than 440 cases of poliovirus around the world.

India was declared polio-free in January 2014, after three years of zero cases. The last case of wild poliovirus in the country was detected on January 13, 2011. In August this year, the African Region was also certified as wild poliovirus free.

Afghanistan and Pakistan are the last two polio-endemic countries in the world.

Child vaccination drives, including polio campaigns, were halted in both Afghanistan and Pakistan in March 2020 due to COVID-19 pandemic. This resulted in increased reported polio cases in Afghanistan (34 cases) and Pakistan (63 cases) as well as in some previously polio-free parts of the country, according to the UNICEF.

NOTE: Immunisation against polio is the most effective way to prevent the disease. Polio vaccination is recommended for all children from three to 18 months of age. Three booster doses should be given to all children up to 12 years of age.

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