Nigeria Set to Introduce Inactivated Polio Vaccine (IPV) into Routine Immunisation Schedule 11th February, 2015

Nigeria has made remarkable progress towards Polio Eradication.

Only six (6) cases of WPV type 1 were recorded in 2014 compared to 53 cases recorded in 2013.

Over 6 months have passed since the last case of wild poliovirus (WPV) type 1 was recorded.

However, at least 12 months must pass without detection of WPV, in the presence of certification quality surveillance, before Nigeria would be considered as having stopped transmission of WPV. -

As part of the Polio end game strategy recommended by the World Health Organisation which recommends the strengthening systems, introducing at least one dose of affordable IPV into the routine immunisation schedule globally and then replacing the trivalent OPV with bivalent OPV in all OPV-using countries.

A Nigerian Child getting Vaccinated with IPV in Kano

The inactivated polio vaccine produces antibodies in the blood to all three types of poliovirus. In the event of infection, these antibodies prevent the spread of the virus to the central nervous system and protect against paralysis.

IPV introduction into the RI schedule of the country is planned in 2 stages:

Stage 1 introduction is planned for 11^th February 2015 in the 13 Polio High Risk states of the NWZ, NEZ and FCT; while stage 2 introduction is planned for 16^th March 2015 in all the other remaining states (SEZ, SSZ, SWZ, NCZ).

Pre-implementation activities for introduction in the phase 1 states are on-going.

IPV was already introduced in campaign mode in Borno and Yobe states (June & August 2014) and Kano (Dec. 2014)

Financing for GAVI eligible and graduating countries:

GAVI supported countries are eligible to receive support for IPV introduction into routine immunization programmes (based on a 1 dose vaccination schedule) and associated supplies including auto-disable syringes and waste disposal boxes. 

A one-time cash Vaccine Introduction Grant (VIG) is also available to GAVI eligible countries to support a share of costs related to new vaccine introduction. 

The VIG is calculated at $0.80 per child in the birth cohort or a lump sum of $100,000 (whichever is higher). 

Technical assistance in planning and preparing for IPV introduction through WHO and UNICEF is also available to all countries.

Scheduling of IPV: Single dose of IPV at 14 weeks of age with Penta 3. 

Advantages of IPV Use:

• As IPV is not a 'live' vaccine, it carries no risk of vaccine-associated polio paralysis.
• IPV triggers an excellent protective immune response in most people.

Disadvantages

• IPV induces very low levels of immunity in the intestine. As a result, when a person immunized with IPV is infected with wild poliovirus, the virus can still multiply inside the intestines and be shed in the faeces, risking continued circulation.
• IPV is over five times more expensive than oral polio vaccine.
• Administering the vaccine requires trained health workers and sterile injection equipment and procedures.

Safety:

IPV is one of the safest vaccines in use. No serious systemic adverse reactions have been shown to follow vaccination.

Efficacy:

IPV is highly effective in preventing paralytic disease caused by all three types of poliovirus.

Recommended Use:

An increasing number of industrialised, polio-free countries are using IPV as the vaccine of choice. This is because the risk of paralytic polio associated with continued routine use of oral polio vaccine (OPV) is deemed greater than the risk of imported wild virus. 

Reference:

(1) IPV webpages live: http://www.who.int/immunization/diseases/poliomyelitis/inactivated_polio_vaccine/en/index.html

(2) WHO IPV safety, and price and presentation options

http://www.who.int/immunization/diseases/poliomyelitis/inactivated_polio_vaccine/vaccines/en/

(3) Polio Eradication & Endgame Strategic Plan 2013 - 2018 http://www.polioeradication.org/resourcelibrary/strategyandwork.aspx