Most vaccine-associated paralytic poliomyelitis
(VAPP) outbreaks are associated with Type 2 polio vaccine strains, and approximately 26–31% of genetically divergent vaccine-derived polioviruses (VDPVs) cases are associated with the Type 2 component of OPV.
Revertant vaccine viruses with increased neuropathogenicity might cause vaccine-associated paralytic poliomyelitis
(VAPP) in OPV recipients or unimmunized contacts.
Primary health care providers in the United States should recognize the potential for live viral vaccine diseases, such as vaccine-associated paralytic poliomyelitis
and BCG-osis, in foreign-born children recently arrived from abroad.
In Japan, although live polio vaccine derived from attenuated Sabin-strain poliovirus has been used in periodic regular immunisation, vaccine-associated paralytic poliomyelitis
(VAPP) is found to develop in one of several million vaccine recipients, and hence there has been an increasing call for the development of an inactivated polio vaccine that does not induce VAPP, Takeda said.
The Sabin oral polio vaccine (OPV) has been successful in eliminating poliomyelitis, although replication of live attenuated polioviruses following vaccination can generate mutated viruses with renewed neurovirulence: vaccine-associated paralytic poliomyelitis
(VAPP) and vaccine-derived polioviruses (VDPVs) are rare risks of OPV.
Vaccine-associated paralytic poliomyelitis
in India during 1999: decreased risk despite massive use of oral polio vaccine.
Since 2000, the United States has exclusively used IPV, resulting in prevention of 8-10 vaccine-associated paralytic poliomyelitis
However, reversion to virulence may occur during OPV replication in humans and may result in the rare cases of vaccine-associated paralytic poliomyelitis
in OPV recipients and their close contacts.
17-19) Although the risk of paralytic polio from the vaccine virus is 10 000 times less than for wild-type virus, 1 in 2 million for vaccine virus as against 1 in 200 for wild-type virus, it was this minute risk of vaccine-associated paralytic poliomyelitis
(VAPP) that motivated most countries in the developed world to switch from TOPV to TIPV for routine immunisation.
Choice of sequential schedule was related to the risk of vaccine-associated paralytic poliomyelitis
and liability (P [is less than or equal to] .
Before the VDPV identification in Minnesota, the most recent known VDPV excreter in the United States was a child with SCID (now deceased) who developed vaccine-associated paralytic poliomyelitis
in 1995 (4).
AFP cases with isolation of SL vaccine viruses are evaluated through detailed epidemiologic investigation and by National Expert Review Committees for the possibility of vaccine-associated paralytic poliomyelitis