Polio double shield in place

The health ministry today launched a new polio vaccine, an injection to be given to infants alongside the traditional oral vaccine, in the free immunisation programme to eliminate the risk of a resurgence of the disease eradicated from India in 2011.

The injectible vaccine that contains inactivated polio virus (IPV) will be rolled out in the coming weeks in Assam, Bihar, Gujarat, Madhya Pradesh, Punjab, and Uttar Pradesh before it is expanded to other states, health minister J.P. Nadda said, announcing the launch.

The ministry will give IPV to infants below one year of age when they receive the third dose of the oral polio vaccine (OPV). "New evidence clearly shows that IPV and OPV together strengthen the (infant's) immune system and provide double protection against polio," Nadda said.

But sections of paediatricians say the move is not in line with standard immunisation practices adopted across India's private health care sector where IPV has been available for nearly a decade. The Indian Academy of Paediatrics prescribes three doses of IPV - at six weeks, 10 weeks and 14 weeks.

"This one-dose IPV strategy appears to be a stop-gap manoeuvre," Vipin Vashishtha, a paediatrician in Bijnore and a member of the paediatrics academy's advisory committee on vaccines, told PG Times. "Under the IAP guidelines, we use three doses of IPV along with OPV."

However, a senior ministry official said the initiative with IPV should be viewed differently from the use of this vaccine in the private sector. "In the government programme, we're introducing IPV only as an additional risk-protection tool," said the official. "We will continue to provide OPV, IPV is only to boost immunity just before we switch from a three-component OPV to a two-component OPV next year."

The World Health Organisation (WHO) in May this year had recommended the introduction of IPV as part of a global polio endgame strategy to roll out IPV in 126 countries to prevent the resurgence of polio that has been eradicated by all but two countries: Afghanistan and Pakistan.

Virologists have long expressed concern that live but weakened polio viruses in OPV, which are shed by immunised infants in stools, have the potential to survive in sewage, regain their virulence and cause vaccine-derived polio in poorly-immunised children who ingest them through contaminated water.

The immunisation programme in April 2016 is expected to switch to a two-component OPV, eliminating from OPV one of three types of wild poliovirus eradicated in 1999. "The introduction of IPV is in preparation for the switch to this bivalent OPV," the ministry official said.

India will require nearly 80 million doses of IPV to ensure that all 27 million children born each year receive three doses of IPV as prescribed.

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