Current Status and Future of Polio Vaccines and Vaccination
The history of polio vaccines and their use illustrates the concept of evolution of vaccines driven by changing epidemiological and socioeconomic conditions. The development of two vaccines against poliomyelitis—inactivated Salk vaccine (IPV) and live ora
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Current Status and Future of Polio Vaccines and Vaccination Konstantin Chumakov Abstract The history of polio vaccines and their use illustrates the concept of evolution of vaccines driven by changing epidemiological and socioeconomic conditions. The development of two vaccines against poliomyelitis—inactivated Salk vaccine (IPV) and live oral Sabin vaccine (OPV)—is among the most consequential achievements of prophylactic medicine of the past century. Each with their own strengths and weaknesses, they were used over the past 50 years in different settings and different regimens and combinations. This resulted in virtual elimination of the disease in almost the entire world with the exception of a few countries. Continuation of the eradication campaign coordinated by WHO may soon result in complete cessation of wild poliovirus transmission, and poliovirus may join smallpox virus in the club of extinct pathogens. However, unlike smallpox vaccination that was stopped after the interruption of virus circulation, vaccination against poliomyelitis will have to continue into the foreseeable future, due to significant differences in the nature and epidemiology of the viruses. This chapter reviews the reasons for the need to maintain high population immunity against polioviruses, makes the case for developing a new generation of polio vaccines, and discusses their desirable properties as well as new vaccine technologies that could be used to create polio vaccines for the post-eradication environment.
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Introduction
Vaccines occupy a unique place among medical biotechnology products. Among the oldest of such products, some vaccines were developed and are still manufactured using centuries-old methods. Increasing demands for safety, efficacy, and manufacturing efficiency create strong pressures to use modern technologies for vaccine manufacture requiring introduction of innovative approaches. Vaccines against poliomyelitis are among the most widely used and successful vaccines ever, K. Chumakov (*) Office of Vaccines Research and Review, Center for Biologics Evaluation and Research, Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, MD 20993, USA e-mail: [email protected] © Springer-Verlag Wien 2014 I.S. Lukashevich, H. Shirwan (eds.), Novel Technologies for Vaccine Development, DOI 10.1007/978-3-7091-1818-4_4
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and thus they represent a paradigm for other vaccines. Their introduction almost 60 years ago resulted in virtual elimination of the dreadful disease from the face of the Earth. This dramatic change in the epidemiology of poliomyelitis and shifts in societal perception of the risk-benefit balance triggered several important changes in polio immunization policies. Potential complete eradication of the disease in the foreseeable future may require replacement of the currently used vaccines with products having a new target profile more suitable for post-eradication environments. This process represents a clear illustration of the evolution of vaccines in res
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