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Source-This post on Need for Vaccine Strategy Reassessment has been created based on the article “Intriguing silence – India should switch to inactivated polio vaccine” published in “The Hindu” on 23 August 2024.
UPSC Syllabus-GS Paper-2- Issues Relating to Development and Management of Social Sector/Services relating to Health
Context- A recent case of acute flaccid paralysis (AFP) in a child from Tikrikilla, Meghalaya, has raised concerns about whether it is caused by vaccine-derived poliovirus (VDPV) or wild poliovirus. Till recently, Afghanistan and Pakistan have reported 14 cases of WPV type 1, highlighting the continued presence of this virus in those regions.
What are the concerns?
1) Uncertainty Over Polio Virus Type -There is no definitive information on whether the polio case in Meghalaya is caused by a vaccine-derived virus or a wild poliovirus. Since wild poliovirus types 2 and 3 were eradicated globally in 2015 and 2019, and wild poliovirus type 1 hasn’t been seen in India for years, it is unlikely that the case is caused by wild poliovirus type 1 unless it was brought into the country from elsewhere.
2) Distinguishing Between iVDPV and cVDPV -The polio case in Meghalaya raises uncertainty about whether it is caused by iVDPV, which is confined to an individual with an immune deficiency, or cVDPV, which spreads within the community. Globally, in 2024, there have been 68 cases of cVDPV2 and four cases of cVDPV1, with many countries detecting cVDPV in environmental samples, indicating that cVDPV is actively circulating
3) Impact of Vaccine Type– In 2016, India changed to a polio vaccine that only covers types 1 and 3, so it’s unlikely that the child contracted a type 2 virus from this vaccine. However, the possibility of an imported type 2 virus can’t be overlooked.
4) Identifying Immune-Deficient Children -The child’s samples were sent to the ICMR-NIV Mumbai unit, part of a global network of polio labs. Identifying children with immune deficiencies before giving them the oral polio vaccine (OPV) is difficult, and this challenge means India may continue to see similar cases in the future.
Read More- Vaccine Regulations in India
Way ahead- The case in Meghalaya highlights the urgent need for India to stop using the oral polio vaccine (OPV) and switch to the inactivated polio vaccine (IPV). Most developed countries have used IPV for years because it is safer and more effective. India should make this change without delay.
Question for practice
What are the concerns surrounding the recent case of acute flaccid paralysis (AFP) in a child from Tikrikilla?
