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A Health Economic Analysis for Oral Poliovirus Vaccine to Prevent COVID‐19 in the United States

COVID‐19 led to a recent high‐profile proposal to reintroduce oral poliovirus vaccine (OPV) in the United States (U.S.), initially in clinical trials, but potentially for widespread and repeated use. We explore logistical challenges related to U.S. OPV administration in 2020, review the literature r...

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Autores principales: Thompson, Kimberly M., Kalkowska, Dominika A., Badizadegan, Kamran
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7983986/
https://www.ncbi.nlm.nih.gov/pubmed/33084153
http://dx.doi.org/10.1111/risa.13614
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author Thompson, Kimberly M.
Kalkowska, Dominika A.
Badizadegan, Kamran
author_facet Thompson, Kimberly M.
Kalkowska, Dominika A.
Badizadegan, Kamran
author_sort Thompson, Kimberly M.
collection PubMed
description COVID‐19 led to a recent high‐profile proposal to reintroduce oral poliovirus vaccine (OPV) in the United States (U.S.), initially in clinical trials, but potentially for widespread and repeated use. We explore logistical challenges related to U.S. OPV administration in 2020, review the literature related to nonspecific effects of OPV to induce innate immunity, and model the health and economic implications of the proposal. The costs of reintroducing a single OPV dose to 331 million Americans would exceed $4.4 billion. Giving a dose of bivalent OPV to the entire U.S. population would lead to an expected 40 identifiable cases of vaccine‐associated paralytic polio, with young Americans at the highest risk. Reintroducing any OPV use in the U.S. poses a risk of restarting transmission of OPV‐related viruses and could lead to new infections in immunocompromised individuals with B‐cell related primary immunodeficiencies that could lead to later cases of paralysis. Due to the lack of a currently licensed OPV in the U.S., the decision to administer OPV to Americans for nonspecific immunological effects would require purchasing limited global OPV supplies that could impact polio eradication efforts. Health economic modeling suggests no role for reintroducing OPV into the U.S. with respect to responding to COVID‐19. Countries that currently use OPV experience fundamentally different risks, costs, and benefits than the U.S. Successful global polio eradication will depend on sufficient OPV supplies, achieving and maintaining high OPV coverage in OPV‐using countries, and effective global OPV cessation and containment in all countries, including the U.S.
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spelling pubmed-79839862021-03-24 A Health Economic Analysis for Oral Poliovirus Vaccine to Prevent COVID‐19 in the United States Thompson, Kimberly M. Kalkowska, Dominika A. Badizadegan, Kamran Risk Anal Original Research Articles COVID‐19 led to a recent high‐profile proposal to reintroduce oral poliovirus vaccine (OPV) in the United States (U.S.), initially in clinical trials, but potentially for widespread and repeated use. We explore logistical challenges related to U.S. OPV administration in 2020, review the literature related to nonspecific effects of OPV to induce innate immunity, and model the health and economic implications of the proposal. The costs of reintroducing a single OPV dose to 331 million Americans would exceed $4.4 billion. Giving a dose of bivalent OPV to the entire U.S. population would lead to an expected 40 identifiable cases of vaccine‐associated paralytic polio, with young Americans at the highest risk. Reintroducing any OPV use in the U.S. poses a risk of restarting transmission of OPV‐related viruses and could lead to new infections in immunocompromised individuals with B‐cell related primary immunodeficiencies that could lead to later cases of paralysis. Due to the lack of a currently licensed OPV in the U.S., the decision to administer OPV to Americans for nonspecific immunological effects would require purchasing limited global OPV supplies that could impact polio eradication efforts. Health economic modeling suggests no role for reintroducing OPV into the U.S. with respect to responding to COVID‐19. Countries that currently use OPV experience fundamentally different risks, costs, and benefits than the U.S. Successful global polio eradication will depend on sufficient OPV supplies, achieving and maintaining high OPV coverage in OPV‐using countries, and effective global OPV cessation and containment in all countries, including the U.S. John Wiley and Sons Inc. 2020-10-20 2021-02 /pmc/articles/PMC7983986/ /pubmed/33084153 http://dx.doi.org/10.1111/risa.13614 Text en © 2020 The Authors. Risk Analysis published by Wiley Periodicals LLC on behalf of Society for Risk Analysis This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Research Articles
Thompson, Kimberly M.
Kalkowska, Dominika A.
Badizadegan, Kamran
A Health Economic Analysis for Oral Poliovirus Vaccine to Prevent COVID‐19 in the United States
title A Health Economic Analysis for Oral Poliovirus Vaccine to Prevent COVID‐19 in the United States
title_full A Health Economic Analysis for Oral Poliovirus Vaccine to Prevent COVID‐19 in the United States
title_fullStr A Health Economic Analysis for Oral Poliovirus Vaccine to Prevent COVID‐19 in the United States
title_full_unstemmed A Health Economic Analysis for Oral Poliovirus Vaccine to Prevent COVID‐19 in the United States
title_short A Health Economic Analysis for Oral Poliovirus Vaccine to Prevent COVID‐19 in the United States
title_sort health economic analysis for oral poliovirus vaccine to prevent covid‐19 in the united states
topic Original Research Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7983986/
https://www.ncbi.nlm.nih.gov/pubmed/33084153
http://dx.doi.org/10.1111/risa.13614
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