POLIO'S LAST ACT. (cover story)

POLIO prevention; INTERNATIONAL cooperation on public health; ORAL poliomyelitis vaccines; VACCINATION of children; VACCINATION complications; POLIOVIRUS; VIRUS inactivation; MEDICAL personnel supply & demand; MEDICAL care costs; INTERNATIONAL cooperation; GOVERNMENT policy

The article looks at the state of the global attempt to eradicate polio, with particular focus on the role of the poliovirus vaccination itself in spreading the disease in some regions. Many public health experts have advocated for the removal of the type 2 poliovirus strain from the oral trivalent polio vaccine used in poorer countries, citing the rise in the incidence in children of secondary infections called vaccine-associated paralytic poliomyelitis (VAPP). The challenges faced in the transition from the trivalent oral formulation to the injectable inactivated virus vaccine or bivalent oral vaccine are discussed, including costs, health safety risks, and availability of trained medical personnel for the administration of vaccines. INSET: Tools for the Endgame.