Tag: OPV

Are Mutant Strains of Polio Vaccine Now Causing More Paralysis Than Wild Polio?

Believe it or not, it’s true.

Mutant strains of polio vaccine have been causing more paralysis than wild polio.

Are Mutant Strains of Polio Vaccine Now Causing More Paralysis Than Wild Polio?

Although anti-vaccine folks seem to be having a field day over the news, it doesn’t really mean what they think it means.

It isn’t even true anymore…

Not getting polio is a good thing. A pediatrician, especially one who wrote a vaccine book should understand the benefits of the polio vaccine.

The article Bob Sears shared isn’t even current…

“So far in 2017, there have been only six cases of “wild” polio reported anywhere in the world. By “wild,” public health officials mean the disease caused by polio virus found naturally in the environment.

By contrast, there have been 21 cases of vaccine-derived polio this year.”

Mutant Strains Of Polio Vaccine Now Cause More Paralysis Than Wild Polio

It was from two years ago.

There were only 22 cases of wild polio in the world in 2017. We are on track for many more cases this year.
There were only 22 cases of wild polio in the world in 2017. We are on track for many more cases this year.

He doesn’t even mention the main reason that mutant strains of polio vaccine are now causing more paralysis than wild polio.

“Global efforts to immunise children with the oral polio vaccine (OPV) have reduced wild poliovirus cases by 99.9% since 1988.”

Fact Sheet: Vaccine-Derived Poliovirus

And that is simply because most people are vaccinated and protected and we are very close to eradicating polio!

“As recently as 30 years ago, wild poliovirus paralysed more than 350,000 children in more than 125 countries every year. In 2018 there were fewer than 30 reported cases in just two countries – Afghanistan and Pakistan.”

“Zero polio transmission and health for all”, WHO Director-General gives new year’s wish to the people of Afghanistan and Pakistan

Nor does he mention that vaccine derived polio virus strains mutate when too many people are unvaccinated.

What else does Bob Sears leave out of his post?

Polio this week as of 24 July 2019, with more paralysis from wild polio viruses than mutant strains of the polio vaccine.
Polio this week as of 24 July 2019, with more paralysis from wild polio viruses than mutant strains of the polio vaccine.

So far, this year, we are tragically seeing more paralysis from wild polio than mutant strains of the polio vaccine!

What’s the last thing Bob Sears left out of his post?

Most of the “mutant strains” of polio vaccine are from the type 2 vaccine virus, which isn’t being used anymore. In 2016, all countries switched to bivalent OPV, which doesn’t include the type 2 polio virus strain.

And since most cases of wild polio are in just a few countries, namely Pakistan and Afghanistan, we will hopefully get back on track to eradication and also see a drop in paralysis from the mutant vaccine strains. That’s when we can stop using the oral polio vaccine all together.

At least we will if folks stop listening to anti-vaccine misinformation and propaganda that scares them away from vaccinating and protecting their kids.

More On Paralysis from Mutant Strains of Polio Vaccine Vs Wild Polio

Do You Remember Sabin Sundays?

You may have heard of the Polio Pioneers, the kids who got Jonas Salk‘s original inactivated polio vaccine in 1954.

They were part of a large clinical trial, getting either the polio shot or a saline placebo, and helped prove that the vaccine was safe and effective.

Do You Remember Sabin Sundays?

Of course, that wasn’t the end of the story though.

After the Cutter Incident, Albert Sabin soon proved that his live, oral polio vaccine was better than Salk’s inactivated polio vaccine.

And it was first given in the United States on April 24, 1960 – the first Sabin Sunday, when 20,000 children came to Cincinnati Children’s to receive his sugar cube vaccine.

“On three consecutive Sundays — “Sabin Sundays” — in 1960, millions of families lined up at churches and schools across the country to swallow a spoonful of pink syrup or a sugar cube treated with a life-saving polio vaccine, developed by UC researcher Albert Sabin.”

Sabin Sunday, 1960

Sabin Oral Sunday immunization programs continued over the next few years all over the country as kids got caught up on their polio vaccines.

Several Sabin Sundays were held in Arizona in 1962.

Can you imagine taking your kids to school to get them vaccinated on a Sunday?

Millions of parents did it!

Newspapers urged folks to attend the Sabin on Sunday clinics to help end the threat of "crippling poliomyelitis."
Newspapers urged folks to attend the Sabin on Sunday clinics to help end the threat of “crippling poliomyelitis.”

They lined up to get their kids vaccinated and protected.

More on Sabin Sundays

What is Eczema Vaccinatum?

Did you know that having eczema is a contraindication to getting a vaccine?

Which vaccine?

The smallpox vaccine!

Yes, smallpox has been eradicated, but the vaccine is sometimes still used in very specific situations, especially in the military.

What is Eczema Vaccinatum?

Not only is eczema a contraindication to getting the smallpox vaccine, you shouldn’t even get it if a household contact has eczema.

Why not?

Shedding.

Yes, although anti-vaccine folks needlessly worry about shedding when kids get routine childhood vaccines and even talk about a shedding season, with the smallpox vaccine, problems with shedding are really a thing.

Since the smallpox vaccine is a live virus vaccine and since it very commonly causes a skin reaction at the injection site, shedding can spread it to others. While that’s a good thing with some vaccines, like the oral polio vaccine, because it increases herd immunity, it isn’t with the smallpox vaccine.

If the weakened smallpox vaccine can cause a skin reaction on your arm where you got the shot, what is it going to do if it gets on a child’s skin that is irritated all over with eczema?

An 8-month-old boy with eczema vaccinatum.
An 8-month-old boy with eczema vaccinatum. Photo by CDC/Arthur E. Kaye

It’s a good thing that we don’t routinely have to use the smallpox vaccine anymore.

“Because persons with eczema are deferred from vaccination, only a single, accidentally transmitted case of EV has been described in the medical literature since military vaccination was resumed in the United States in 2002.”

Reed et al on Eczema vaccinatum.

And that it doesn’t happen with any other vaccines!

More on Eczema Vaccinatum

What Is the Morbidity/Mortality Rate of the Polio Vaccine vs the Wild Virus?

Some anti-vaccine folks still think that the risks of vaccines are far greater than the risks of the vaccine-preventable diseases they keep you from getting.

As more people are vaccinated and diseases disappear, they forget how bad those diseases are, skip or delay getting their vaccines, and trigger outbreaks.
As more people are vaccinated and diseases disappear, they forget how bad those diseases are, skip or delay getting their vaccines, and trigger outbreaks. Photo by WHO

They aren’t, but you can kind of understand why they might think that with a disease like polio, when they might never actually have known anyone to have the disease.

What Is the Morbidity/Mortality Rate of the Polio Vaccine vs the Wild Virus?

Still, even though polio is under good control and close to being eradicated, the risk/benefit ratio clearly favors getting vaccinated and protected.

That’s because the polio vaccines are very safe and if we stopped vaccinating, polio could come back.

In fact, morbidity/mortality from polio vaccines are decreasing, as we are using much less oral polio vaccine (OPV) in the transition (OPV cessation) to just using inactivated polio vaccine (IPV).

“Over the past ten years, more than 10 billion doses of OPV have been given to nearly three billion children worldwide. More than 16 million cases of polio have been prevented, and the disease has been reduced by more than 99%. It is the appropriate vaccine through which to achieve global polio eradication.”

OPV Cessation

And while most developed countries already use IPV, those that are still using OPV recently switched from a trivalent (tOPV) to a bivalent (bOPV) form of OPV. We could do this because type 2 poliovirus has already been eradicated (2015)!

Of course, the issue with the OPV vaccines is that they rarely cause vaccine-associated paralytic polio (VAPP) and circulating vaccine-derived polioviruses (cVDPV).

Fortunately, this is even less common with bOPV.

As this chart from the WHO shows, polio vaccines are very safe.
As this chart from the WHO shows, polio vaccines are very safe.

So morbidity (getting sick)/mortality (dying) from polio vaccines is low.

There were only 31 cases of wild polio in 2018, in Afghanistan and Pakistan, and an additional 102 cases of cVDPV in 7 countries.

What about morbidity/mortality from polio?

“As recently as 30 years ago, wild poliovirus paralysed more than 350 000 children in more than 125 countries every year. In 2018 there were fewer than 30 reported cases in just two countries – Afghanistan and Pakistan.”

“Zero polio transmission and health for all”, WHO Director-General gives new year’s wish to the people of Afghanistan and Pakistan

With a 99.9% drop in polio cases since 1998, your risk of getting polio in most parts of the world is very low, but you still have to consider both the morbidity/mortality of polio in the pre-vaccine era and the risk of polio returning if we stop vaccinating before it is eradicated.

What about the idea that you don’t have to worry about polio because only 1% of kids with polio developed paralysis?

“The mortality rate for acute paralytic polio ranges from 5–15%.”

Disease factsheet about poliomyelitis

Well, when everyone gets polio, even 1% is a lot.

With such a safe vaccine, why put your kids at risk of getting polio?

Do you even understand what the risks are?

No, it isn’t just the risk of wild polio in Afghanistan and Pakistan.

Since the oral polio vaccines shed, if you are unvaccinated, in addition to the risk of wild polio, there is a small risk of getting circulating vaccine-derived polioviruses (cVDPV) if you are not vaccinated and protected. No, it is not a big risk, as there were only 102 cases of cVDPV in 7 countries in 2018, but it isn’t zero either.

And the other big risk is that if enough folks stop getting vaccinated, taking their chances hiding in the herd, polio will come back and our chance to eradicate another vaccine-preventable disease will fail.

More on the Morbidity and Mortality Rates of Polio