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      Review and assessment of poliovirus immunity and transmission: Synthesis of knowledge gaps and identification of research needs

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          Abstract

          With the intensifying global efforts to eradicate wild polioviruses, policymakers face complex decisions related to achieving eradication and managing post-eradication risks. These decisions and the expanding use of inactivated poliovirus vaccine (IPV) trigger renewed interest in poliovirus immunity, particularly the role of mucosal immunity in the transmission of polioviruses. Sustained high population immunity to poliovirus transmission represents a key prerequisite to eradication, but poliovirus immunity and transmission remain poorly understood despite decades of studies. In April 2010, the US Centers for Disease Control and Prevention convened an international group of experts on poliovirus immunology and virology to review the literature relevant for modeling poliovirus transmission, develop a consensus about related uncertainties, and identify research needs. This paper synthesizes the quantitative assessments and research needs identified during the process. Limitations in the evidence from OPV challenge studies and other relevant data led to differences in expert assessments, indicating the need for additional data, particularly in several priority areas for research: 1) the ability of IPV-induced immunity to prevent or reduce excretion and affect transmission, 2) the impact of waning immunity on the probability and extent of poliovirus excretion, 3) the relationship between the concentration of poliovirus excreted and infectiousness to others in different settings, and 4) the relative role of fecal-oral versus oropharyngeal transmission. This assessment of current knowledge supports the immediate conduct of additional studies to address the gaps.

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          Author and article information

          Journal
          8109978
          7018
          Risk Anal
          Risk Anal
          Risk analysis : an official publication of the Society for Risk Analysis
          0272-4332
          1539-6924
          8 February 2021
          28 March 2013
          April 2013
          18 February 2021
          : 33
          : 4
          : 606-646
          Affiliations
          [1. ]Kid Risk, Inc., P.O. Box 590129, Newton, MA 02459
          [2. ]Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, Division of Viral Diseases, Atlanta, GA, 30333
          [3. ]Center for Biologics Evaluation and Research, Food and Drug Administration, Rockville, MD 20852
          [4. ]Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore MD 21205
          [5. ]National Institute for Health and Welfare (THL), Helsinki, Finland
          [6. ]National Institute of Biological Standards and Control, Health Protection Agency, South Mimms, Potters Bar, Hertfordshire, EN6 3QG UK
          [7. ]Dartmouth Medical School, Hanover, NH 03755
          [8. ]Biologics Consulting Group, Inc., Bethesda, MD 20814 USA
          [9. ]Polio Eradication Initiative, World Health Organization, Geneva, Switzerland
          [10. ]Dartmouth Medical School, Hanover, NH 03755
          [11. ]Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, Global Immunization Division, Atlanta, GA, 30333
          Author notes
          Correspondence to: Radboud J. Duintjer Tebbens, Kid Risk, Inc., P.O. Box 590129, Newton, MA 02459, USA, rdt@ 123456kidrisk.org
          Article
          PMC7890644 PMC7890644 7890644 hhspa1670167
          10.1111/risa.12031
          7890644
          23550968
          d2ce5bf0-82f5-4685-8465-a689d7680b05
          History
          Categories
          Article

          polio eradication,dynamic modeling,expert judgment
          polio eradication, dynamic modeling, expert judgment

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