Costs and Benefits of Including Inactivated in Addition to Oral Poliovirus Vaccine in Outbreak Response After Cessation of Oral Poliovirus Vaccine Use
by Radboud J. Duintjer Tebbens and Kimberly M. Thompson, Medical Decision Making Policy & Practice 2017; doi:10.1177/2381468317697002 (published on-line March 1, 2017).

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What are the study’s main findings?
What are the study’s main recommendations?
Background on polio

What are the study’s main findings?

• This study estimated the effectiveness, cost-effectiveness, and incremental net benefits of adding inactivated poliovirus vaccine (IPV) to outbreak response supplemental immunization activities (oSIAs) that already use serotype 2 monovalent oral poliovirus vaccine (mOPV2) in response to a hypothetical outbreak of serotype 2 circulating vaccine-derived poliovirus (cVDPV2) in northwest Nigeria.
• Adding IPV to the first or second oSIA resulted in a 4-6% reduction in expected polio cases compared to exclusive mOPV2 oSIAs.
• Adding IPV to later oSIAs or to older age groups resulted in a negligible reduction in expected polio cases but a small increase in population immunity to serotype 2 transmission after the outbreak.
• IPV use yielded the greatest effectiveness if added preemptively as a ring around the initial oSIA target population, while it led to an increase in expected polio cases if IPV replaced mOPV2 during an oSIA.
• Due to the small number of additional polio cases prevented, adding IPV to mOPV2 SIAs did not represent a cost-effective or net beneficial intervention in this population for a wide range of assumptions about the specific IPV strategy, IPV take rate, IPV price, and wastage rate.
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• The poor cost-effectiveness and current limited IPV supply make adding IPV to mOPV2 oSIAs an economically unattractive strategy for high-risk settings in which IPV does not significantly affect transmission.
• Further research should address the possible effect of IPV on reducing the probability of exportations to other populations of outbreak virus or viruses related to mOPV2 used for the outbreak response.
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