Modeling the Costs and Benefits of Temporary Recommendations for Poliovirus Exporting Countries to Vaccinate International Travelers
by Radboud J. Duintjer Tebbens and Kimberly M. Thompson, Vaccine 2017; doi.org/10.1016/j.vaccine.2017.05.090 (published on-line June 9, 2017).

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

What are the study’s main findings?

• Temporary recommendations to vaccinate travelers from countries with continued transmission of wild poliovirus serotype 1 (WPV1) transmission represent a significant cost to those countries, but remain small compared to the overall costs to stop transmission in those countries.
• Importation outbreaks in polio-free countries occur regularly and lead to greater expected costs than implementing the temporary recommendations.
• Despite the high costs of the temporary recommendations, their potential to prevent outbreaks results in substantial expected incremental net benefits.
• Increasing the intensity of the temporary recommendations only after documented exportations occur misses the opportunity to prevent those exportations.
• Maintaining high population immunity to WPV1 transmission in polio-free countries remains the most important way to reduce the probability of WPV1 importation outbreaks.
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• Noting the reactive nature of the temporary recommendations at the time of the study, we recommend further discussion about the feasibility of issuing temporary recommendations on the basis of extent of WPV1 circulation (e.g., approximated by WPV1 polio incidence) instead of documented WPV1 exportations.
• Temporary recommendations for WPV1 should continue, because although countries may not perceive benefits of implementing the temporary recommendations within their borders, they produce real benefits for other countries.
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