Research on risk management strategies for polioviruses

The Kids Risk Project research on polio characterized the enormous health and financial benefits of poliovirus vaccination in the United States. Even though you might think that polioviruses are gone, take a couple of minutes to learn more background about polioviruses and why you should still care about them.

The overall goal of polio research done by the Kids Risk Project was to create useful analytical modeling tools to help decision makers consider the implications of the various immunization and risk management strategies they will face after the certification of the world as free of wild polioviruses.  The modeling process synthesized existing information and characterized the current knowledge and uncertainties to produce a structured model that explicitly addressed the risks, costs, and benefits of different policy options.  This project was funded by the U.S. Centers for Disease Control and Prevention (CDC) (Grant Numbers: U50/CCU300860, TS-0675; U01 IP000029; U66 IP000169-01) and it involved extensive collaboration with numerous polio experts at the CDC and the World Health Organization (WHO). This work started as part of the CDC-Harvard Joint Initiative in Vaccine Economics (JIVE) collaboration that identified high-priority, emerging issues for economic research by interviewing and ranking the assessments of experts (T.A. Lieu, K.M. Thompson, L.A. Prosser, M.A. O’Brien, H.R. Yusuf, A.M. Shefer, M.C. Weinstein, and D.L. Rickert, “Emerging Issues in Vaccine Economics -- Perspectives from the United States," Expert Review of Vaccines 1(4):89-98, 2002 - see the complete lists of domestic ideas and global ideas mentioned in the paper).

In addition to numerous presentations, the Kids Risk Project research on polio produced peer-reviewed publications (several appeared in a special issue of the journal Risk Analysis) related to:

• the decision options that national and international health leaders will face in the future
• a dynamic disease model for polio outbreaks
• health and financial benefits of historical poliovirus vaccination in the United States
• context related to risk management in a polio-free world
• characterization of the risks of future options
• characterization of the costs of future options
• trade-offs associated with outbreak response options
• consideration of the costs and value of global poliovirus surveillance
• lessons learned during this collaborative project (as of December 2006)
• polio eradication better than control (this paper won the 2008 Jay Wright Forrester Award from the System Dynamics Society)
• the risks, costs, and benefits of global policies for managing polio after eradication
• uncertainty and sensitivity analyses of our results related to global post-eradication policies
• analysis of the need for global cooperation on a vaccine stockpile and coordinated OPV cessation
• the role of system dynamics in our research
• the consequences of priority shifting when seeking to eradicate multiple diseases
• a framework for optimizing the future use of vaccines from the global polio vaccine stockpile
• building an "individual-based" or "agent-based" model to explore and optimize post wild poliovirus eradication outbreak response strategies

Currently, Kid Risk, Inc. research is focused on:

• characterizing the health and financial benefits of historical global poliovirus vaccination, which includes surveying national and international health leaders and economists to assess the value of vaccines and willingness-to-pay for treatment and prevention of paralysis
• modeling population immunity and characterizing pre-eradication decisions
• understanding the evolution of OPV viruses and the development of circulating vaccine-derived polioviruses (cVDPVs)
• assessing the economics of eradication