Supplemental Polio Immunization Campaigns: Uganda to introduce IPV into routine immunization schedule

Uganda is at increased risk of polio outbreaks due to the political unrest in its neighbors, the porous nature of our borders, massive cross border movements and an influx of refugees especially in areas with low performance in routine immunization and poor surveillance indicators.

An outbreak of polio in South Sudan was confirmed on 24th November 2014, where 2 cases of circulating vaccine-derived polio (cVDPV2) were identified in Unity state. Presence of cVDPV2 is an indication of ongoing weak- nesses in routine immunization efforts in affected areas. Such cVDPV2 incidence9s need to be eliminated before the withdrawal of trivalent oral polio vaccine (tOPV). Therefore multiple supplemental immunization campaigns with tOPV have been planned in all countries with an on-going cVDPV2 outbreak or at high risk for such an outbreak if the end game strategic plan goals are to be realized.

Uganda therefore has planned several supplemental immunization activities (SIAs) with tOPV to ensure full protection of all children <59 months before the switch. This switch from tOPV to bOPV is scheduled for April 2016. It’s a globally synchronized replacement of all tOPV with bivalent OPV (bOPV) containing only types 1 and 3 polioviruses.

To prepare for the global switch from tOPV to bOPV, as recommended in the Polio eradication and endgame strategic plan 2013–2018, the WHO strategic advisory group of experts (SAGE) on immunization recommended that at least one inactivated Polio Vaccine (IPV) dose be introduced into routine immunization schedules in all countries.

The IPV will help protect against paralytic polio caused by type 2 polioviruses, provide a degree of population protection against type2 poliovirus out-breaks, facilitate responses to any cVDPV2 outbreaks after the switch to bOPV, and aid in eradicating wild polio virus by boosting immunity to types 1 and 3 polioviruses.

The first round of SIAs was implemented from 21st-23rd January 2016 in 57 high risk districts.

This will be followed by the national house to house polio campaign from 1st to 3rd April 2016 that will cover children <5years using tOPV.

Subsequently inactivated polio vaccine (IPV) will be introduced into routine immunization at 14 weeks together with OPV3 starting 18th April, 2016.

This will then be followed by another round of SIAs using tOPV in 65 high risk districts before the national switch day on 29th April, 2016.