Government has started giving fractional doses of injectable polio vaccine (IPV) which is 1/5th of the full IPV dose via the intradermal route in high performing states of the country to overcome the demand supply gap of IPV vaccine due to its current shortage. These high performing states are Tamil Nadu, Kerala, Andhra Pradesh, Telangana, Karnataka, Orissa, Maharashtra and Puducherry.

As per the programme, two fractional doses of IPV are administered at 6 weeks and 14 weeks as an alternative to the intramascular injection of one full dose of IPV. Meanwhile, as part of the polio immune strategy, larger states are availing single dose of IPV through intra-mascular administration at 14 weeks to tide over the shortage.

According to the information available through Union health ministry, the main reason behind shortage of IPV in India is the failure of major producers of IPV globally to supply adequate quantity of the vaccine to India.

As part of the national immunisation programme, government started giving injectable polio vaccine (IPV) along with bi-valent oral polio vaccine (OPV) from April 25, 2016 onwards to build population immunity in India for complete polio eradication.

The health ministry’s polio immune strategy aims to make a switch over from trivalent oral polio vaccine to bivalent oral polio vaccine in a phased manner to completely stop oral polio vaccination and switch to IPV by 2020.

According to experts, this will help accomplish the switch over from trivalent OPV to bivalent OPV effectively and will gradually be scaled up until the OPV is completely stopped. The trivalent OPV currently in practice covers three viruses, of which disease caused by type 2 virus has not been seen since 1999.

According to the World Health Organization (WHO), routine immunisation with OPV must cease after the eradication of polio virus because of the danger of outbreaks of circulating vaccine-derived polio virus and the risk of vaccine-associated paralytic poliomyelitis (VAPP).

Informs Dr Pramod Jog, president, Indian Academy of Paediatrics (IAP), “Health ministry’s plan to switch over to bivalent oral polio vaccine(OPV) from trivalent OPV from  April 25, 2016 onwards towards polio eradication is in accordance with the recommendations to WHO-SAGE (Strategic Advisory Group of Experts on Immunization).”

The Global Commission for Certification of the Eradication of Poliomyelitis recently certified that type 2 wild poliovirus has been eradicated. Now it exists only in laboratories and in trivalent oral polio vaccine (tOPV) in an attenuated form, though in rare circumstances it surfaces in the community through persistent transmission, in the form of out-breaks of vaccine -derived viruses.

“All countries should have access to enough inactivated polio vaccine (IPV) to administer at least one dose to all children through the routine immunisation programme. IPV provides immunity against all three polio-viruses without generating any infectious vaccine-associated polio viruses. In India, type 2 is responsible for around 40 per cent of all cases of VAPP and majority of them occur after four months of age. Thus the single dose of IPV given at 14 weeks would not only prevent all cases of vaccine-associated paralytic poliomyelitis (VAPP) caused by type 2 but will also significantly reduce the overall tally of VAPP,” added Dr Jog.
 
Government decided April 25, 2016 as National Switch Date for switching from trivalent OPV to bivalent OPV (containing only types 1 and 3) all over the country.