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Countries using oral poliovirus vaccine (OPV) in May 2016 following the global switch from trivalent OPV to bivalent OPV. Data are unpublished and from the World Health Organization Immunization Repository. 

Countries using oral poliovirus vaccine (OPV) in May 2016 following the global switch from trivalent OPV to bivalent OPV. Data are unpublished and from the World Health Organization Immunization Repository. 

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Eliminating the risk of polio from vaccine-derived polioviruses is essential for creating a polio-free world, and eliminating that risk will require stopping use of all oral polio vaccines (OPVs) once all types of wild polioviruses have been eradicated. In many ways, the experience with the global switch from trivalent OPV (tOPV) to bivalent OPV (b...

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Context 1
... of August 2016, 6 companies were producing World Health Organization (WHO)-prequalified bOPV for the international market [14], with 7 additional companies producing bOPV for their domestic markets [15]. Among the 150 countries and terri- tories currently using OPV (Figure 2), approximately 75 procure bOPV through the United Nations Children's Fund (UNICEF), while the rest self-produce or self-procure bOPV. Among coun- tries and territories procuring bOPV through UNICEF, SIAs are the key demand driver, with routine immunization accounting for approximately 20% of UNICEF's procurement of 1.2 billion doses in 2016. ...
Context 2
... the other components of OPV withdrawal, the moni- toring and confirmation process could potentially involve more than just the countries that are still using bOPV at the date of OPV withdrawal or the countries that continued to use OPV after the switch (Figure 2). To fully minimize the possibility of OPV being used after its withdrawal, all countries that have ever used OPV, including those that ceased using it years before the switch, should ideally confirm that all of their OPV has either been (1) withdrawn and destroyed or (2) safely contained in an approved poliovirus-essential facility. ...

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... Because global polio eradication is predicated on the achievement of the eradication of paralytic polio due to all live polioviruses, including vaccinerelated viruses [7], eliminating the risk of VAPP and cVDPVs will require stopping all use of OPV in routine immunization services and supplementary immunization activities [8,9]. The Global Commission for the Certification of the Eradication of Poliomyelitis certified the eradication of type 2 poliovirus in 2015 [10] following the last case in 1999 and type 3 poliovirus in 2019 following the last case in 2012 [11], making type 2 and type 3 polioviruses the first human pathogens to be eradicated since smallpox. ...
... The first phase of OPV withdrawal took place in 2016 with the global switch from trivalent OPV (tOPV) to bivalent OPV (bOPV) in the 155 OPV-using countries of the world, through cessation of all manufacturing and distribution of tOPV and its rapid withdrawal from clinics and storage facilities [8,9]. The type 2 vaccine virus was prioritized for removal because type 2 cVDPV (cVDPV2) cases comprised approximately 95% of all cVDPV cases during 2006 to May 2016 and approximately 30% of all VAPP cases. ...
... The type 2 vaccine virus was prioritized for removal because type 2 cVDPV (cVDPV2) cases comprised approximately 95% of all cVDPV cases during 2006 to May 2016 and approximately 30% of all VAPP cases. Additionally, the type 2 OPV vaccine virus is the most infectious and immunogenic of the 3 vaccine virus strains and interferes with the replication of other vaccine strains in the intestinal tract and, hence, the type 1 and 3 vaccine effectiveness using tOPV was lower [2,8,9]. A stockpile of monovalent type 2 (mOPV2) vaccine was established to respond to potential outbreaks of cVDPV2. ...
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