Support for inactivated polio vaccine

Newsdesk United Nations rallies support to tackle HIV/AIDS production and distribution to multinational firms to contribute. The developing countries, with 50% of the International Olympic Committee has $7 billion funding expected to be donated $100 000, the US government directed to sub-Saharan Africa. has offered $200 million, and the UK Treatment funding will also be offered $100 million. The Bill and directed to building hospitals and Melinda Gates foundation has donated health centres in $100 million. developing countries, as The UN warns that Rights were well as training local although there are not granted to personnel. The initiative indications that the is set to provide health AIDS pandemic could include this expertise from medical be declining in some image in practitioners and health African countries, “we electronic care managers from are worried about the donor countries as plight of HIV/AIDS media. Please well as information patients in Asia and refer to the campaigns on disease Europe”. printed journal. prevention in the A recent report by targeted nations. Bernhard Scwartlander An alliance of Annan tells world to “wake up” and colleagues, on governments, private Science Online organisations, and charities, the fund is (www.sciencemag.org) states that expected to stockpile donations over 15 000 new infections occur each day. the next 5 years. The first commercial He adds, “by 2005, $9·2 billion will be donation came on June 8 from needed annually to support an Winterthur Insurance, who pledged expanded response to HIV/AIDS in $1 million. Annan hopes this middle-income countries.” Georgina Kenyon contribution will prompt other AP

Participants at the United Nations General Assembly on HIV/AIDS in New York on June 25 signed a declaration of commitment to combating HIV/AIDS and pledged to contribute to the global health fund. The declaration proposes to reduce by a quarter new HIV infections in the 15–24-year age-group in the worst affected countries by 2005. The UN hopes that mother-to-child transmission can be reduced by onefifth of current rate. “It is an achievable goal as this transmission is easily preventable,” said a UN spokesperson. Kofi Annan has announced that the fund will need at least US$7 billion per year in donations above current spending figures to combat the diseases of AIDS, malaria, and tuberculosis. A total of $528 200 000 has been pledged, with Annan announcing he would donate $100 000 from the Philadelphia Liberty Medal for peace. Half of the funding is expected to be spent on treatment, the other on prevention. Part of the prevention plan will focus on increasing condom

Support for inactivated polio vaccine US researchers have lent support to the use of inactivated poliovirus vaccine (IPV) in two studies published recently. The research demonstrates that IPV is not linked to vaccine-associated paralytic poliomyelitis (VAPP), and that switching from oral polio vaccine (OPV) to an IPV regimen does not adversely affect compliance and the immunisation status of young children. OPV has been associated with VAPP, with eight or nine cases each year in the USA. When the enhanced potency IPV was developed in the late 1980s many countries, including the USA and most of Europe, amended their polio immunisation policies. For example, in 1997, the US Centers for Disease Control and Prevention (CDC) recommended the four-dose sequential IPV/OPV schedule with IPV replacing OPV in the first two doses. In 2000, the CDC recommended that clinicians should

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use IPV for all four childhood doses. In the first study, Wendy A Wattigney (CDC, Atlanta, GA, USA) and colleagues analysed immunisation data from the US vaccine adverse event reporting system from 1991–1998. In that database, researchers found that although allergic reactions were 2·5% higher in infants aged 4–6 months old receiving IPV instead of OPV, overall symptoms were “not remarkably different for IPV compared with OPV.” No cases of VAPP were reported after the use of IPV, compared to five VAPP cases after the administration of OPV in infants aged 1–6 months old (Pediatrics 2001; 107: e83). “Vaccine-associated polio is associated only with the live oral vaccine,” says Robert Chen (CDC, Atlanta) of the National Immunization Program. “So by switching to an all-IPV schedule, you’d expect to eliminate

VAPP completely.” In the second study, James Taylor (University of Washington, Seattle, WA, USA) and colleagues analysed immunisation data of 13 520 children who received poliovirus vaccines from 177 US pediatricians. The authors concluded that despite the change to an IPV-containing vaccine schedule, children were at least as likely as OPV recipients to be fully immunised at 8 and 12 months of age (Pediatrics 2001; 107: e90). “There had been concern that particularly among poor and minority children, [where widespread vaccination has been more difficult], the change to injections, as opposed to oral drops, would discourage some parents from having their children immunised,” said Taylor. “But our study showed that the transition to IPV has been made with surprising ease.” Richard Trubo

THE LANCET Infectious Diseases Vol 1 August 2001

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