Abstract
The Pan American Health Organization, with the support of its Strategic Advisory Group on Vaccine-Preventable Diseases, recommends the following for the prevention and control of poliomyelitis in the Americas:
1. Countries currently using bivalent oral polio vaccine (bOPV) should continue to do so. It is not advisable to consider stopping bOPV use unless all criteria for high readiness for bOPV cessation are met and progress towards the goal of global polio eradication is more advanced. The value of bOPV use is to ensure adequate mucosal immunity to prevent transmission of poliovirus types 1 and 3 that may be imported into the region. Such mucosal immunity is particularly important when there are trends of low polio vaccination coverage.
2. Countries that are assessed as being at very high risk or high risk of polio transmission or a polio outbreak should take preventive action to improve population immunity, such as national or sub-national campaigns or outreach vaccination, as appropriate.
3. Strategic planning and costing must be done by countries and by the Region for all measures needed to ensure an adequate polio endgame within the Americas.
4. Countries that are ready and opt to transition to an Inactive Poliovirus Vaccine (IPV)- only schedule must have a national polio outbreak preparedness and response plan in place that has been recently prepared or evaluated within three to five years of the proposed time of switch. Further, a tabletop simulation exercise with sub-national participation should be conducted prior to the switch.
5. Countries should strengthen their referral systems to ensure the timely transport and receipt of specimens at destination laboratories. In parallel, the poliovirus laboratory network of the Americas should continue enhancing its technical capacities, including upgrading selected laboratories to serve as regional referral centers for sequencing, serology, and environmental surveillance.
