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Page: Latrogenic (Vaccine-induced) Polio
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A major concern attributable to the oral polio vaccine is that it can revert to a virulent form. Clinical disease caused by vaccine-derived poliovirus (VDPV) is indistinguishable from that caused by wild polioviruses. This is believed to be a rare event, but outbreaks of vaccine-derived poliovirus (VDPV) have been reported, and tends to occur in areas of low coverage by OPV, presumably because the OPV is itself protective against the related outbreak strain.
The rate of vaccine-associated paralytic poliomyelitis (VAPP) varies by region but is generally about 1 case per 750,000 vaccine recipients. VAPP is more likely to occur in adults than in children. In immunodeficient children, the risk of VAPP is almost 7,000 times higher, particularly for persons with B-lymphocyte disorders (e.g., agammaglobulinemia and hypogammaglobulinemia), which reduce the synthesis of protective antibodies.
Outbreaks of VAPP occurred independently in Belarus (1965–66), Egypt (1983–1993), Hispaniola (2000–2001), Philippines (2001), Madagascar (2001–2002), and in Haiti (2002), where political strife and poverty have interfered with vaccination efforts. In 2006 an outbreak of vaccine-derived poliovirus occurred in China.
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