Table 1.

Comparison of the Switch From Trivalent Oral Polio Vaccine (tOPV) to Bivalent OPV (bOPV) Versus the Full Withdrawal of OPVs

ComparisonSwitch From tOPV to bOPVFull Withdrawal of OPVs
Reason for changeEnd of transmission of type 2 wild polioviruses made the risks from continued regular use of OPV containing type 2 Sabin strain polioviruses outweigh the benefitsEnd of transmission of all 3 types of wild polioviruses will make the risks from continued regular use of any OPV containing Sabin strain polioviruses outweigh the benefits
SynchronizationAll countries using tOPV needed to withdraw all tOPV in a synchronized manner within a short time frame to avoid creating type 2 cVDPVsAll countries using OPV will need to withdraw all OPV in a synchronized manner within a short time frame to avoid creating cVDPVs
Potential risks from incomplete withdrawal of vaccinetOPV left in the cold chain and used long after the switch could potentially result in new cVDPVsOPV left in the cold chain and used long after full OPV withdrawal could potentially result in new cVDPVs
OPV use in routine immunization after eventRoutine immunization programs used bOPV instead of tOPV after the switchNo OPV should be used in routine immunization programs after full OPV withdrawal
Introduction of new form of OPV during eventbOPV was introduced simultaneously with the withdrawal of tOPV during the switchNo new form of OPV will be introduced during full OPV withdrawal
Availability of OPV stockpileMonovalent OPV stockpile available for use in response to polio outbreaks caused by type 2 polioviruses after the switchMonovalent OPV stockpiles will be available for use in response to polio outbreaks caused by any type of poliovirus after OPV withdrawal
Outbreak response resourcesExtensive resources available for organizing responses to polio outbreaks caused by cVDPVs after the switchFewer resources may be available for organizing responses to polio outbreaks caused by cVDPVs after full OPV withdrawal
ComparisonSwitch From tOPV to bOPVFull Withdrawal of OPVs
Reason for changeEnd of transmission of type 2 wild polioviruses made the risks from continued regular use of OPV containing type 2 Sabin strain polioviruses outweigh the benefitsEnd of transmission of all 3 types of wild polioviruses will make the risks from continued regular use of any OPV containing Sabin strain polioviruses outweigh the benefits
SynchronizationAll countries using tOPV needed to withdraw all tOPV in a synchronized manner within a short time frame to avoid creating type 2 cVDPVsAll countries using OPV will need to withdraw all OPV in a synchronized manner within a short time frame to avoid creating cVDPVs
Potential risks from incomplete withdrawal of vaccinetOPV left in the cold chain and used long after the switch could potentially result in new cVDPVsOPV left in the cold chain and used long after full OPV withdrawal could potentially result in new cVDPVs
OPV use in routine immunization after eventRoutine immunization programs used bOPV instead of tOPV after the switchNo OPV should be used in routine immunization programs after full OPV withdrawal
Introduction of new form of OPV during eventbOPV was introduced simultaneously with the withdrawal of tOPV during the switchNo new form of OPV will be introduced during full OPV withdrawal
Availability of OPV stockpileMonovalent OPV stockpile available for use in response to polio outbreaks caused by type 2 polioviruses after the switchMonovalent OPV stockpiles will be available for use in response to polio outbreaks caused by any type of poliovirus after OPV withdrawal
Outbreak response resourcesExtensive resources available for organizing responses to polio outbreaks caused by cVDPVs after the switchFewer resources may be available for organizing responses to polio outbreaks caused by cVDPVs after full OPV withdrawal

Abbreviation: cVDPV, circulating vaccine-derived poliovirus.

Table 1.

Comparison of the Switch From Trivalent Oral Polio Vaccine (tOPV) to Bivalent OPV (bOPV) Versus the Full Withdrawal of OPVs

ComparisonSwitch From tOPV to bOPVFull Withdrawal of OPVs
Reason for changeEnd of transmission of type 2 wild polioviruses made the risks from continued regular use of OPV containing type 2 Sabin strain polioviruses outweigh the benefitsEnd of transmission of all 3 types of wild polioviruses will make the risks from continued regular use of any OPV containing Sabin strain polioviruses outweigh the benefits
SynchronizationAll countries using tOPV needed to withdraw all tOPV in a synchronized manner within a short time frame to avoid creating type 2 cVDPVsAll countries using OPV will need to withdraw all OPV in a synchronized manner within a short time frame to avoid creating cVDPVs
Potential risks from incomplete withdrawal of vaccinetOPV left in the cold chain and used long after the switch could potentially result in new cVDPVsOPV left in the cold chain and used long after full OPV withdrawal could potentially result in new cVDPVs
OPV use in routine immunization after eventRoutine immunization programs used bOPV instead of tOPV after the switchNo OPV should be used in routine immunization programs after full OPV withdrawal
Introduction of new form of OPV during eventbOPV was introduced simultaneously with the withdrawal of tOPV during the switchNo new form of OPV will be introduced during full OPV withdrawal
Availability of OPV stockpileMonovalent OPV stockpile available for use in response to polio outbreaks caused by type 2 polioviruses after the switchMonovalent OPV stockpiles will be available for use in response to polio outbreaks caused by any type of poliovirus after OPV withdrawal
Outbreak response resourcesExtensive resources available for organizing responses to polio outbreaks caused by cVDPVs after the switchFewer resources may be available for organizing responses to polio outbreaks caused by cVDPVs after full OPV withdrawal
ComparisonSwitch From tOPV to bOPVFull Withdrawal of OPVs
Reason for changeEnd of transmission of type 2 wild polioviruses made the risks from continued regular use of OPV containing type 2 Sabin strain polioviruses outweigh the benefitsEnd of transmission of all 3 types of wild polioviruses will make the risks from continued regular use of any OPV containing Sabin strain polioviruses outweigh the benefits
SynchronizationAll countries using tOPV needed to withdraw all tOPV in a synchronized manner within a short time frame to avoid creating type 2 cVDPVsAll countries using OPV will need to withdraw all OPV in a synchronized manner within a short time frame to avoid creating cVDPVs
Potential risks from incomplete withdrawal of vaccinetOPV left in the cold chain and used long after the switch could potentially result in new cVDPVsOPV left in the cold chain and used long after full OPV withdrawal could potentially result in new cVDPVs
OPV use in routine immunization after eventRoutine immunization programs used bOPV instead of tOPV after the switchNo OPV should be used in routine immunization programs after full OPV withdrawal
Introduction of new form of OPV during eventbOPV was introduced simultaneously with the withdrawal of tOPV during the switchNo new form of OPV will be introduced during full OPV withdrawal
Availability of OPV stockpileMonovalent OPV stockpile available for use in response to polio outbreaks caused by type 2 polioviruses after the switchMonovalent OPV stockpiles will be available for use in response to polio outbreaks caused by any type of poliovirus after OPV withdrawal
Outbreak response resourcesExtensive resources available for organizing responses to polio outbreaks caused by cVDPVs after the switchFewer resources may be available for organizing responses to polio outbreaks caused by cVDPVs after full OPV withdrawal

Abbreviation: cVDPV, circulating vaccine-derived poliovirus.

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