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This is not the big, massive victory that the article makes it sound like. The caveat "wild" is doing a lot of work that isn't properly explained. What this mea
by makomk 6y ago
This is not the big, massive victory that the article makes it sound like. The caveat "wild" is doing a lot of work that isn't properly explained. What this means is that for the last several years, all the cases of polio in Africa have been from circulating vaccine-derived poliovirus - basically, a version of the weakened virus used in the vaccine which has circulated for long enough to reverse the mutations that weaken it. It spreads like wild virus and paralyzes like wild virus, but technically it's not wild-type virus. (As I understand it, the only practical difference is that we can tell from genetic sequencing that it came from the vaccine rather than being wild-type.) And this can't be fixed by stopping the vaccination program - in fact, that actually makes things worse, since it gives the deadly vaccine-derived poliovirus more people who don't have immunity to infect.
Some of the other news coverage like the Reuters article is a little better at correctly pointing this caveat out: https://uk.reuters.com/article/uk-health-polio-africa/wild-polio-sufferers-reflect-as-africa-declared-free-of-the-disease-idUKKBN25L14I https://uk.reuters.com/article/uk-health-polio-africa/wild-p...
It's not even clear that it's poasible to actually eliminate polio in developing countries with this vaccine or any existing vaccines. The developed countries managed it but they had far better infrastructure to roll out first the oral vaccine and then the inactivated vaccine to everyone, and also far better sanitation, and it's likely both of these things mattered - under-vaccination makes this problem a lot worse, and whilst the inactivsted vaccine protects people from polio there's some doubt as to whether it can stop them spreading it via the oral-fecal route due to poor immunity in the gut. The current hope seems to be developing and deploying a new, better live vaccine which cannot easily regain its original virulence.
- vilhelm_s 6y agoRight. There was some previous discussion on Hacker News about this under the headline "Polio eradication program faces hard choices as endgame strategy falters" [https://news.ycombinator.com/item?id=21920406 https://news.ycombinator.com/item?id=21920406].
- yyyk 6y agoCVDPV still is weaker than "wild" polio - only about 1000 cases ever (out of billions of vaccinations), and outbreaks are controlled quickly (if slower than the original expectation). Apparently both due to remaining mutations and since it's nearly all polio type 2 - which was otherwise eradicated a long time ago, apparently that type is a bit less "fit". It's a problem, but one that can be managed by the existing tools which brought polio down to this level - many countries switched from trivalent OPV or removed OPV2 precisely to avoid this scenario, and a new OPV2 vaccine will hopefully eliminate the problem in the affected areas: http://polioeradication.org/wp-content/uploads/2020/07/cVDPV2-nOPV2-fact-sheet-July-2020.pdf http://polioeradication.org/wp-content/uploads/2020/07/cVDPV...