Recipient vaccine-associated paralytic poliomyelitis in China, 2010-2015

Wendi Wu; Huaqing Wang; Keli Li; J Pekka Nuorti; Dawei Liu; Disha Xu; Jiakai Ye; Jingshan Zheng; Chunxiang Fan; Ning Wen; Zhijie An

doi:10.1016/j.vaccine.2018.01.019

Recipient vaccine-associated paralytic poliomyelitis in China, 2010-2015

Vaccine. 2018 Feb 21;36(9):1209-1213. doi: 10.1016/j.vaccine.2018.01.019.

Authors

Wendi Wu¹, Huaqing Wang², Keli Li³, J Pekka Nuorti⁴, Dawei Liu⁵, Disha Xu⁵, Jiakai Ye⁵, Jingshan Zheng⁵, Chunxiang Fan⁵, Ning Wen⁵, Zhijie An⁵

Affiliations

¹ National Immunization Programme, Chinese Center for Diseases Control and Prevention, China; Department of Epidemiology, Health Sciences, Faculty of Social Sciences, University of Tampere, Finland.
² National Immunization Programme, Chinese Center for Diseases Control and Prevention, China. Electronic address: Wanghq@chinacdc.cn.
³ National Immunization Programme, Chinese Center for Diseases Control and Prevention, China. Electronic address: Likl@chinacdc.cn.
⁴ Department of Epidemiology, Health Sciences, Faculty of Social Sciences, University of Tampere, Finland; Department of Health Security, National Institute for Health and Welfare (THL) Helsinki, Finland.
⁵ National Immunization Programme, Chinese Center for Diseases Control and Prevention, China.

PMID: 29395524
DOI: 10.1016/j.vaccine.2018.01.019

Abstract

Introduction: Vaccine-associated paralytic poliomyelitis (VAPP) is one of the most important adverse effects of vaccines that are in current use globally. The Chinese national adverse event following immunization information system (CNAEFIS) is a passive surveillance system which collects data on VAPP.

Aims: To describe the epidemiological characteristics of VAPP and estimate the risk of recipient VAPP in China.

Methods: We retrieved information from reported cases of recipient VAPP from CNAEFIS from 2010 to 2015, examined the demographic characteristics of the cases, and used administrative data on vaccination doses and the estimated number of births as denominators to calculate VAPP incidence.

Results: During 2010-2015, 157 cases of recipient VAPP were reported to CNAEFIS (male-to-female ratio, 8.2:1); 151 cases (96.2%) were less than six months old. All cases were associated with trivalent OPV (tOPV), and 89.8% occurred after the receipt of first dose. Of the 157 recipient VAPP cases, type II, type III, and type I poliovirus vaccine strains were isolated from 27 (17.2%) , 25 (15.9%) , and 16 (10.2%) cases, respectively. One case died and one case recovered completely; the other 155 cases had various physical disabilities, such as monolateral or bilateral limping. Using the administered doses of OPV as the denominator, the incidence of recipient VAPP during the study period was estimated at 0.4 per million doses. The estimated recipient VAPP per million births ranged from 1.0 to 2.4 during 2010-2015.

Conclusion: The epidemiological characteristics of recipient VAPP cases in China, such as age distribution, were comparable to those in previous studies from other countries. The risk of recipient VAPP, using either estimated births or vaccination doses, was comparable to that in the US and Japan. We recommend using an inactive poliovirus vaccine to decrease the number of recipient VAPP cases in China.

Keywords: Oral poliovirus vaccine; Risk; Vaccine-associated paralytic poliomyelitis.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

China / epidemiology
Female
Humans
Immunization Programs
Infant
Infant, Newborn
Male
Poliomyelitis / epidemiology*
Poliomyelitis / etiology*
Poliovirus Vaccine, Oral / administration & dosage
Poliovirus Vaccine, Oral / adverse effects
Poliovirus Vaccines / administration & dosage
Poliovirus Vaccines / adverse effects*

Substances

Poliovirus Vaccine, Oral
Poliovirus Vaccines