Spatial Analyses of Oral Polio Vaccine Transmission in an Community Vaccinated With Inactivated Polio Vaccine

Clin Infect Dis. 2018 Oct 30;67(suppl_1):S18-S25. doi: 10.1093/cid/ciy622.

Abstract

Background: Understanding the spatial dynamics of oral polio vaccine (OPV) transmission will improve resource targeting. Mexico provides a natural laboratory, as it uses inactivated polio vaccine routinely as well as OPV bi-annually.

Methods: Using geospatial maps, we measured the distance and density of OPV vaccinees' shedding in the areas nearest to unvaccinated households in 3 Mexican villages. Comparison of transmission to unvaccinated households utilized a mixed effects logistic regression with random effects for household and time, adjusted for age, gender, area, and running water.

Results: The median distance from an unvaccinated household to its nearest OPV-shedding household was 85 meters (interquartile range, 46-145) and the median number of vaccinees shedding OPV within 200 m was 3 (2-6). Transmission to unvaccinated households occurred by day 1. There was no association (odds ratio [OR] 1.04; 95% credible interval [CrI] 0.92-1.16) between the distance from OPV shedding and the odds of transmission. The number of OPV vaccinees shedding within 200 m came close to a significant association with unvaccinated transmission (OR 0.93; CrI 0.84-1.01), but this was not the case for households 100 or 500 m apart. Results were consistent across the 3 villages.

Conclusions: Geospatial analysis did not predict community transmission from vaccinated to unvaccinated households, because OPV use resulted in rapid, low transmission levels. This finding supports the global cessation of OPV.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Child, Preschool
  • Cluster Analysis
  • Disease Eradication*
  • Family Characteristics
  • Feces / virology
  • Female
  • Humans
  • Male
  • Mexico
  • Poliomyelitis / prevention & control*
  • Poliomyelitis / transmission
  • Poliomyelitis / virology
  • Poliovirus / immunology*
  • Poliovirus / physiology
  • Poliovirus Vaccine, Inactivated / administration & dosage*
  • Poliovirus Vaccine, Oral / administration & dosage*
  • Prospective Studies
  • Spatial Analysis
  • Vaccination Coverage
  • Virus Shedding
  • Young Adult

Substances

  • Poliovirus Vaccine, Inactivated
  • Poliovirus Vaccine, Oral