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Why is OPV the vaccine of choice in endemic areas?

July 4, 2022
Christopher R. Teeple

The last case of smallpox in the United States occurred in 1949. A worldwide campaign to find new cases followed. Case clusters persisted into the 1960s and 70s. The last case was finally diagnosed in Somalia in 1977. The disease was declared eradicated by the WHO 2 years later and by 1980 the routine administration of the vaccine ended throughout the world.

Polio has been targeted as the next viral disease to be eliminated; however, many challenges continue. In the 1940s and early 1950s, an average of more than 35,000 cases per year occurred in the United States. With the advent of the Salk, inactivated polio vaccine (IPV) and the live Sabin, oral polio vaccine (OPV) naturally occurring paralytic polio cases rapidly diminished in the United States. The last outbreak occurred in the Midwest among the Amish community in 1979. The last imported case of wild-strain polio in the US was diagnosed in 1993. An additional 154 cases related to the use of the live OPV were seen between 1980 and 1999. Since 2000 the US has abandoned the use of OPV in favor of the inactivated vaccine (IPV) as a safer vaccine given the elimination of wild-virus disease in the US.

Globally the efforts to eradicate paralytic polio persist. The disease continues to be endemic in Afghanistan, Pakistan, and Nigeria, and to cause periodic outbreaks in other countries in sub-Sahara Africa. In these areas the live OPV is the vaccine of choice.

Unfortunately OPV still poses a small risk of vaccine-related polio, or of transmission of vaccine-derived polio virus infection (VDPV). In fact, several cases of imported VDPV have occurred in the US since 2005 despite the use of IPV.

Why is OPV the vaccine of choice in endemic areas?
Did the US make the right decision to switch from OPV to IPV?
Why is VDPV being seen in the US?
What should be the global policy for the use of polio vaccines?
Can the eradication of a disease causing organism be justified scriipturally? Cite Old and/or New Testament passages to support your position.

Any sources besides bible must be published within the last 5 years

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