Are most cases of polio derived from the polio vaccine?

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According to this National Public Radio article:

For the first time, the number of children paralyzed by mutant strains of the polio vaccine are greater than the number of children paralyzed by polio itself.

So far in 2017, there have been only six cases of "wild" polio reported anywhere in the world. By "wild," public health officials mean the disease caused by polio virus found naturally in the environment. By contrast, there have been 21 cases of vaccine-derived polio this year.

Are the claims in this article accurate?

edited 3 hours ago

DJClayworth

39.6k16155161

asked Nov 16 at 15:51

Roger

1,023313

add a comment |

up vote
52
down vote

favorite

According to this National Public Radio article:

For the first time, the number of children paralyzed by mutant strains of the polio vaccine are greater than the number of children paralyzed by polio itself.

So far in 2017, there have been only six cases of "wild" polio reported anywhere in the world. By "wild," public health officials mean the disease caused by polio virus found naturally in the environment. By contrast, there have been 21 cases of vaccine-derived polio this year.

Are the claims in this article accurate?

edited 3 hours ago

DJClayworth

39.6k16155161

asked Nov 16 at 15:51

Roger

1,023313

add a comment |

up vote
52
down vote

favorite

According to this National Public Radio article:

For the first time, the number of children paralyzed by mutant strains of the polio vaccine are greater than the number of children paralyzed by polio itself.

So far in 2017, there have been only six cases of "wild" polio reported anywhere in the world. By "wild," public health officials mean the disease caused by polio virus found naturally in the environment. By contrast, there have been 21 cases of vaccine-derived polio this year.

Are the claims in this article accurate?

edited 3 hours ago

DJClayworth

39.6k16155161

asked Nov 16 at 15:51

Roger

1,023313

According to this National Public Radio article:

For the first time, the number of children paralyzed by mutant strains of the polio vaccine are greater than the number of children paralyzed by polio itself.

So far in 2017, there have been only six cases of "wild" polio reported anywhere in the world. By "wild," public health officials mean the disease caused by polio virus found naturally in the environment. By contrast, there have been 21 cases of vaccine-derived polio this year.

Are the claims in this article accurate?

medical-science vaccines

edited 3 hours ago

DJClayworth

39.6k16155161

asked Nov 16 at 15:51

Roger

1,023313

edited 3 hours ago

DJClayworth

39.6k16155161

asked Nov 16 at 15:51

Roger

1,023313

edited 3 hours ago

DJClayworth

39.6k16155161

edited 3 hours ago

DJClayworth

39.6k16155161

edited 3 hours ago

DJClayworth

39.6k16155161

asked Nov 16 at 15:51

Roger

1,023313

asked Nov 16 at 15:51

Roger

1,023313

asked Nov 16 at 15:51

Roger

1,023313

add a comment |

1 Answer
1

active

oldest

votes

up vote
89
down vote

accepted

Numbers not exact, ratio plausible. This is a success story.

The WHO provides a queryable database on AFP / polio. I am a bit unclear on the exact meaning of the headers, so I'll list the 2017 global totals for all columns:

AFP (acute flaccid paralysis) cases: 104090

Non polio AFP Rate: 5.46

% Adequate stool collection: 89

Pending: 118

Wild poliovirus cases: 22

cVDPV cases: 96

Compatibles: 259

cVDPV stands for circulating vaccine-derived poliovirus.

So 96 cVDPV cases to 22 wild cases with 118 "pending" at least makes the claim's 21 to 6 cases plausible (assuming "at the point of writing").

This graph visualizes the progress of polio eradication:

enter image description here

(Tobus, Own work, CC BY-SA 4.0)

Note that cVDPV does not mean that the vaccinated person becomes ill. It means that viruses shedded by a freshly vaccinated person start infecting other, unvaccinated people. A fully vaccinated population would be immune from both types of polio.

Quoted from the WHO page, emphasis mine:

It takes a long time for a cVDPV to occur. Generally, the strain will have been allowed to circulate in an un- or under-immunized population for a period of at least 12 months. Circulating VDPVs occur when routine or supplementary immunization activities (SIAs) are poorly conducted and a population is left susceptible to poliovirus, whether from vaccine-derived or wild poliovirus. Hence, the problem is not with the vaccine itself, but low vaccination coverage. If a population is fully immunized, they will be protected against both vaccine-derived and wild polioviruses.

Since 2000, more than 10 billion doses of OPV have been administered to nearly 3 billion children worldwide. As a result, more than 13 million cases of polio have been prevented, and the disease has been reduced by more than 99%. During that time, 24 cVDPV outbreaks occurred in 21 countries, resulting in fewer than 760 VDPV cases.

Actually they felt they could remove the most problematic strain of the virus from the vaccination:

Until 2015, over 90% of cVDPV cases were due to the type 2 component in OPV. With the transmission of wild poliovirus type 2 already successfully interrupted since 1999, in April 2016 a switch was implemented from trivalent OPV to bivalent OPV in routine immunization programmes. The removal of the type 2 component of OPV is associated with significant public health benefits, including a reduction of the risk of cases of cVDPV2.

So allowing for the latency mentioned for cVDPV to actually occur, vaccine-derived polio cases can be expected to go down as well.

edited 3 hours ago

Ilmari Karonen

266210

answered Nov 16 at 16:15

DevSolar

9,01933741

7

There's maybe a mismatch here where the quote in the question says 'paralysed by polio' but the data is more 'caught polio', which presumably doesn't have a 100% rate of paralysing people. I would perhaps hope that the live vaccine is with a strain that is unlikely to cause paralysis, so that rate would be lower even if it caused more infections, but I don't know anywhere enough about polio to know if that's possible.
– mbrig
2 days ago

12

@mbrig [Paralysis] occurs in less than 1% of all infections, so nope, not even close to 100%.
– Nic Hartley
2 days ago

3

@NicHartley - However, since the same article states that 90 to 95% of all polio infections are asymptomatic, and presumably not detected in the populations being discussed, a 1% paralysis rate of overall infections implies a 10 to 20% paralysis rate in diagnosed cases.
– WhatRoughBeast
2 days ago

3

@NicHartley - Sure, the tests exist. But for the population currently under discussion (3rd world) it seems most unlikely that anything other than symptomatic infections will be reported.
– WhatRoughBeast
yesterday

1

Your statement: "A fully vaccinated population would be immune from both types of polio." is slightly stronger than the source "If a population is fully immunized, they will be protected against both vaccine-derived and wild polioviruses." If vaccination is not 100% effective, the population won't be "immune", but it will be protected by herd immunity, making outbreaks much less likely.
– Oddthinking♦
3 hours ago

|
show 4 more comments

1 Answer
1

active

oldest

votes

1 Answer
1

active

oldest

votes

up vote
89
down vote

accepted

Numbers not exact, ratio plausible. This is a success story.

The WHO provides a queryable database on AFP / polio. I am a bit unclear on the exact meaning of the headers, so I'll list the 2017 global totals for all columns:

AFP (acute flaccid paralysis) cases: 104090

Non polio AFP Rate: 5.46

% Adequate stool collection: 89

Pending: 118

Wild poliovirus cases: 22

cVDPV cases: 96

Compatibles: 259

cVDPV stands for circulating vaccine-derived poliovirus.

So 96 cVDPV cases to 22 wild cases with 118 "pending" at least makes the claim's 21 to 6 cases plausible (assuming "at the point of writing").

This graph visualizes the progress of polio eradication:

enter image description here

(Tobus, Own work, CC BY-SA 4.0)

Quoted from the WHO page, emphasis mine:

It takes a long time for a cVDPV to occur. Generally, the strain will have been allowed to circulate in an un- or under-immunized population for a period of at least 12 months. Circulating VDPVs occur when routine or supplementary immunization activities (SIAs) are poorly conducted and a population is left susceptible to poliovirus, whether from vaccine-derived or wild poliovirus. Hence, the problem is not with the vaccine itself, but low vaccination coverage. If a population is fully immunized, they will be protected against both vaccine-derived and wild polioviruses.

Since 2000, more than 10 billion doses of OPV have been administered to nearly 3 billion children worldwide. As a result, more than 13 million cases of polio have been prevented, and the disease has been reduced by more than 99%. During that time, 24 cVDPV outbreaks occurred in 21 countries, resulting in fewer than 760 VDPV cases.

Actually they felt they could remove the most problematic strain of the virus from the vaccination:

Until 2015, over 90% of cVDPV cases were due to the type 2 component in OPV. With the transmission of wild poliovirus type 2 already successfully interrupted since 1999, in April 2016 a switch was implemented from trivalent OPV to bivalent OPV in routine immunization programmes. The removal of the type 2 component of OPV is associated with significant public health benefits, including a reduction of the risk of cases of cVDPV2.

So allowing for the latency mentioned for cVDPV to actually occur, vaccine-derived polio cases can be expected to go down as well.

edited 3 hours ago

Ilmari Karonen

266210

answered Nov 16 at 16:15

DevSolar

9,01933741

7

There's maybe a mismatch here where the quote in the question says 'paralysed by polio' but the data is more 'caught polio', which presumably doesn't have a 100% rate of paralysing people. I would perhaps hope that the live vaccine is with a strain that is unlikely to cause paralysis, so that rate would be lower even if it caused more infections, but I don't know anywhere enough about polio to know if that's possible.
– mbrig
2 days ago

12

@mbrig [Paralysis] occurs in less than 1% of all infections, so nope, not even close to 100%.
– Nic Hartley
2 days ago

3

@NicHartley - However, since the same article states that 90 to 95% of all polio infections are asymptomatic, and presumably not detected in the populations being discussed, a 1% paralysis rate of overall infections implies a 10 to 20% paralysis rate in diagnosed cases.
– WhatRoughBeast
2 days ago

3

@NicHartley - Sure, the tests exist. But for the population currently under discussion (3rd world) it seems most unlikely that anything other than symptomatic infections will be reported.
– WhatRoughBeast
yesterday

1

Your statement: "A fully vaccinated population would be immune from both types of polio." is slightly stronger than the source "If a population is fully immunized, they will be protected against both vaccine-derived and wild polioviruses." If vaccination is not 100% effective, the population won't be "immune", but it will be protected by herd immunity, making outbreaks much less likely.
– Oddthinking♦
3 hours ago

|
show 4 more comments

up vote
89
down vote

accepted

Numbers not exact, ratio plausible. This is a success story.

The WHO provides a queryable database on AFP / polio. I am a bit unclear on the exact meaning of the headers, so I'll list the 2017 global totals for all columns:

AFP (acute flaccid paralysis) cases: 104090

Non polio AFP Rate: 5.46

% Adequate stool collection: 89

Pending: 118

Wild poliovirus cases: 22

cVDPV cases: 96

Compatibles: 259

cVDPV stands for circulating vaccine-derived poliovirus.

So 96 cVDPV cases to 22 wild cases with 118 "pending" at least makes the claim's 21 to 6 cases plausible (assuming "at the point of writing").

This graph visualizes the progress of polio eradication:

enter image description here

(Tobus, Own work, CC BY-SA 4.0)

Quoted from the WHO page, emphasis mine:

It takes a long time for a cVDPV to occur. Generally, the strain will have been allowed to circulate in an un- or under-immunized population for a period of at least 12 months. Circulating VDPVs occur when routine or supplementary immunization activities (SIAs) are poorly conducted and a population is left susceptible to poliovirus, whether from vaccine-derived or wild poliovirus. Hence, the problem is not with the vaccine itself, but low vaccination coverage. If a population is fully immunized, they will be protected against both vaccine-derived and wild polioviruses.

Since 2000, more than 10 billion doses of OPV have been administered to nearly 3 billion children worldwide. As a result, more than 13 million cases of polio have been prevented, and the disease has been reduced by more than 99%. During that time, 24 cVDPV outbreaks occurred in 21 countries, resulting in fewer than 760 VDPV cases.

Actually they felt they could remove the most problematic strain of the virus from the vaccination:

Until 2015, over 90% of cVDPV cases were due to the type 2 component in OPV. With the transmission of wild poliovirus type 2 already successfully interrupted since 1999, in April 2016 a switch was implemented from trivalent OPV to bivalent OPV in routine immunization programmes. The removal of the type 2 component of OPV is associated with significant public health benefits, including a reduction of the risk of cases of cVDPV2.

So allowing for the latency mentioned for cVDPV to actually occur, vaccine-derived polio cases can be expected to go down as well.

edited 3 hours ago

Ilmari Karonen

266210

answered Nov 16 at 16:15

DevSolar

9,01933741

7

There's maybe a mismatch here where the quote in the question says 'paralysed by polio' but the data is more 'caught polio', which presumably doesn't have a 100% rate of paralysing people. I would perhaps hope that the live vaccine is with a strain that is unlikely to cause paralysis, so that rate would be lower even if it caused more infections, but I don't know anywhere enough about polio to know if that's possible.
– mbrig
2 days ago

12

@mbrig [Paralysis] occurs in less than 1% of all infections, so nope, not even close to 100%.
– Nic Hartley
2 days ago

3

@NicHartley - However, since the same article states that 90 to 95% of all polio infections are asymptomatic, and presumably not detected in the populations being discussed, a 1% paralysis rate of overall infections implies a 10 to 20% paralysis rate in diagnosed cases.
– WhatRoughBeast
2 days ago

3

@NicHartley - Sure, the tests exist. But for the population currently under discussion (3rd world) it seems most unlikely that anything other than symptomatic infections will be reported.
– WhatRoughBeast
yesterday

1

Your statement: "A fully vaccinated population would be immune from both types of polio." is slightly stronger than the source "If a population is fully immunized, they will be protected against both vaccine-derived and wild polioviruses." If vaccination is not 100% effective, the population won't be "immune", but it will be protected by herd immunity, making outbreaks much less likely.
– Oddthinking♦
3 hours ago

|
show 4 more comments

up vote
89
down vote

accepted

Numbers not exact, ratio plausible. This is a success story.

The WHO provides a queryable database on AFP / polio. I am a bit unclear on the exact meaning of the headers, so I'll list the 2017 global totals for all columns:

AFP (acute flaccid paralysis) cases: 104090

Non polio AFP Rate: 5.46

% Adequate stool collection: 89

Pending: 118

Wild poliovirus cases: 22

cVDPV cases: 96

Compatibles: 259

cVDPV stands for circulating vaccine-derived poliovirus.

So 96 cVDPV cases to 22 wild cases with 118 "pending" at least makes the claim's 21 to 6 cases plausible (assuming "at the point of writing").

This graph visualizes the progress of polio eradication:

enter image description here

(Tobus, Own work, CC BY-SA 4.0)

Quoted from the WHO page, emphasis mine:

It takes a long time for a cVDPV to occur. Generally, the strain will have been allowed to circulate in an un- or under-immunized population for a period of at least 12 months. Circulating VDPVs occur when routine or supplementary immunization activities (SIAs) are poorly conducted and a population is left susceptible to poliovirus, whether from vaccine-derived or wild poliovirus. Hence, the problem is not with the vaccine itself, but low vaccination coverage. If a population is fully immunized, they will be protected against both vaccine-derived and wild polioviruses.

Since 2000, more than 10 billion doses of OPV have been administered to nearly 3 billion children worldwide. As a result, more than 13 million cases of polio have been prevented, and the disease has been reduced by more than 99%. During that time, 24 cVDPV outbreaks occurred in 21 countries, resulting in fewer than 760 VDPV cases.

Actually they felt they could remove the most problematic strain of the virus from the vaccination:

Until 2015, over 90% of cVDPV cases were due to the type 2 component in OPV. With the transmission of wild poliovirus type 2 already successfully interrupted since 1999, in April 2016 a switch was implemented from trivalent OPV to bivalent OPV in routine immunization programmes. The removal of the type 2 component of OPV is associated with significant public health benefits, including a reduction of the risk of cases of cVDPV2.

So allowing for the latency mentioned for cVDPV to actually occur, vaccine-derived polio cases can be expected to go down as well.

edited 3 hours ago

Ilmari Karonen

266210

answered Nov 16 at 16:15

DevSolar

9,01933741

Numbers not exact, ratio plausible. This is a success story.

The WHO provides a queryable database on AFP / polio. I am a bit unclear on the exact meaning of the headers, so I'll list the 2017 global totals for all columns:

AFP (acute flaccid paralysis) cases: 104090

Non polio AFP Rate: 5.46

% Adequate stool collection: 89

Pending: 118

Wild poliovirus cases: 22

cVDPV cases: 96

Compatibles: 259

cVDPV stands for circulating vaccine-derived poliovirus.

So 96 cVDPV cases to 22 wild cases with 118 "pending" at least makes the claim's 21 to 6 cases plausible (assuming "at the point of writing").

This graph visualizes the progress of polio eradication:

enter image description here

(Tobus, Own work, CC BY-SA 4.0)

Quoted from the WHO page, emphasis mine:

It takes a long time for a cVDPV to occur. Generally, the strain will have been allowed to circulate in an un- or under-immunized population for a period of at least 12 months. Circulating VDPVs occur when routine or supplementary immunization activities (SIAs) are poorly conducted and a population is left susceptible to poliovirus, whether from vaccine-derived or wild poliovirus. Hence, the problem is not with the vaccine itself, but low vaccination coverage. If a population is fully immunized, they will be protected against both vaccine-derived and wild polioviruses.

Since 2000, more than 10 billion doses of OPV have been administered to nearly 3 billion children worldwide. As a result, more than 13 million cases of polio have been prevented, and the disease has been reduced by more than 99%. During that time, 24 cVDPV outbreaks occurred in 21 countries, resulting in fewer than 760 VDPV cases.

Actually they felt they could remove the most problematic strain of the virus from the vaccination:

Until 2015, over 90% of cVDPV cases were due to the type 2 component in OPV. With the transmission of wild poliovirus type 2 already successfully interrupted since 1999, in April 2016 a switch was implemented from trivalent OPV to bivalent OPV in routine immunization programmes. The removal of the type 2 component of OPV is associated with significant public health benefits, including a reduction of the risk of cases of cVDPV2.

So allowing for the latency mentioned for cVDPV to actually occur, vaccine-derived polio cases can be expected to go down as well.

edited 3 hours ago

Ilmari Karonen

266210

answered Nov 16 at 16:15

DevSolar

9,01933741

edited 3 hours ago

Ilmari Karonen

266210

edited 3 hours ago

Ilmari Karonen

266210

edited 3 hours ago

Ilmari Karonen

266210

answered Nov 16 at 16:15

DevSolar

9,01933741

answered Nov 16 at 16:15

DevSolar

9,01933741

answered Nov 16 at 16:15

DevSolar

9,01933741

7

There's maybe a mismatch here where the quote in the question says 'paralysed by polio' but the data is more 'caught polio', which presumably doesn't have a 100% rate of paralysing people. I would perhaps hope that the live vaccine is with a strain that is unlikely to cause paralysis, so that rate would be lower even if it caused more infections, but I don't know anywhere enough about polio to know if that's possible.
– mbrig
2 days ago

12

@mbrig [Paralysis] occurs in less than 1% of all infections, so nope, not even close to 100%.
– Nic Hartley
2 days ago

3

@NicHartley - However, since the same article states that 90 to 95% of all polio infections are asymptomatic, and presumably not detected in the populations being discussed, a 1% paralysis rate of overall infections implies a 10 to 20% paralysis rate in diagnosed cases.
– WhatRoughBeast
2 days ago

3

@NicHartley - Sure, the tests exist. But for the population currently under discussion (3rd world) it seems most unlikely that anything other than symptomatic infections will be reported.
– WhatRoughBeast
yesterday

1

Your statement: "A fully vaccinated population would be immune from both types of polio." is slightly stronger than the source "If a population is fully immunized, they will be protected against both vaccine-derived and wild polioviruses." If vaccination is not 100% effective, the population won't be "immune", but it will be protected by herd immunity, making outbreaks much less likely.
– Oddthinking♦
3 hours ago

|
show 4 more comments

7

There's maybe a mismatch here where the quote in the question says 'paralysed by polio' but the data is more 'caught polio', which presumably doesn't have a 100% rate of paralysing people. I would perhaps hope that the live vaccine is with a strain that is unlikely to cause paralysis, so that rate would be lower even if it caused more infections, but I don't know anywhere enough about polio to know if that's possible.
– mbrig
2 days ago

12

@mbrig [Paralysis] occurs in less than 1% of all infections, so nope, not even close to 100%.
– Nic Hartley
2 days ago

3

@NicHartley - However, since the same article states that 90 to 95% of all polio infections are asymptomatic, and presumably not detected in the populations being discussed, a 1% paralysis rate of overall infections implies a 10 to 20% paralysis rate in diagnosed cases.
– WhatRoughBeast
2 days ago

3

@NicHartley - Sure, the tests exist. But for the population currently under discussion (3rd world) it seems most unlikely that anything other than symptomatic infections will be reported.
– WhatRoughBeast
yesterday

1

Your statement: "A fully vaccinated population would be immune from both types of polio." is slightly stronger than the source "If a population is fully immunized, they will be protected against both vaccine-derived and wild polioviruses." If vaccination is not 100% effective, the population won't be "immune", but it will be protected by herd immunity, making outbreaks much less likely.
– Oddthinking♦
3 hours ago

There's maybe a mismatch here where the quote in the question says 'paralysed by polio' but the data is more 'caught polio', which presumably doesn't have a 100% rate of paralysing people. I would perhaps hope that the live vaccine is with a strain that is unlikely to cause paralysis, so that rate would be lower even if it caused more infections, but I don't know anywhere enough about polio to know if that's possible.
– mbrig
2 days ago

@mbrig [Paralysis] occurs in less than 1% of all infections, so nope, not even close to 100%.
– Nic Hartley
2 days ago

@NicHartley - However, since the same article states that 90 to 95% of all polio infections are asymptomatic, and presumably not detected in the populations being discussed, a 1% paralysis rate of overall infections implies a 10 to 20% paralysis rate in diagnosed cases.
– WhatRoughBeast
2 days ago

@NicHartley - Sure, the tests exist. But for the population currently under discussion (3rd world) it seems most unlikely that anything other than symptomatic infections will be reported.
– WhatRoughBeast
yesterday

Your statement: "A fully vaccinated population would be immune from both types of polio." is slightly stronger than the source "If a population is fully immunized, they will be protected against both vaccine-derived and wild polioviruses." If vaccination is not 100% effective, the population won't be "immune", but it will be protected by herd immunity, making outbreaks much less likely.
– Oddthinking♦
3 hours ago

|
show 4 more comments

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