Polio in US, UK and Israel reveals rare risk of oral vaccine
For years, global health officials have used billions of drops of an oral vaccine in a remarkably effective campaign aimed at wiping out polio in its last remaining strongholds — typically, poor, politically unstable corners of the world. Now, in a surprising twist in the decades-long effort to eradicate the virus, authorities in Jerusalem, New York and London have discovered evidence that polio is spreading there. The original source of the virus? The oral vaccine itself. Scientists have long known about this extremely rare phenomenon. That is why some countries have switched to other polio vaccines. But these incidental infections from the oral formula are becoming more glaring as the world inches closer to eradication of the disease and the number of polio cases caused by the wild, or naturally circulating, virus plummets. Since 2017, there have been 396 cases of polio caused by the wild virus, versus more than 2,600 linked to the oral vaccine, according to figures from the World Health Organization and its partners. “We are basically replacing the wild virus with the virus in the vaccine, which is now leading to new outbreaks,” said Scott Barrett, a Columbia University professor who has studied polio eradication. “I would assume that countries like the U.K. and the U.S. will be able to stop transmission quite quickly, but we also thought that about monkeypox.” The latest incidents represent the first time in several years that vaccine-connected polio virus has turned up in rich countries. Earlier this year, officials in Israel detected polio in an unvaccinated 3-year-old, who suffered paralysis. Several other children, nearly all of them unvaccinated, were found to have the virus but no symptoms. In June, British authorities reported finding evidence in sewage that the virus was spreading, though no infections in people were identified. Last week, the government said all children in London ages 1 to 9 would be offered a booster shot. In the U.S., an unvaccinated young adult suffered paralysis in his legs after being infected with polio, New York officials revealed last month. The virus has also shown up in New York sewers, suggesting it is spreading. But officials said they are not planning a booster campaign because they believe the state's high vaccination rate should offer enough protection. Genetic analyses showed that the viruses in the three countries were all “vaccine-derived,” meaning that they were mutated versions of a virus that originated in the oral vaccine. The oral vaccine at issue has been used since 1988 because it is cheap, easy to administer — two drops are put directly into children's mouths — and better at protecting entire populations where polio is spreading. It contains a weakened form of the live virus. Read:WHO updates Covid strategy to vaccinate all health workers, vulnerable groups But it can also cause polio in about two to four children per 2 million doses. (Four doses are required to be fully immunized.) In extremely rare cases, the weakened virus can also sometimes mutate into a more dangerous form and spark outbreaks, especially in places with poor sanitation and low vaccination levels. These outbreaks typically begin when people who are vaccinated shed live virus from the vaccine in their feces. From there, the virus can spread within the community and, over time, turn into a form that can paralyze people and start new epidemics. Many countries that eliminated polio switched to injectable vaccines containing a killed virus decades ago to avoid such risks; the Nordic countries and the Netherlands never used the oral vaccine. The ultimate goal is to move the entire world to the shots once wild polio is eradicated, but some scientists argue that the switch should happen sooner. “We probably could never have gotten on top of polio in the developing world without the (oral polio vaccine), but this is the price we’re now paying,” said Dr. Paul Offit, director of the Vaccine Education Center at the Children’s Hospital of Philadelphia. “The only way we are going to eliminate polio is to eliminate the use of the oral vaccine." Aidan O’Leary, director of WHO's polio department, described the discovery of polio spreading in London and New York as “a major surprise,” saying that officials have been focused on eradicating the disease in Afghanistan and Pakistan, where health workers have been killed for immunizing children and where conflict has made access to some areas impossible. Still, O'Leary said he is confident Israel, Britain and the U.S. will shut down their newly identified outbreaks quickly. The oral vaccine is credited with dramatically reducing the number of children paralyzed by polio. When the global eradication effort began in 1988, there were about 350,000 cases of wild polio a year. So far this year, there have been 19 cases of wild polio, all in Pakistan, Afghanistan and Mozambique. In 2020, the number of polio cases linked to the vaccine hit a peak of more than 1,100 spread out across dozens of countries. It has since declined to around 200 this year so far. Last year, WHO and partners also began using a newer oral polio vaccine, which contains a live but weakened virus that scientists believe is less likely to mutate into a dangerous form. But supplies are limited. To stop polio in Britain, the U.S. and Israel, what is needed is more vaccination, experts say. That is something Columbia University's Barrett worries could be challenging in the COVID-19 era. “What’s different now is a reduction in trust of authorities and the political polarization in countries like the U.S. and the U.K.,” Barrett said. “The presumption that we can quickly get vaccination numbers up quickly may be more challenging now.” Oyewale Tomori, a virologist who helped direct Nigeria’s effort to eliminate polio, said that in the past, he and colleagues balked at describing outbreaks as “vaccine-derived,” wary it would make people fearful of the vaccine. “All we can do is explain how the vaccine works and hope that people understand that immunization is the best protection, but it’s complicated,” Tomori said. “In hindsight, maybe it would have been better not to use this vaccine, but at that time, nobody knew it would turn out like this.”
WHO DG announces Global Health Leaders Awards
The WHO Director-General Dr Tedros Adhanom Ghebreyesus on Sunday announced six awards to recognize outstanding contributions to advancing global health, demonstrated leadership and commitment to regional health issues. Dr Tedros himself decides on the awardees for the World Health Organization Director-General’s Global Health Leaders Awards. Also read: Monkeypox usually self-limiting but may be severe in some individuals: WHO The ceremony for the awards, which were established in 2019, was part of the live-streamed high-level opening session of the 75th World Health Assembly, according to the World Health Organization (WHO). “At a time when the world is facing an unprecedented convergence of inequity, conflict, food insecurity, the climate crisis and a pandemic, this award recognizes those who have made an outstanding contribution to protecting and promoting health around the world,” said Dr Tedros. “These awardees embody lifelong dedication, relentless advocacy, a commitment to equity, and selfless service of humanity.” Honorees of Global Health Leaders Awards Dr Paul Farmer Dr Farmer, who passed away in his sleep in February, 2022 in Rwanda, was Chair of the Department of Global Health and Social Medicine at Harvard Medical School and co-founder of Partners in Health. He was co-founder and chief strategist of Partners In Health, an international non-governmental organization established in 1987 to provide direct health care services, research and advocacy for those who are sick and living in poverty. Dr. Farmer has written extensively on health, human rights, and the consequences of social inequality. Wingdie “Didi” Bertrand, co-founder and President of Women and Girls Initiative, accepted the award on behalf of her late husband. Dr Ahmed Hankir A British-Lebanese psychiatrist, Dr Ahmed Hankir is Senior Research fellow at the Centre for Mental Health Research in association with Cambridge University and Academic Clinical Fellow in Psychiatry at the King’s College London in the United Kingdom. He also works in frontline psychiatry for the NHS at South London and Maudsley NHS Foundation Trust and serves as Visiting Professor of Academic Psychiatry at the Carrick Institute for Graduate Studies in Cape Canaveral, in the United States of America. While in medical school in the UK, he developed a debilitating episode of psychological distress, triggered by the traumatic events when living in Lebanon. He is author of The Wounded Healer, an anti-stigma program that blends the power of the performing arts and storytelling with psychiatry, which has been integrated into the medical school curriculum of four UK universities. He is also known for his work on Muslim mental health, islamophobia and violent extremism. Ludmila Sofia Oliveira Varela A youth sports advocate from Cabo Verde and player of the Cabo Verde national volleyball team, Oliviera Varela’s work to facilitate access to sports for all provides a healthy alternative to risky behaviors among young people, and tackles the growing threat of non-communicable diseases. She holds weekly training sessions for youths in Praia City. In 2021 she was one of the finalists of the UNESCO global competition on the 'Power of Sport in a time of crisis' and she has received awards in several sports competitions in the African Region. Polio workers in Afghanistan Also honored were eight volunteer polio workers who were shot and killed by armed gunmen in Takhar and Kunduz provinces in Afghanistan on 24 February 2022. Four of these polio workers were women. The eight volunteers were reaching thousands of children through house-to-house campaigns in north-eastern Afghanistan. Their work was crucial in a country where wild polio virus type 1 is still circulating. Their names were Mohamamd Zubair Khalazai, Najibullah Kosha, Shadab Yosufi, Shareefullah Hemati, Haseeba Omari, Khadija Attaee, Munira Hakimi and Robina Yosufi and her brother Shadab. ASHA (Accredited Social Health Activist Workers) ASHA (which means hope in Hindi) are the more than 1 million female volunteers in India, honored for their crucial role in linking the community with the health system, to ensure those living in rural poverty can access primary health care services, as shown throughout the COVID-19 pandemic. ASHAs worked to provide maternal care and immunization for children against vaccine-preventable diseases; community health care; treatment for hypertension and tuberculosis; and core areas of health promotion for nutrition, sanitation, and healthy living. Also read: WHO: COVID-19 falling everywhere, except Americas and Africa Yōhei Sasakawa Yōhei Sasakawa is the WHO Goodwill Ambassador for Leprosy Elimination, and Japan's Ambassador for the Human Rights of People Affected by leprosy. For more than 40 years, he has continued his global fight against leprosy as well as its stigma and social discrimination. As chairman of The Nippon Foundation, Japan's largest charitable foundation, Mr Sasakawa has been a pioneer in guiding public-interest activities by the private sector in modern Japan.
Vaccination Demand Observatory launched to address vaccine misinformation
To combat vaccine hesitancy worldwide, Public Good Projects (PGP), UNICEF and Yale Institute for Global Health launched the Vaccination Demand Observatory on Thursday. As countries begin rolling out COVID-19 vaccination, public health experts know that the last inch -- getting the vaccine from vial to arm -- can be the hardest. Public uncertainty in the current pandemic has been exacerbated by an “infodemic,” a confusing epidemic of information and misinformation. The Vaccination Demand Observatory (The Observatory) is developing tools, training, technical support and research to equip in-country teams to mitigate the impact of misinformation and mistrust on all vaccines. This programme is organized in three pillars: social listening analytics and insight generation, a training and education program to tackle challenges related to all vaccines, and a communications lab. The Vaccine Acceptance Interventions Lab (VAIL) will draw upon behavioural and social research and insights from social listening to develop engaging, relevant content to fill information gaps. Also read: Covid vaccine: UNICEF emphasises speed, simplicity to remove barriers VAIL also will develop “inoculation” messages to vaccinate people against vaccine misinformation. The content and programs will be rapid field tested for tone, format and behavior change impact before being implemented. “In these times of heightened anxiety and uncertainty, people have many perfectly reasonable questions and concerns about vaccines. But their search for answers may be confounded by huge information gaps and a miasma of mis- and disinformation,” says Dr. Angus Thomson, PhD, Senior Social Scientist for UNICEF.“We can’t address people’s concerns if we don’t first understand them. Then we must speak with - not at - people, where they are, about what matters to them. The Observatory will help empower countries to do this.” Working much like a disease surveillance system, an Observatory-supported country programme will contextualize vaccine conversations, characterizing questions, concerns, and misinformation, to provide regular updates to local health agencies and partner organizations. Unlike previous efforts, this programme is built around a “Field Infodemic Manager” rather than a dashboard. This manager will coordinate the listening, analytics, and identification and assessment of vaccine rumours and information gaps to provide real-time actionable insights and recommendations to the teams which are engaging with communities. “Because local communication is key to the success of any vaccination program, we are focused on building local-level programs that are as powerful and sophisticated as any global system. Each country on earth has its own cultural nuances. The Observatory system will entail both quantitative and qualitative methods for tracking and characterizing local vaccine narratives. Subsequent public health programs can then be customized to each country’s context, and evaluated by potential traction and impact,” says Dr Joe Smyser, PhD, MSPH, Chief Executive Officer of PGP. Also read: Covid vaccines should be declared as global public goods: PM Hasina UNICEF helps reach almost half of the world’s children with life-saving vaccines and those kids’ access to education, health and protection services has been severely disrupted by the pandemic. UNICEF’s local-level footprint, through active community engagement, risk communication, social mobilization and partnership in countries around the world will be informed in real-time by this social listening programme. UNICEF works through the Vaccination Demand Hub to coordinate its support to countries with other multilaterals, global partnerships, donors, non-governmental and civil society organizations. As a first step, the Observatory released the Vaccine Misinformation Management Field Guide in December 2020. This practical guide, available in 6 languages, aims to help organizations to address the global infodemic through the development of strategic and well-coordinated national action plans to rapidly counter vaccine misinformation and build demand for vaccination. The Observatory’s first on-the-ground project is ongoing in multiple West African countries supporting UNICEF polio teams in the launch of a new oral polio vaccine. Also read: Twitter cracks down on COVID vaccine misinformation “Existing global-level vaccine social listening efforts lack the granularity for community-level insights, and focus on digital channels,” says Dr Thomson. “Data equity is essential if countries are to reach every person with vaccines. The Observatory focuses on aggregating both online and offline listening sources, to ensure we also hear the voices of the digitally disenfranchised.” As a first step to enhancing capabilities in countries, the Observatory has stood up regional listening dashboards that are being interpreted by Infodemic Managers. But it is now seeking support to rapidly take these tools, training and technical assistance to countries as they manage COVID-19 and polio vaccine introductions, and work to sustain trust in routine immunization programs. “We should expect the same rigor from vaccine acceptance science as we do from vaccine development science,” says Professor Saad B. Omer, MBBS MPH PhD, Director of Yale Institute for Global Health. “The Observatory brings together evidence-informed approaches to inoculate against misinformation and increase vaccine acceptance and demand.” “We applaud the mobilization of funders to support the COVAX facility providing COVID-19 vaccines to over 100 countries. However, lack of investment in misinformation management and demand generation means we risk precious doses sitting unwanted and unused,” says Dr Smyser. “Current investment in this crucial work remains only a tiny fraction of a percent of the investment in producing and distributing vaccine doses.”
WHO says coronavirus outbreak in China not yet global health emergency
The World Health Organization (WHO) said on Thursday that it was "too early" to declare the outbreak of the novel coronavirus in China a public health emergency of international concern (PHEIC), while warning that the number of cases may rise as many about the virus remain unknown.
Impact of trade frictions raises concerns for global health
Las Vegas, Oct. 20 (Xinhua/UNB) -- As over 17,000 attendees gathered here on Friday at an annual global exhibition on health ingredients, they were faced with the burning question of how the U.S.-initiated trade frictions with China is affecting their business.