Health economic analysis of vaccine options for the polio eradication endgame: 2022-2036

Expert Rev Vaccines. 2022 Nov;21(11):1667-1674. doi: 10.1080/14760584.2022.2128108. Epub 2022 Oct 5.


Background: Multiple vaccine options are available for polio prevention and risk management. Integrated global risk, economic, and poliovirus transmission modeling provides a tool to explore the dynamics of ending all use of one or more poliovirus vaccines to simplify the polio eradication endgame.

Research design and methods: With global reported cases of poliomyelitis trending higher since 2016, we apply an integrated global model to simulate prospective vaccine policies and strategies for OPV-using countries starting with initial conditions that correspond to the epidemiological poliovirus transmission situation at the beginning of 2022.

Results: Abruptly ending all OPV use in 2023 and relying only on IPV to prevent paralysis with current routine immunization coverage would lead to expected reestablished endemic transmission of poliovirus types 1 and 2, and approximately 150,000 expected cases of poliomyelitis per year. Alternatively, if OPV-using countries restart trivalent OPV (tOPV) use for all immunization activities and end IPV use, the model shows the lowest anticipated annual polio cases and lowest costs.

Conclusions: Poor global risk management and coordination of OPV cessation remain a critical failure mode for the polio endgame, and national and global decision makers face difficult choices due to multiple available polio vaccine options and immunization strategies.

Keywords: dynamic modeling; eradication; health economic analysis; interdependent risks; polio; poliovirus vaccine.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Disease Eradication
  • Global Health
  • Humans
  • Poliomyelitis* / epidemiology
  • Poliomyelitis* / prevention & control
  • Poliovirus Vaccine, Inactivated
  • Poliovirus Vaccine, Oral
  • Poliovirus*


  • Poliovirus Vaccine, Oral
  • Poliovirus Vaccine, Inactivated