CDC may use oral polio vaccine for the first time in 20 years to prevent outbreak in New York

The Centers for Disease Control and Prevention is considering using an oral polio vaccine for the first time in more than 20 years to prevent outbreak in the major metropolitan area of ​​New York City paralyze an adult during the summer.

“We are in discussions with our colleagues in New York State and New York City about the use of nOPV,” said Dr. Janell Routh, CDC team leader on domestic polio. New oral polio vaccine. The oral vaccine the CDC is considering is a newer, more stable form with a lower risk of mutations.

“It’s going to be a process. It’s not something that we can trigger and let it happen overnight,” Routh told CNBC on Friday. “There will be a lot of thought and discussion about bringing the oral polio vaccine into the United States,” she said.

The New York State Department of Health, in a statement, said it was working with the CDC on potential future options for responding to the outbreak.

US drug regulators pulled the oral vaccine off shelves in 2000 because it contained a live – but attenuated – strain of the virus that could, in rare cases, mutate transforms into a virulent form that spreads easily and is capable of paralyzing the unvaccinated.

Scientists believe this latest outbreak was caused by someone vaccinated against the virus who lived abroad and started a chain of transmission that eventually made its way to the United States. New York wastewater samples are linked to earlier samples in London and Jerusalem. It is not clear where the transmission of the disease began in the first place.

While the common oral vaccine doesn’t cause polio that paralyzes people, it did because it could mutate into more virulent strains while spreading among unvaccinated people. strains.

The United States currently uses an inactivated polio vaccine, which is given as an injection and contains a chemically killed virus that cannot reproduce, mutate, or cause disease. While New York state health officials have kicked off a vaccination campaign with inactivated polio shots, that vaccine has yet to stop the outbreak.

CDC has established a working group on a committee of independent vaccine advisors to develop criteria for when a new oral polio vaccine may be needed to contain the current outbreak in the United States. New York City area and potential future outbreaks. The working group met publicly for the first time on Wednesday and included experts from New York.

Dr Oliver Brooks, working group chair and chief medical officer at Watts Healthcare in Los Angeles, said: “Since this outbreak occurred in New York, we have determined that we need to be retested. polio. It’s really that simple.”

The problem is that although the inactivated vaccine is highly effective at preventing polio, it does not stop transmitting the virus. The oral polio vaccine is much more effective at stopping the transmission of the virus and is often used to quell outbreaks.

The strain of polio virus currently circulating in the New York City metro area has mutated from and is genetically related to the Sabin Type 2 strain used in an older version of the oral polio vaccine.

The United States, if necessary, will use the new oral polio vaccine, which is newer and safer, more stable, and has less risk of mutating into a strain of the virus that can spread and cause illness. for the unvaccinated, according to Routh.

According to the Global Polio Eradication Initiative, the new oral polio vaccine was developed to prevent outbreaks of the polio virus caused by a less stable older version of the vaccine. More than 450 million doses have been administered in 21 countries around the world.

Any decision to use a new oral polio vaccine requires urgent approval or authorization from the Food and Drug Administration. CNBC has reached out to the FDA for comment.

Routh, during a meeting of CDC advisers Wednesday, said the goal of the public health response is to prevent further cases of paralysis but also to eliminate circulation of the virus in wastewater.

“As long as we have found that the wastewater of this circulating virus is related to the patient’s virus, we know that there is transmission going on in the community even without anesthesia,” says Routh. paralysis,” said Routh.

The World Health Organization recommends that countries using inactivated vaccines, such as the United States, consider developing a new oral polio vaccine if inactivated shots do not stop the epidemic.

“If we’re starting to see this virus break out of its current geography and population, then I think we need to start thinking about other approaches,” Routh said during Wednesday’s meeting. .

An unvaccinated adult in Rockland County, New York, was paralyzed in June after contracting the polio virus. This is the first known case in the US in nearly a decade and the first in New York since 1990. There have been no additional cases of paralysis to date, despite state health officials. New York has warned that unvaccinated people are at serious risk and should stand up. to update their photos instantly.

The CDC considers a single case of polio to be a public health emergency. Most people infected with the polio virus have no symptoms, so when someone is paralyzed it is a sign that the virus has spread widely and silently.

The New York State Department of Health has detected poliovirus in wastewater since April and as recently as September in several counties in the New York City area. The virus was detected in 70 wastewater samples in Rockland, Sullivan, Orange, Nassau, Kings and Queens counties.

The United States was declared polio-free in 1979.

New York Governor Kathy Hochul announced state of emergency in Septemberand Health Commissioner, Dr Mary Bassett declared the spread of the polio virus an imminent threat to public health.