Sabin monovalent oral polio vaccines:: Review of past experiences and their potential use after polio eradication

After global eradication of polio is achieved, there will be a need for stockpiles of vaccine to combat potential outbreaks of poliomyelitis caused by (1) unforeseen release of polioviruses, (2) continued circulation of vaccine-derived strains, or (3) prolonged replication of polioviruses in immunodeficient persons. We conducted a review of the literature to document the immunogenicity and safety of monovalent Sabin vaccines, considered ideal candidates for these situations. The National Library of Medicine archives were searched for the keywords polio, monovalent, and vaccine. Seroconversion rates for monovalent Sabin type 1 ranged from 53% to 100% (median, 95%); for type 2, 77%-100% (median, 93%); and for type 3, 52%-100% (median, 85%). The risk of vaccine-associated poliomyelitis per million persons vaccinated ranged from .05 to 0.99 (type 1), 0-0.65 (type 2), and 1.18-8.91 (type 3). Single-dose monovalent Sabin vaccines are highly immunogenic and safe and should be considered for stockpiles of vaccine to provide an effective response to potential outbreaks of poliomyelitis in the post-eradication period.