An economic analysis of poliovirus risk management policy options for 2013–2052

BMC Infectious Diseases

Table 5 Undiscounted, average total cases for the main minimum global policy options and number of iterations with OPV restart and with any outbreaks requiring a response for 100 stochastic iterations

Result	RC with SIAs	RC no SIAs	IPV5	IPV10	IPV through T_end	No IPV
Average number of cases after type-specific OPV cessation, 2013-2052^a	6,800	1,600,000
- No OPV restart^b			340	120	470	840
- OPV restart with SIAs			350,000	320,000	120,000	170,000
- OPV restart without SIAs			720,000	680,000	540,000	880,000
- All iterations, OPV restart with SIAs			7,300	6,400	12,000	11,000
- All iterations, OPV restart without SIAs			15,000	14,000	55,000	54,000
Number if iterations with OPV restart	N/A	N/A	2	2	10^c	6
Number of iterations with one or more post-OPV cessation outbreak response	N/A	N/A	96	96	96	100

Abbreviations(see Table 1for policy abbreviations): IPV, inactivated poliovirus vaccine; N/A, not applicable; OPV, oral poliovirus vaccine; SIA, supplemental immunization activity; T_end, end of analytical time horizon (i.e., December 31, 2052)
^aDoes not include a total of approximately 1,150 cases (i.e., approximately 1,100 VAPP, 80 WPV1, and 3 cVDPV2 cases) before OPV cessation of each type for the two reference cases or the No IPV options and approximately 1,000 cases (i.e., approximately 920 VAPP, 80 WPV1, and 3 cVDPV2 cases) before OPV cessation of each type for the policies that involve IPV use everywhere
^b OPV restart defined as the occurrence of at least 50,000 polio cases since 2016 and by 2051, leading to OPV restart at the beginning of 2052 or earlier
^c In addition, in 4 other iterations, the model included ongoing transmission of live poliovirus at the end of the analytical time horizon, but the cumulative number of cases did not hit the contingency of 50,000 yet

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