The switch from Trivalent to Bivalent vaccine is almost upon us.  Case numbers are low but VDPV2 is still potentially circulating in Nigeria (last case May 2015), Mynamar (last case October 2015) and Guinea (last case Dec 2015).  

As we prepare for this important global transition in the eradication strategy a few critical questions emerge.  In relation to managing the remaining trivalent stock how well have we identified and collected all the stock in the field?  Have we done everything possible to reduce the chance of uncontrolled pockets remaining and being used by mistake?  Have we done enough to train people to look for and recognise the difference between vaccine labels to avoid confusion?  Are new labels being introduced quickly to reduce potential confusion?  In relation to communication do countries have plans in place to respond to questions from the media and/or public? In relation to future outbreaks or re-established circulation will we be able to respond with adequate amounts of vaccine?  In relation to the shift to IPV and strengthening routine immunisation is enough being done where it counts.

There have been some good explanatory materials developed at the global level but thinking about the most vulnerable countries, the ones most at risk or reimportation, the ones with the lowest coverage rates, the ones with mobile populations, the ones with major conflicts etc how confident are we that 2016 will remain a year without a case of circulating VDPV2?

If you have insights, concerns or reasons to be optimistic we hope you can find a little to join the dialogue.

Cheers

Chris