The only human disease ever eliminated was smallpox. With polio, we’re 99.9% of the way therePeter F. Wright, MD
Decades of safe, effective vaccination distribution have made polio a historic artifact for most Americans. Some might know that polio put President Franklin Roosevelt in a wheelchair or heard of the polio panic of the 1940s and 1950s, but few have seen or experienced polio’s debilitating or fatal impact. So why have Dartmouth-Hitchcock (D-H) researchers joined with peers at the University of Vermont and the University of North Carolina to test the safety of a novel oral polio vaccine (NOPV)?
Like any infectious disease, polio will continue to threaten human populations until it is eliminated around the world. “In the late 1980s, the World Health Organization set a goal of eradicating polio by the year 2000,” says Peter F. Wright, MD, Infectious Diseases and International Medicine, who, along with Madonna K. Gordon, APRN, Pediatric Specialties Research, is leading the D-H study. “The Sabin vaccine has become the primary tool for achieving that goal, but it has a problem,” says Wright.
The orally administered Sabin vaccine is a weakened, live virus. “Vaccinated children shed the virus through their stool,” says Wright. “The shed virus can revert to a novel, severe form of polio and be transmitted to others.”’
Funded by the Bill and Melinda Gates Foundation and sponsored by PATH, a global organization devoted to health equity, the research is one of the last steps before the global distribution of this safer polio vaccine.
The effort is right on time. Small but growing numbers of polio infections are being noted. “In 2020, there were 1,000 cases of polio in the world, all but 4 originating from vaccine,” says Gordon. “The World Health Organization has warned that failure to eradicate polio from the last remaining regions of the world may result in as many as 200,000 new polio cases every year, within 10 years.
“There are three types of poliovirus,” says Wright. “A novel oral polio vaccine for type 2 has already received emergency use authorization and is being used in Africa and the Middle East. It is proving to be safe and effective and serves as the prototype for the type 1 and type 3 vaccines we are testing.”
D-H will be responsible for enrolling one-third of the study’s 250 participants. “This study has attracted people interested in global and public health and in serving the greater good,” says Gordon. “Enrollment has begun and will continue until we reach our target.”
Candidates must be healthy, not immune-suppressed, 18 to 45 years old, and vaccinated for polio as a child. They cannot live or work with someone who is immune-suppressed, pregnant or under two years old, nor can they work in foodservice.
Study participation includes four to six visits over six months. In-person visits are completed within the first two months. Participants are carefully screened through a medical history, physical exam and blood work to make sure they are healthy and have an adequate level of poliovirus antibodies before receiving the vaccine. Participants are compensated for their effort in participating in the study.
“Thanks to the D-H Clinical Research Unit, our capacity for this kind of global impact work is growing,” says Wright. “We are hopeful the vaccine we’re testing will effectively replace the Sabin vaccine. The only human disease ever eliminated was smallpox. With polio, we’re 99.9% of the way there.”
To learn more, email Polio.Study@hitchcock.org or call (603)-650-1383.