Inactivated Polio Vaccine (IPV) has played an instrumental role in the ongoing effort to eradicate polio globally. Since the widespread adoption of the vaccine in the late 20th century, polio cases have declined by over 99%. While great progress has been made, the fight against this paralytic disease is not yet won. Continued vaccination remains critical to protect communities and future generations.

History of IPV Development and Use

The quest to develop a polio vaccine began in the early 1950s as epidemics of the disease swept across much of the world. Jonas Salk developed the first effective vaccine - an inactivated poliovirus vaccine (IPV) - which was approved for use in the United States in 1955 after successful field trials. Delivering by injection, IPV uses killed virus particles that cannot cause polio but can still provoke an immune response. This breakthrough paved the way for the widespread control of polio in industrialized nations over subsequent decades.

By the late 1980s, IPV had virtually eliminated polio from the Americas, Europe, Western Pacific and other developed regions. However, vaccine costs and the need for medical administration made IPV less practical for developing countries where polio remained endemic. In 1988, an oral polio vaccine (OPV) formulated by Albert Sabin was more broadly introduced internationally. Containing live attenuated viruses, OPV could be easily administered and conferred herd immunity through fecal-oral transmission. This complementary approach saw dramatic reductions as polio was brought under control in new regions.

Maintaining IPV for Polio Eradication

While IPV Vaccines  played a defining role in global polio eradication efforts, its live nature carried a small risk of vaccine-derived polio outbreaks in under-immunized communities. This triggered a strategic switch beginning in the late 1990s - with countries transitioning exclusively to IPV which eliminates any vaccine-associated risk. Today, more than 180 countries have stopped OPV use, with only Afghanistan and Pakistan continuing limited campaigns to stop wild poliovirus transmission.

The polio endgame plan relies primarily on IPV to maintain protection in a world certifiably free of wild polio. Eradication is within reach, but risks remain so long as any person or community remains under-vaccinated. Sustained high IPV coverage globally acts as an important safeguard against the re-emergence of polio from any still-existing reservoir or importation from other parts of the world where polio may persist. It also helps build herd immunity as immunity from past OPV use wanes over time in older populations.

Ensuring IPV Access and Affordability

While IPV has proven effective at controlling and eliminating polio, its delivery via injection brings higher costs compared to the live oral vaccine. This has posed accessibility challenges, especially in low-income developing countries where the disease primarily impacted in past decades. However, new strategies are helping to address this barrier as the world moves into the polio endgame of stopping all transmission and certification of eradication.

Major IPV manufacturers like the Serum Institute of India have increased production capacity to reduce prices over 50% from 2010 levels, placing the per-dose cost at an affordable $1 or less. Gavi, the Vaccine Alliance, has also provided financing support to help transition lower-middle income countries fully to IPV. International donor coordination and transition planning have been essential to ensure a reliable supply of affordable IPV globally. Additional investments in research and development additionally seek to create more heat-stable IPV formulations that require no cold chain for storage and delivery, further increasing access. These collective efforts help set the world on track to fully transition to IPV and sustain protection to reach the historic goal of polio eradication.

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