topv to bopv FACTSHEET 25 APRIL 2016

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topv to bopv FACTSHEET th 25 APRIL 2016 POLIO FREE INDIA POLIO FREE WORLD

Polio immunization is important Polio is a crippling disease that can permanently paralyze any part of the body especially the arms and legs and can lead even to death. The virus usually affects children under 5 years of age. Immunization through vaccination is the only way to defeat the poliovirus. Progress in polio eradication The Global Polio Eradication Initiative (GPEI), launched in 1988, aimed to eradicate this disease through polio immunization campaigns and routine immunization. As a result, the incidence of polio has been reduced by more than 99 per cent worldwide. India celebrates 5 years of being polio free India has achieved tremendous success in polio eradication. India was certified Polio Free on 27 th March 2014 by the World Health Organization. The country has now been polio free for five consecutive years since the wild poliovirus was last detected in January 2011. Globally polio eradication is not yet complete India is at risk as long as poliovirus is present in the world. Wild poliovirus is still circulating in neighboring Afghanistan and Pakistan the only two remaining polio endemic countries in the world. Since poliovirus can re-infect polio free areas through importation, India continues highly sensitive poliovirus surveillance and immunization with oral polio vaccine in routine immunization and campaigns to reduce the risks of poliovirus importation. For ensuring double protection, at least one dose of the Inactivated Polio Vaccine (IPV) has been introduced into the routine immunization programme from November 2015. topv bopv What is the SWITCH? The trivalent oral polio vaccine (topv) currently being used contains all three types of attenuated polioviruses type 1, 2 and 3. The last case of wild poliovirus (WPV) type 2 was reported in 1999 and the global eradication of type 2 WPV has been declared by the Global Certification Commission of World Health Organization on 20 th September 2015. Therefore, now there is no need to include type 2 in OPV. Accordingly, as part of the Global Polio Eradication and Endgame Strategy 2013-18, all OPV using countries across the world will switch from trivalent to bivalent vaccine (which contains only type 1 and 3) in a globally coordinated manner in April 2016. All topv stocks will be withdrawn, replaced and destroyed in a globally coordinated switch within a two week window in April 2016. When is the SWITCH? topv to bopv th 25 APRIL 2016 In India, the National Switch Day will be 25 th April 2016, when topv will be completely withdrawn and replaced by bopv in routine immunization and polio campaigns.

Key steps in implementing the SWITCH Control topv supply to avoid wastage The topv supply will be controlled and balanced to minimize excess stock of topv and wastage during the SWITCH. Vaccine manufacturers will stop supply accordingly to government and private facilities before the SWITCH date. Monthly monitoring and accounting of existing topv stocks All vials of topv returned from session sites to cold chain points will be accounted for on a weekly basis through an online tracking system (http://poliovaccine.npspindia.org). bopv stocks supplied should not be opened before the SWITCH The topv and bopv stock will be segregated in the cold chain. The sealed bopv stock will be opened only on the SWITCH date, i.e., 25 th April 2016. On the SWITCH day 25 th April 2016 is National Switch Day in India. District vaccine switch teams formed from notified health staff will pushexchange topv with bopv in vehicles. Each team will exchange vaccines at multiple cold chain points in a day. All remaining topv on the SWITCH date will be removed from the cold chain, packed and marked distinctly as waste and sent to district headquarters for safe disposal. After reaching a cold chain point, the district vaccine switch team will: Collect all remaining topv; Deliver bopv for 1-2 months; Certify there is no topv left; and Collect certificates submitted by ANMs documenting return of all unused/partially used topv vials after the last session prior to the SWITCH. Switch validation for complete removal and destruction of topv All cold chain points at all levels will be physically validated by independent switch monitors from WHO-NPSP to ensure No topv is remaining anywhere. The National Committee for Certification of Poliomyelitis Eradication (NCCPE) will collect and analyze topv recall and disposal data. On 9 th May 2016, after validation of complete withdrawal of topv, the country will be certified topv free thus completing the process of the SWITCH.

Remember your responsibilities Medical practitioners Understand and know about the SWITCH. 25 th April 2016 is the National Switch Day. Inform all your para-medical staff about the SWITCH so that they can support you during the SWITCH. Ensure that there is no excess topv stock in your clinic otherwise the stock will be wasted as it cannot be used on or after the SWITCH date of 25 th April 2016. date, remove any remaining topv stock from your clinic. Put the topv stock in a package and mark it clearly as biowaste. You must return this excess topv stock to the District Health Officer/Chief Medical Officer for disposal. Check your clinic for any remaining topv stock. Remember using topv after the SWITCH date is dangerous and may jeopardize the polio eradication. Professional bodies (IMA, IAP, FOGSI etc.) Circulate IEC materials (fact sheets, joint appeals and SMS content) on the topv to bopv SWITCH, given by the Ministry of Health and Family Welfare, to all your members. Send out repeated reminders to educate your members about the SWITCH. Ensure only bopv is being used. Ensure participation of members in switch validation. Ensure appropriate disposal of topv is synchronized with the public sector.

Vaccine manufacturers Ensure supply of topv to the government and private sector till the SWITCH date. Ensure timely supply of bopv before the SWITCH date. Media professionals Understand the SWITCH strategy and its importance to the Global Strategy for Elimination of Polio. Remember, the world is very close to eradication of polio and the SWITCH is an important step towards it. Before and after the SWITCH In case of queries contact the designated spokesperson for the SWITCH at the State level. Dispose all remaining topv and type 2 polio bulks including control samples and batches on the stability programme according to guidelines given by the government. Transfer any required poliovirus type 2 material to an essential facility if it cannot be disposed. bopv

1. Receive last topv deliveries IMPORTANT DATES PREPARATION PHASE January-March 2016 2. Redistribute remaining topv stock as required 3. Prepare training materials ROLLOUT PHASE April 2016 1. Training switch monitors and health workers 2. Distribution of bopv to periphery and service points. NATIONAL SWITCH DAY 25 th April 2016 1. Stop use of topv 2. Remove topv from cold chain 3. Send all topv for disposal 4. Begin use of bopv VALIDATION 25 th April - 9 th May 2016 1. Complete disposal of topv 2. Validate topv disposal NATIONAL VALIDATION DAY 9 th May 2016 Declare the country topv free Developed by UNICEF for Ministry of Health and Family Welfare, Government of India.