Table 2.
Possible Timeline of Preparations and Activities Related to Oral Poliovirus Vaccine (OPV) Withdrawal
| Timing a | Area of Work for OPV Withdrawal | |||||
|---|---|---|---|---|---|---|
| General | Coordination | Communications | OPV Collection and Disposal | Monitoring | Financial Support | |
| ≥24 mo prior | Date of global OPV withdrawal set |
OPV Withdrawal Working Group assembled by GPEI World Health Assembly and other relevant bodies asked to endorse global OPV withdrawal date Manufacturers set OPV production targets through OPV withdrawal date Countries plan bivalent OPV orders in coordination with relevant procurement agency (UNICEF, Pan American Health Organization, and manufacturers) to avoid overstock |
Overall communications plan developed for OPV withdrawal Ongoing communications related to IPV supply and status of polio eradication |
OPV disposal practices reviewed and evaluated by GPEI in light of trivalent OPV to bivalent OPV switch experience Discussions held with vaccine manufacturers regarding OPV disposal following OPV withdrawal |
OPV withdrawal incorporated into work of global and regional certification commissions All countries that will need to confirm withdrawal of OPV identified |
Model developed for estimating country level OPV withdrawal costs and need for external support Country eligibility criteria for external support determined GPEI budget finalized for country-level OPV withdrawal funding Mechanism established for disbursing funds to countries |
| 18–24 mo prior | Detailed global plan and guidelines developed for OPV withdrawal |
Procurement planning guidelines developed for countries WHO and UNICEF regional coordinators hired for OPV withdrawal |
Core reference materials for global advocacy and awareness developed on OPV withdrawal Once decision on timing is confirmed, letter on OPV withdrawal disseminated to ministers of health, including need to budget for OPV |
Detailed guidelines for OPV disposal developed | Detailed global plan for monitoring OPV withdrawal developed | Broad estimate of funds for OPV withdrawal included in countries’ annual budgets Materials developed for countries to apply for external support |
| 12–18 mo prior | OPV withdrawal guidance, tools, applications, and other information, including training materials on OPV disposal and withdrawal monitoring, provided from global level to regions, including through global workshop on planning for OPV withdrawal | National OPV withdrawal coordinators identified and OPV withdrawal coordination committees established Continued coordination with manufacturers and countries regarding OPV production and distribution |
Full package of communications guidance and materials developed and disseminated | Countries conduct OPV inventories | … | Mechanism established for reviewing requests for external support |
|
7–12 mo prior
|
Regional workshops for national OPV withdrawal coordination staff on planning for OPV withdrawal, including OPV disposal and monitoring OPV withdrawal OPV withdrawal guidance, tools, applications, and other information provided from regional level to countries |
National OPV withdrawal plans developed Continued coordination with manufacturers and country vaccine procurement officials |
National media planning Outreach begins to health professional organizations and key stakeholders, CSOs, NGOs, and others |
National OPV disposal plans developed as part of OPV withdrawal plans Agreements with private sector disposal contractors established if necessary |
National OPV withdrawal monitoring plans developed in conjunction with overall OPV withdrawal and disposal plans | Detailed national budgets for OPV withdrawal and disposal developed Countries’ requests for external support submitted to and reviewed by GPEI External support funds disbursed to countries |
| 6 wk–6 mo prior | National materials and documents for OPV withdrawal, including OPV disposal and withdrawal monitoring, developed and printed | Subnational OPV withdrawal coordinators identified Trainings held for national and subnational immunization staff All sites involved with OPV withdrawal identified Last distribution of OPV to countries |
Global, regional, and national media outreach begins Outreach begins to private sector immunization providers |
Trainings held for staff involved with OPV disposal Sites for OPV disposal identified Countries conduct OPV inventories OPV stocks redistributed and OPV use maximized to minimize the amount of OPV on hand by OPV withdrawal date |
NOWCC established National and subnational OPV withdrawal monitoring coordinators identified Sites to be monitored for OPV withdrawal identified |
… |
| 2–6 wk prior | … | Trainings held for remaining national and subnational immunization staff | Global, regional, and national media outreach continues | Trainings held for remaining staff involved with OPV disposal | Monitors for OPV withdrawal recruited | |
| 0–14 d prior | … | OPV withdrawn from cold chain stores and health facilities | Global, regional, and national media outreach continues Media monitoring begins |
… | Monitors for OPV withdrawal trained and equipped | Private sector health facilities compensated for unexpired OPV if necessary |
| 0 d–4 wk after | … | Problems with OPV withdrawal identified by monitors addressed | Issues management plans implemented in response to any problems with OPV withdrawal | OPV disposed of Problems with OPV disposal identified by monitors addressed |
Visits to cold chain stores, selected health facilities, and disposal sites by monitors NOWCCs review reports from monitors and other sources NOWCCs submit initial OPV withdrawal report to government and the WHO |
… |
| 1–3 mo after | … | Problems with OPV withdrawal identified by monitors addressed | Formal evaluation of OPV withdrawal communications efforts | Problems with OPV disposal identified by monitors addressed | Visits to remaining health facilities and any disposal or cold chain sites needing repeat visits NOWCCs review reports from immunization staff and other sources NOWCCs submit final OPV withdrawal reports to government and the WHO |
… |
| ≥3 mo after | … | Problems with continued use or storage of OPV addressed | … | … | Global Polio Laboratory Network monitors for use of OPV Immunization program staff and supervisors alert for any remaining OPV |
Financial reports on external support funds submitted to GPEI by countries Recall of unspent external support funds |
Abbreviations: CSO, civil society organization; GPEI, Global Polio Eradication Initiative; NGO, nongovernmental organization; NOWCC, National OPV Withdrawal Certification Committee; UNICEF, United Nations Children’s Fund; WHO, World Health Organization.
a Values indicate timing of completion of work relative to the global OPV withdrawal date.