Figure 5:

Integrated global model results for 5 realizations for serotype 2 showing contacts of iVDPV excretors with a general population (generated by the DES model), resulting effective infections and potential OPV outbreak response (generated by the global model), and potential new iVDPV infections caused by post-cessation OPV use (generated by the global model using PID patients generated by the DES model). Runs 1–4 represent a quasi-random selection (i.e., the first 4 global model realizations), run 5 represents a selected, non-representative and rare realization in which an outbreak caused by a new iVDPV excretor ultimately triggered an OPV restart.

Abbreviations and notation: DES, discrete event simulation; iVDPV, immunodeficiency-associated vaccine-derived poliovirus; OPV, oral poliovirus vaccine; PID, primary immunodeficiency