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Considering that a similar picture took place in previous years, in Ukraine there was an accumulation of a layer susceptible to poliomyelitis among the child population. In addition, since April 2016, the oral (live) polio vaccine (OPV), which is used in Ukraine, since the 3rd vaccination, does not contain type 2 poliovirus (two-component OPV, which is now used worldwide, contains only polioviruses). ). type ov1 and 3). This also contributes to a decrease in both individual and population immunity to type 2 poliovirus. The result was an outbreak of poliomyelitis caused by vaccine-derived type 2 poliovirus (a vaccine-derived virus that acquired neurovirulent properties during circulation in a low immune population.). There was no adequate response to this outbreak, namely additional vaccination rounds for children under 6 years of age to stop the circulation of the vaccine-related virus. In January 2022, a new outbreak emerged.

At present, the risk of increased circulation of vaccine-related polioviruses and associated outbreaks with a low level of vaccination coverage against the background of the use of an oral vaccine is also complicated by military operations in the country, leading to the destruction of the infrastructure of cities and towns, intensive migration and evacuation of the population. Ukraine, and to regions where there are no active hostilities (Chernivtsi, Transcarpathian, Lvov, Volyn regions). These areas were the ones with the lowest polio vaccination rates in 2021.

When transitioning to biological therapy, subcutaneous administration should be considered to limit patient contact with the healthcare facility. Selective switching from intravenous infliximab to subcutaneous anti-TNF is not recommended as it may increase the risk of relapse. If the patient is in contact with a COVID-19 person, withdrawal of anti-TNF therapy for 2 weeks should be considered.

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Back in 2002, according to the justification of the Institute, inactivated polio vaccine (IPV) was introduced into the Immunization Calendar of Ukraine for the 1st vaccination against poliomyelitis (children continued to receive OPV for the remaining 5 doses by age). In 2006, this vaccine was also used for the second vaccination. This made it possible to first reduce and then practically stop the cases of vaccine-associated paralytic poliomyelitis in Ukraine. Since then, the issue of switching to a full IPV vaccination scheme in Ukraine has been repeatedly raised, as has been practiced for many years in all European countries, the USA, Canada, and Australia. Currently, this problem is becoming even more urgent, given both the epidemic situation and the prospects for Ukraine's accession to the EU.


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