[cyberax]

Yes, it's called cVDPV. It's caused by the virus in the live vaccine "unweakening" itself, and it's typically happening in people with weakened immune systems (e.g. from chronic malnutrition). It's not causing unvaccinated people to get infected, per se.

Most cases are mild, and on average there are about 300-400 cases per _year_ for the entire world.

But it's absolutely heinous to accuse Gates of deliberately infecting people with the live virus. The weakened vaccine has been the standard for polio vaccination for the last 80 years. There is simply no alternative for it for places like DRC or Chad. Inactivated vaccines require refrigeration and injections, and this is not feasible.

We're >.< this close to eradicating polio: https://polioeradication.org/wild-poliovirus-count/ - there are only two countries with the wild virus. A little bit more, and we can actually stop vaccinating from polio altogether.

[mgraczyk]

I largely agree, but there is essentially no possibility of ever eradicating polio with the current OPV strategy.

If you stop vaccinating, cVDPV will spread person to person. Some people carry virus for decades and it can become infectious at any time, many years after they were first vaccinated or infected. There will sparse but significant episodes until all humans who were vaccinated with OPV (or infected with the wild virus) have died.

but that doesn't mean we shouldn't do it! It's ok if we don't eradicate the virus. The point is to prevent children from being paralyzed, and it works for that.

[pclmulqdq]

Unfortunately, if you look at the situation with type 2, you will see what happens when OPV stops too early (and type 2 is a much less aggressive disease than type 1). In a perfect world, OPV cessation happens in most healthy communities rather soon, while the people who are in need of a much stronger vaccine continue to get OPV.

Also, Gates's pet project of a novel OPV has been shown to have caused a few confirmed cases of VAPP now, so it seems that project won't save OPV.

Essentially the best hope for eradicating polio within 20 years seems to be giving out a lot of OPV to places like Afghanistan and the DRC and forcing the local warlord to give it to the kids who need it (the latter has generally been a total failure of the Gates project). Once OPV gets wild-type and cVDPV outbreaks under control, a global switch to IPV seems safe to prevent future outbreaks. But, to get there, it seems a very aggressive OPV campaign is necessary compared to where we are now. It may take a militarized organization to do this, also, given the fact that you necessarily have to deal with tribal warlords. Shame we don't have USAID any more...

We aren't going to do that because it seems we generally aren't capable of doing that. So we're likely stuck with a decent amount of polio for a long time.

[cyberax]

cVDPV outbreaks die out on their own, and the newer vaccines are designed to be less likely to escape.

People also don't carry the virus for decades. That's a myth. People with a weakened immune system can get infected with polio even after a childhood vaccination, so that's probably where this myth comes from.

[mgraczyk]

It's not a myth at all, off the top of my head I know of at least two cases studies including the study that led to the discovery that remdesivir may treat polio

https://pmc.ncbi.nlm.nih.gov/articles/PMC10022663/

Immunocompromised hosts can shed infectious polio for their entire lives.

These outbreaks sometimes die on their own, but there's no reason to believe they wouldn't spread widely if we completely stopped vaccinating