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本周,，隨著中國和其他154個國家一起轉(zhuǎn)換現(xiàn)有脊髓灰質(zhì)炎（脊灰）免疫接種程序,，全球向消滅脊灰的目標(biāo)又邁進了一步,。新的脊灰免疫接種程序更安全，免疫效果更好,，也是歷史上首次全球同時將現(xiàn)已消滅的脊灰病毒“剔除”出脊灰疫苗的行動,。此次行動將能為兒童，尤其是容易感染脊灰的兒童,，提供更好的保護,。     施賀德博士    世界衛(wèi)生組織駐華代表   “這不僅是數(shù)十年抗擊脊灰行動中取得的重大成就，也是全球免疫接種史上的不朽豐碑,。中國國家衛(wèi)生和計劃生育委員會今天發(fā)布聲明,，要求接種服務(wù)點停止使用三價口服脊灰減毒活疫苗。這是中國免疫程序首次,，也是最重要的轉(zhuǎn)換行動,。這是好消息！”    脊髓灰質(zhì)炎野病毒有三個血清型,，相應(yīng)的疫苗也包含這三個血清型的疫苗株,，即目前全世界兒童接種的（三價）脊灰疫苗，但這種情況即將改變,。全球于2015年宣布已經(jīng)消滅其中一種脊灰野病毒,，這意味著可以去除脊灰疫苗中已經(jīng)消滅的病毒。    這一轉(zhuǎn)換行動的重要性在于,，脊灰疫苗不再需要包含已消滅的病毒,；事實上,，不這么做將有潛在危害：因為繼續(xù)在疫苗中保留該脊灰病毒，該型別病毒將有重新傳播的罕見風(fēng)險,。因此,，世界各地正在引進僅包含兩個型別脊灰病毒的新疫苗（二價疫苗）。全球同步轉(zhuǎn)換疫苗計劃也是必要步驟,，能夠避免不同步導(dǎo)致的野病毒重新傳播而部分人卻得不到疫苗保護的情況。    該轉(zhuǎn)換行動作為脊灰尾聲戰(zhàn)略的關(guān)鍵一步,，得到免疫戰(zhàn)略咨詢專家組的推薦和世界衛(wèi)生大會的認(rèn)可,。    花楠女士    聯(lián)合國兒童基金會駐華代表   “脊灰是一種致殘傳染病，全球在消滅脊灰的道路上已經(jīng)取得了長足的進步,。從1988年以來,，脊灰病例減少99.9%，從約35萬例降低至2015年報告的80例,。我們和政府以及衛(wèi)生領(lǐng)域?qū)＜业墓餐繕?biāo),，是幫助每一個兒童預(yù)防這種疾病，而全球疫苗轉(zhuǎn)換行動讓我們距離實現(xiàn)全球零感染的目標(biāo)更近了一步,?！?    全球轉(zhuǎn)換疫苗是實現(xiàn)全球無脊灰的重要一步。2015年,，無論是報告的脊灰病例數(shù)量,，還是報告出現(xiàn)脊灰病例的國家，均是歷史最低值?，F(xiàn)在,，重點應(yīng)是向每一個兒童提供脊灰疫苗，攻下脊灰病毒殘余的堡壘,。    在中國,，三價口服脊灰減毒活疫苗將轉(zhuǎn)換為二價疫苗，逐步將脊灰滅活疫苗引進國家免疫程序：    中國父母將見證兒童接受新的脊灰免疫程序,，包括一劑脊灰滅活疫苗,，后接種三劑新的兩型病毒（二價）口服脊灰減毒活疫苗。脊灰滅活疫苗采用注射進行接種,，而二價口服脊灰減毒活疫苗將通過口服滴液接種（不再使用“糖丸”）,；且口服脊灰減毒活疫苗也將逐步淘汰，最后全部采用脊灰滅活疫苗,。    這個行動的另一重要性在于,，在極罕見情況下（每300萬劑引起1例病例），由活病毒制成的口服脊灰減毒活疫苗會造成兒童麻痹,。將口服脊灰減毒活疫苗從三種型別脊灰病毒減為兩種,，以及逐步完全使用脊灰滅活疫苗（采用滅活病毒制成,，不會引起兒童麻痹）的兩項行動，將本已極其罕見的風(fēng)險進一步大幅降低,，使數(shù)代人用于成功預(yù)防脊灰的脊灰疫苗更加安全,。   “這意味著新的脊灰免疫程序更安全，相比于現(xiàn)有脊灰疫苗,，甚至能提供更好的保護,。父母們可以相信，他們始終信任的中國免疫規(guī)劃正在積極回饋,，為兒童提供一個更加安全的無脊灰世界,。”    —— 施賀德博士    世界衛(wèi)生組織駐華代表   “在今年世界免疫周即將結(jié)束之際,，這擺脫脊灰災(zāi)難的一大進步提醒我們,，免疫接種對于兒童健康至關(guān)重要。正如36年前我們消滅了天花一樣,，我們現(xiàn)在正站在歷史的拐角,，徹底消除脊灰指日可待?！?    —— 花楠女士    聯(lián)合國兒童基金會駐華代表 Eradication of polio one step closer for China, and the world WHO/UNICEF Joint News Release The global goal of eradicating polio is one step closer this week, as China along with 154 other countries, make the shift to a new, safer, and more immunogenic polio vaccination schedule – including an unprecedented, globally-synchronized change to ‘switch off’ a now-eradicated strand of polio virus in polio vaccines. This effort will provide better protection for children against polio, particularly those most vulnerable to infection. “This is an important milestone in the decades-long fight against polio, and in the history of immunization globally. The notice issued by the National Health and Family Planning Commission today instructing immunization providers to stop using trivalent Oral Polio Vaccine formalizes the first, and most crucial, shift in the changed immunization schedule in China – which is great news,” said Dr Bernhard Schwartl?nder, WHO Representative in China. Dr Bernhard Schwartl?nder WHO Representative in China There are three strains of wild polio virus, each of which have been used in polio vaccines given to children around the world (trivalent vaccines) – until now. One of the three strains of wild polio was declared eradicated in 2015 – which means that the eradicated strain can now be removed from polio vaccine. This change is important because there is no longer a need to continue including the eradicated strain of virus in polio vaccine – and in fact there is now potential harm in doing so, because whenever this strain of polio is used in vaccine there is a very small risk it could come into circulation again. Hence, a new vaccine using only two strains of polio virus (bivalent vaccine) is being introduced around the world. It was critically important that the ‘switch off’ be synchronized globally – to remove any risk of the wild virus recirculating without a vaccine to protect against it. This global vaccine ‘switch’ has been recommended by the Strategic Advisory Group of Experts on Immunization and endorsed by the World Health Assembly as a critical component of the polio endgame strategy. "Globally, we have made remarkable progress towards eradicating polio, a crippling infectious disease.  The number of cases has decreased by over 99.9% since 1988 – from an estimated 350,000 cases to fewer than 80 reported cases in 2015. Working with the Government, and with health professionals our collective goal is to protect every child from this disease – and the global vaccine switch takes us ever closer to achieving zero infections in the world,” said Ms Rana Flowers, UNICEF Representative in China. Ms Rana Flowers UNICEF Representative in China The global switch is a significant step in the effort to achieve a polio-free world. In 2015, there were fewer cases reported in fewer countries than ever before. Now, the focus is on reaching every child with the polio vaccine and stopping the virus in its remaining strongholds. In China, switching off trivalent Oral Polio Vaccine will coincide with the gradual introduction of Inactivated Polio Vaccine (IPV) into the national immunization schedule: parents will see their children receive a new polio vaccination schedule consisting of one dose of IPV, followed by 3 doses of the new two-strain (bivalent) Oral Polio Vaccine.  IPV is given by injection, and the reduced OPV will be given by mouth as drops (no more sugar pills). Over time, Oral Polio Vaccine will be phased out altogether, with only IPV used. This is also a significant change because in extremely rare cases (1 in 3 million doses), Oral Polio Vaccine, which includes live polio virus, can itself cause paralysis in children. The combined effect of reducing the number of strains of polio virus from three to two in Oral Polio Vaccine, and phasing in IPV (which cannot cause paralysis because it does not contain live virus), will greatly reduce this risk, which is already miniscule – and thus further increase the safety of this vaccine, which has been used successfully to immunize against polio for generations. “This means the new polio immunization schedule will be safer, and provide even stronger protection against the remaining types of polio. Parents can be confident that their longtime trust in China’s immunization program is delivering dividends of a safer, polio-free world for children,” said Dr Schwartl?nder. “At the end of this year’s World Immunization Week, this giant step toward getting rid of the scourge of polio serves as a reminder of the importance of immunization to the health of children. Just as smallpox was eradicated 36 years ago, we now stand on the cusp of having eliminated polio forever,” concluded Ms Flowers.