{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T22:22:49Z","timestamp":1776896569447,"version":"3.51.2"},"reference-count":67,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,10,20]],"date-time":"2020-10-20T00:00:00Z","timestamp":1603152000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Risk Analysis"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>COVID\u201019 led to a recent high\u2010profile proposal to reintroduce oral poliovirus vaccine (OPV) in the United States (U.S.), initially in clinical trials, but potentially for widespread and repeated use. We explore logistical challenges related to U.S. OPV administration in 2020, review the literature related to nonspecific effects of OPV to induce innate immunity, and model the health and economic implications of the proposal. The costs of reintroducing a single OPV dose to 331 million Americans would exceed $4.4 billion. Giving a dose of bivalent OPV to the entire U.S. population would lead to an expected 40 identifiable cases of vaccine\u2010associated paralytic polio, with young Americans at the highest risk. Reintroducing any OPV use in the U.S. poses a risk of restarting transmission of OPV\u2010related viruses and could lead to new infections in immunocompromised individuals with B\u2010cell related primary immunodeficiencies that could lead to later cases of paralysis. Due to the lack of a currently licensed OPV in the U.S., the decision to administer OPV to Americans for nonspecific immunological effects would require purchasing limited global OPV supplies that could impact polio eradication efforts. Health economic modeling suggests no role for reintroducing OPV into the U.S. with respect to responding to COVID\u201019. Countries that currently use OPV experience fundamentally different risks, costs, and benefits than the U.S. Successful global polio eradication will depend on sufficient OPV supplies, achieving and maintaining high OPV coverage in OPV\u2010using countries, and effective global OPV cessation and containment in all countries, including the U.S.<\/jats:p>","DOI":"10.1111\/risa.13614","type":"journal-article","created":{"date-parts":[[2020,10,21]],"date-time":"2020-10-21T03:52:38Z","timestamp":1603252358000},"page":"376-386","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["A Health Economic Analysis for Oral Poliovirus Vaccine to Prevent COVID\u201019 in the United States"],"prefix":"10.1111","volume":"41","author":[{"given":"Kimberly M.","family":"Thompson","sequence":"first","affiliation":[{"name":"Kid Risk, Inc.  Orlando Florida 32819 USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dominika A.","family":"Kalkowska","sequence":"additional","affiliation":[{"name":"Kid Risk, Inc.  Orlando Florida 32819 USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kamran","family":"Badizadegan","sequence":"additional","affiliation":[{"name":"Kid Risk, Inc.  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