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Poliomyelitis (polio) is a highly infectious intestinal disease caused by the poliovirus. Poliovirus is transmitted by person-to-person spread mainly through the fecal–oral route, or, less frequently, by contaminated water or food. Humans are the only known reservoir of poliovirus, which is transmitted most frequently by persons with inapparent infections. Initial symptoms of polio include fever, fatigue, headache, vomiting, stiffness in the neck, and pain in the limbs. In a small proportion of cases (1 in 200 infections), poliovirus causes paralysis, which is often permanent. Instead of a cure for polio, it can only be prevented. The Polio vaccine, given multiple times, can protect a child for life.

BACKGROUND: China reduced hepatitis B virus (HBV) infection by 90% among children under 5 years old with safe and effective hepatitis B vaccines (HepB). In December 2013 this success was threatened by widespread media reports of infant deaths following HepB administration. Seventeen deaths and one case of anaphylactic shock following HBV vaccination had been reported. METHODS: We conducted a telephone survey to measure parental confidence in HepB in eleven provinces at four points in time; reviewed maternal HBV status and use of HepB for newborns in birth hospitals in eight provinces before and after the event; and monitored coverage with hepatitis B vaccine and other programme vaccines in ten provinces. RESULTS: HepB from the implicated company was suspended during the investigation which showed that the deaths were not caused by HepB vaccination. Before the event 85% respondents regarded domestic vaccines as safe decreasing to 26.7% during the event. During the height of the crisis 30% of parents reported being hesitant to vaccinate and 18.4% reported they would refuse HepB. Use of HepB in the monitored provinces decreased by 18.6% from 53 653 doses the week before the event to 43 688 doses during the week that Biokangtai HepB was suspended. Use of HepB within the first day of life decreased by 10% among infants born to HBsAg-negative mothers and by 6% among infants born to HBsAg-positive mothers. Vaccine refusal and HepB birth dose rates returned to baseline within 2 months; confidence increased but remained below baseline. CONCLUSIONS: The HBV vaccine event resulted in the suspension of a safe vaccine which was associated with a decline of parental confidence and refusal of vaccination. Suspension of a vaccine can lead to loss of confidence that is difficult to recover. Timely and credible investigation accompanied by proactive outreach to stakeholders and the media may help mitigate negative impact of future coincidental adverse events following immunization. (c) The Author 2016; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.

Background After more than 10 years without a case of wild poliovirus (WPV) in China, an outbreak occurred in 2011 in Xinjiang Uyghur Autonomous Region. Methods Acute flaccid paralysis (AFP) case surveillance was strengthened with epidemiological investigations and specimen collection and serological surveys were conducted among hospitalized patients. Results There were 21 WPV cases and 23 clinical compatible polio cases reported. WPV was isolated from 14 contacts of AFP cases and 13 in the healthy population. Incidence of WPV and clinical compatible polio cases were both highest among children