Polio by the Numbers—A Global Perspective

Abstract Background Investments in national immunization programs and the Global Polio Eradication Initiative (GPEI) have resulted in substantial reductions in paralytic polio worldwide. However, cases prevented because of investments in immunization programs and GPEI remain incompletely characterized. Methods Using a global model that integrates polio transmission, immunity, and vaccine dynamics, we provide estimates of polio incidence and numbers of paralytic cases prevented. We compare the results with reported cases and estimates historically published by the World Health Organization. Results We estimate that the existence and use of polio vaccines prevented 5 million cases of paralytic polio for 1960–1987 and 24 million cases worldwide for 1988–2021 compared to a counterfactual world with no polio vaccines. Since the 1988 resolution to eradicate polio, our estimates suggest GPEI prevented 2.5–6 million cases of paralytic polio compared to counterfactual worlds without GPEI that assume different levels of intensity of polio vaccine use in routine immunization programs. Conclusions Analysis of historical cases provides important context for understanding and communicating the benefits of investments made in polio eradication. Prospective studies will need to explore the expected benefits of future investments, the outcomes of which will depend on whether and when polio is globally eradicated. Since 1960, polio immunization has prevented nearly 30 million cases of paralysis compared to a world with no polio vaccines. We estimate that the Global Polio Eradication Initiative has decreased polio cases by 2.5–6 million since it began in 1988.