RESEARCH AREA ①: UNDERSTAND MUCOSAL IMMUNITY IN INDIA

• Recent IPV/OPV study and serosurvey in Moradabad indicated the per dose efficacy for mOPV1 is higher (40-60%) than previous estimates. These new data seem to increase importance of understanding vaccine-induced mucosal immunity in addition to humoral immunity in northern India
• The Polio Research committee (PRC) recommended to:
  a) investigate epidemiology and risk factors of decreased mucosal immunity
  b) evaluate possible intervention to boost mucosal immunity
  c) develop surrogate measurement of mucosal immunity against poliovirus

a.Epidemiology and risk factors

   - Understand the rate of excretion among children
      (both below and over 5 years old) in high risk area
      (or population) in Uttar Pradesh and Bihar
   - Analyze AFP surveillance data to understand mucosal
      immunity induced by OPV (eg duration and extent of
     shedding, workup of contacts, full workup of a selected
     group for interactions between Sabin and other
     enteroviruses)
   - Investigate risk factors contributing to the decreased
     mucosal immunity (or continued excretion) among
     children under and over 5 years old
   - Evaluate relationship between seroconversion and
     humoral or secretory antibody titer and excretion
   - Evaluate the correlation between waning mucosal
     immunity among population and circulation of virus

b.Intervention to help induce and maintain mucosal immunity

   - Evaluation of different vaccines (OPV and IPV)
     to boost mucosal immunity
   - Evaluation of other intervention (eg nutrition
     or parasite treatment)

c.Surrogate measurement of gut mucosal immunity

   - Validation of new methods or markers to measure gut
     immunity against poliovirus (including oral crevicular
     fluid sIgA, IgG)

Not considered for funding
    - Understanding poliovirus circulation in low season
    - Surrogate measurement not related to gut mucosal
      immunity (eg oral, nasal)
    - Testing interventions without a clear hypothesis of
      the link between intervention and mucosal immune
      function
    - Interventions and diagnostics which cannot be applied
      to the field settings

RESEARCH AREA ②: ADDRESS LOW VACCINE COVERAGE IN NIGERIA

• In some polio-endemic and re-infected countries, here is still room for further improvement in vaccine coverage and/or population immunity.
• Communication research suggests that there are still gaps in knowledge, attitude and perception among caregivers and vaccinators in many countries.
• The Polio Research Committe (PRC) recommend to:
  a) evaluate new approaches to further increase vaccination coverage and population immunity
  b) develop and evaluate tools to improve SIA and AFP surveillance management; and,
  c) evluate vaccinator performance and assess ways to improve performance.

a.Evaluate new approaches to further increase
     vaccination coverage and population immunity

  - Test different communication and social mobilization
    strategies and evaluate their impact on acceptance
    and coverage.
  - Develop and test an innovative and simpler waz to
    monitor immunization coverage (eg Lot
    Quality Assurance Sampling, use of IT to improve
    monitoring and activities).
  - Test feasibility and effectiveness of new approaches to
    increase the population immunity (eg zinc
    supplementation during SIAs, combination of OPV
    and IPV).

b.Develop and evaluate tools to improve SIA/AFP
   surveillance management

  - Develop and test management tools for assessing and
    optimising staff performance (eg proportion of staff
    time spent on identified priority/high-impact tasks).
 -  Apply operational improvement methods proven in
    private sector ( eg TQC, Six Sigma) to IPD/AFP
    surveillance operation.
 - Conduct external assessment of low-SIA performing
    areas (eg assess operational, attitudinal and
    organizational issues) 

c.Evaluate vaccinator performance and assess ways to
   improve performance

 - Identify best practives with focus on optimising
   vaccinator selection, training, supervision and
   incentive/remuneration.

Not considered for funding:
   -Test interventions which are not proven anywhere else.
   -Evaluate activities without clear study question
    and/or hypothesis