 Global Polio Eradication Initiative Over the last decade the oral poliomyelitis vaccine OPV has been extremely efficacious in preventing wild-type polio disease across the world, including Nepal. The OPV used in the routine vaccine schedule contains three serotypes of weakened poliomyelitis virus types 1, 2 and 3, and has facilitated the eradication of wild-type poliomyelitis in Nepal. On very rare occasions disease may occur as a result of circulating vaccine derived polio viruses cVDPV, particularly of serotype 2. Thus, in countries such as Nepal, there is the situation where wild-type disease has been eradicated yet there remains a rare risk of vaccine derived disease outbreaks. This had led to the proposal to switch to a bivalent OPV types 1 and 3, globally. This cannot happen however, unless populations are protected from type 2 disease through some other means. Furthermore the inactivated poliomyelitis vaccine IPV, which is administered as an intramuscular injection, generates immunity using killed strains of the three poliomyelitis serotypes, and thus does not produce vaccine type disease or result in the emergence of cVDPV outbreaks. This has led the WHO to recommend the introduction of IPV in order to interrupt and mitigate the risk of cVDPV type 2 disease, prior to the phasing in of the bivalent OPV and cessation of OPV-type 2 use. In Nepal a single dose of the IPV at 14 weeks of age in addition to the routine schedule of trivalent OPV, has now been implemented September 2014. Nepal was the first GAVI country to introduce IPV, and is ready to participate in the globally synchronized switch to bivalent OPV that will be coordinated by WHO in 2016 . IPV is given at 14 weeks of age; the proposed PCV10 schedule of 6 weeks, 14 weeks, and 9 months of age meant that children would receive three injections at 14 weeks of age IPV, PCV10 and dose 3 of DTwP-HBV-Hib vaccine. The perception by the health care providers and the Ministry of Health is that this will not be acceptable and will lead to reduced vaccine coverage. Therefore the Nepal Ministry of Health has introduced in January 2015 PCV10 on a schedule of 6 weeks, 10 weeks, and 9 months of age. 