Objective To describe the emergency response process of the first type III vaccine-derived poliovirus (VDPV) in environmental sewage in Jiangxi province in 2023, and provide relevant recommendations for polio free maintenance.

Methods We implemented the evaluation of acute flaccid paralysis (AFP) case monitoring system, investigated the polio vaccination rate of resident and migrant children, collected the samples of healthy children’s feces and environmental sewage for poliovirus(PV) detection, implemented catch-up vaccination with poliovirus vaccine.

Results The III VDPV had 11 nucleotide variations in the region of virus protein 1, with a variation rate of 1.22%. The average annual reported incidence of AFP Cases in Jiangxi province from 2020 to 2022 was 1.64 per 100 000. 249 healthy children's fecal samples and 16 environmental sewage samples didn't isolate any relevant PV, while an unrelated vaccine-hypervariable poliovirus was detected in a fecal specimen from a healthy child. Polio vaccination rate per dose of school-age children in Jiangxi province was ≥90%, of surveying 900 resident children and 210 migrant children were all ≥95%. The supplementary of polio vaccine was 96.48%. This event was a single type III VDPV event, which emergency response measures were rapid and effective with no VDPV circulation.

Conclusion Environmental surveillance helps early detection and response to VDPV, and maintaining high levels of polio vaccination rates can help block the spread of VDPV. It is recommended to further improve the polio surveillance system, strengthen the PV surveillance and early warning, bring the checkpoint forward, build a solid polio immunity barrier for the population, and maintain the achievement of polio-free work in china.