 The potential need to restart production and use of oral polio virus vaccine, OPV, due to the inability to successfully stop all use as part of the polio endgame and the possibility of reintroduction of live polio viruses after successful cessation implies logistical challenges and implications for modeling the possibility of OPV restart. The complexity of phase cessation of the three OPV serotypes requires different potential combinations of OPV use long term, which raises key unresolved policy questions that may impact continuing and future use of OPV and or inactivated polio virus vaccine, OPV. Restarting production of OPV would imply some likely delays associated with ramp up, re-licensing, and other logistics that would impact the availability and costs of restarting the use of OPV in national immunization programs after globally coordinated cessation of one or more OPV serotypes. This article was authored by Kimberly M. Thompson and Dominica A. Kalkowska.