Good seroresponse to enhanced-potency inactivated poliovirus vaccine in patients on chronic dialysis

The outbreak of paralytic poliomyelitis in Finland in 1984 was halted by nationwide oral poliovirus vaccination campaign. Immunocompromised patients, including those with chronic uraemia and on continuous dialysis, were excluded from the oral vaccination group and instead were given a dose of the new enhanced-potency inactivated poliovirus vaccine before the campaign. We studied the antibody response to this vaccine in 49 patients on chronic dialysis, using conventional antigen of all three serotypes and two additional type 3 strains. It was observed that 86% (42 of 49) of patients either had a satisfactory concentration of neutralising poliovirus antibodies against all three serotypes prior to vaccination, or responded with at least a four-fold increase of antibodies. Fourteen of 21 patients originally seronegative to at least one of the five virus strains used showed a striking seroconversion. One patient remained seronegative to type 1 poliovirus while two and four other patients were left with low (less than 8) titres of type 1 and 3 antibodies respectively. The latter seven patients showed moderate or good responses to the other two serotypes. We conclude that the enhanced-potency inactivated poliovirus vaccine produces a good antibody response in uraemic patients.