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Serologic response to oral polio vaccine and enhanced-potency inactivated polio vaccines
A M McBean1, M L Thoms, P Albrecht
1Johns Hopkins University School of Hygiene and Public Health, Baltimore, MD.
Insights
Enhanced inactivated polio vaccines showed strong antibody responses after three doses, comparable to oral polio vaccine, especially for types 2 and 3. The third dose significantly boosted inactivated polio vaccine responses.
Area of Science:
- Immunology
- Vaccinology
- Pediatric Infectious Diseases
Background:
- Poliomyelitis remains a global health concern, necessitating effective vaccination strategies.
- Inactivated polio vaccine (IPV) and oral polio vaccine (OPV) are primary tools for polio prevention.
- Comparing the immunogenicity of enhanced-potency IPV formulations with OPV is crucial for optimizing vaccination schedules.
Purpose of the Study:
- To compare the serologic response to three doses of enhanced-potency inactivated polio vaccines (eIPV) versus oral polio vaccine (OPV) in infants.
- To evaluate antibody titers and seroconversion rates for poliovirus types 1, 2, and 3 following different vaccination regimens.
Main Methods:
- A randomized controlled trial involving 1,114 infants vaccinated between November 1980 and July 1983.
- Administration of three doses of either eIPV or OPV at mean ages of 2.2, 4.7, and 19.9 months.
- Serologic assessment of antibody responses, including seroconversion and reciprocal geometric mean titers (GMTs).
Main Results:
- Initial seroconversion varied (35-84%), with OPV showing higher rates for types 2 and 3 after the first dose.
- After two doses, eIPV recipients demonstrated near-universal antibody presence (98-100%) for all types.
- Three doses resulted in universal antibodies against types 2 and 3 for both vaccine types; less than 3% lacked type 1 antibodies.
- eIPV's third dose significantly increased GMTs for all types, leading to higher GMTs than OPV post-vaccination.
Conclusions:
- Enhanced-potency inactivated polio vaccines elicit robust and sustained antibody responses, particularly after a third dose.
- Both eIPV and OPV are effective in achieving high levels of poliovirus antibody protection.
- The findings support the use of enhanced-potency IPV in infant immunization programs, highlighting the impact of a third dose on GMTs.
Abstract:
In a randomized, controlled trial carried out from November 1980 to July 1983 involving 1,114 infants in Baltimore City and in Baltimore and Prince George's counties, Maryland, the serologic response to three doses of two enhanced-potency inactivated polio vaccines was compared with the response to three doses of oral polio vaccine. The mean ages at vaccination were 2.2, 4.7, and 19.9 months, respectively, for the three doses. Seroconversion after the first dose varied from 35% to 84%, and it was higher after oral polio vaccine than after either of the enhanced-potency inactivated polio vaccines for polioviruses types 2 and 3. Approximately two and one-half and 16 months after the second dose, almost all inactivated polio vaccine recipients had antibodies against all three virus types (98-100%). Fewer oral polio vaccine recipients had detectable antibodies to type 1 (89-92%) and to type 3 (96%). After three doses of vaccine, all children had antibodies against types 2 and 3. Approximately 1% of the inactivated polio vaccine recipients and 3% of the oral polio vaccine recipients lacked antibody to type 1. One or two doses of oral polio vaccine stimulated higher reciprocal geometric mean antibody titers against type 2 poliovirus than did the inactivated polio vaccine. For the other two types, the results were mixed. The third dose of inactivated polio vaccine produced significant increases in the reciprocal geometric mean titers against each of the three poliovirus types and resulted in significantly higher reciprocal geometric mean titers after three doses of vaccine for recipients of inactivated polio vaccine than for recipients of oral polio vaccine.