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Effect of diarrhea on the humoral response to oral polio vaccination
J A Myaux1, L Unicomb, R E Besser
1International Centre for Diarrheal Disease Research, Bangladesh, Dhaka.
Insights
Acute diarrhea in infants significantly reduces seroconversion rates for poliovirus types 2 and 3 after the first dose of oral polio vaccine (OPV). This finding highlights the impact of illness on vaccine effectiveness in young children.
Area of Science:
- Pediatrics
- Infectious Diseases
- Immunology
Background:
- Infant vaccination programs rely on effective seroconversion to oral polio vaccine (OPV).
- Acute diarrheal illness is a common comorbidity in infants, potentially impacting immune responses.
Purpose of the Study:
- To evaluate the influence of concurrent diarrheal illness on seroconversion rates following trivalent oral polio vaccine (OPV) administration in infants.
- To quantify the impact of diarrhea on antibody titers against poliovirus types 2 and 3.
Main Methods:
- Infants aged 6-16 weeks with acute diarrhea (cases) and age-matched controls received three doses of trivalent OPV.
- Serum samples were collected at enrollment, before the second OPV dose, and 4 weeks after the third OPV dose.
- Antibody titers to poliovirus were measured using microneutralization assays.
Main Results:
- Four weeks post-first OPV dose, serologic responses to poliovirus types 2 and 3 were significantly lower in infants with diarrhea compared to controls (26% and 34% lower, respectively; P < 0.002).
- Geometric mean antibody titers for poliovirus types 2 and 3 were approximately 50% lower in the diarrhea cohort.
- While seroconversion rates for types 2 and 3 remained about 10% lower in the diarrhea group after the third OPV dose, these differences were not statistically significant.
Conclusions:
- Concurrent acute diarrhea negatively impacts seroconversion rates for poliovirus types 2 and 3 in infants receiving their initial dose of trivalent OPV.
- These findings are particularly relevant for infant vaccination strategies in regions with high burdens of diarrheal diseases, such as Bangladesh.
Objective:
The purpose of this study was to measure the effect of concurrent diarrheal illness on seroconversion to trivalent oral polio vaccine (OPV).
Methods:
Six- to 16-week-old infants with acute diarrhea and age-matched controls received single doses of OPV at enrollment, 4 weeks after enrollment and 8 weeks after enrollment. Serum specimens were obtained at enrollment, before the second OPV dose and 4 weeks after the third OPV dose for measurement of antibody titers to polio virus by the microneutralization assay.
Results:
Four weeks after the first OPV dose, the serologic responses to poliovirus types 2 and 3 in the case cohort were lower by 26 and 34%, respectively, than in the control cohort (P < 0.002 for both comparisons). Poliovirus type 2 and 3 geometric mean antibody titers in the diarrhea cohort were approximately 50% of the geometric mean antibody titers in the control cohort (235 (95% confidence interval (CI) 154 to 359) vs. 446 (95% CI 350 to 569) and 64 (95% CI 45 to 90) vs. 112 (95% CI 88 to 143), respectively, P < 0.01 for both comparisons). After the third OPV dose the seroconvertion rates to poliovirus types 2 and 3 each remained about 10% lower in the case cohort than in the control cohort, but the differences were not statistically significant.
Conclusion:
Concurrent acute diarrhea adversely affects seroconvertion rates of type 2 and 3 polioviruses among infants in Bangladesh receiving the first dose of trivalent OPV.