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OPV WANING IMMUNITY, INDIA

Thursday, 29th of March 2012

 

• OPV WANING IMMUNITY, INDIA

J Infect Dis. (2012)First published online: March 23, 2012

Waning intestinal immunity following vaccination with oral poliovirus vaccines in India

1. 1.       Nicholas C Grassly1, Hamid Jafari2Sunil Bahl2, Raman Sethi2, Jagadish M Deshpande3, Chris Wolff4,

  Roland W Sutter4 and R Bruce Aylward4

+ Author Affiliations

1. 1.       ¹Department of Infectious Disease Epidemiology, Imperial College London, Norfolk Place, London, UK
2. 2.       ²National Polio Surveillance Project, World Health Organization, New Delhi, India
3. 3.       ³Enterovirus Research Centre, Parel, Mumbai, India
4. 4.       ⁴Global Polio Eradication Initiative, World Health Organization, Geneva, Switzerland
5. Corresponding Author: Dr Nicholas C Grassly, Department of Infectious Disease Epidemiology, Imperial College London, Norfolk Place, London, W2 1PG, UK (n.grassly@imperial.ac.uk)

Abstract below; full text to subscribers of J Infectious Diseases

Background The eradication of wild-type polioviruses in areas with efficient fecal-oral transmission relies on intestinal mucosal immunity induced by oral poliovirus vaccine (OPV). Mucosal immunity is thought to wane over time but the rate of loss of protection has not been examined.

Methods We examined the degree and duration of intestinal mucosal immunity in India by measuring the prevalence of vaccine poliovirus in stool samples collected 4-28 days after a ‘challenge’ dose of OPV among 47,574 children with acute flaccid paralysis reported during 2005-9.

Results Previous vaccination with OPV was protective against excretion of vaccine poliovirus after challenge, but the odds of excretion increased significantly with the time since the child was last exposed to an immunization activity (Odds-Ratios (95% confidence-intervals): 1.39 (0.99-1.97), 2.04 (1.28-3.25) and 1.31 (1.00-1.70) comparing 6+ months with 1 month ago for serotypes 1, 2 and 3). Vaccine administered during the high season for enterovirus infections (April-September) was significantly less likely to result in excretion, especially in northern states (Odds-Ratios 0.57 (0.50-0.65), 0.58 (0.41-0.81) and 0.48 (0.40-0.57) for serotypes 1, 2 and 3).

Conclusions Infection with OPV (vaccine ‘take’) is highly seasonal in India and results in intestinal mucosal immunity that appears to wane significantly within a year of vaccination.

       Received July 27, 2011.

       Revision received November 23, 2011.

       Accepted December 2, 2011.

       © The Author 2012. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.