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The Duration of Intestinal Immunity After an Inactivated Poliovirus Vaccine Booster Dose in Children Immunized with Oral Vaccine: A Randomized Controlled Trial

Friday, 24th of August 2018

The Duration of Intestinal Immunity After an Inactivated Poliovirus Vaccine Booster Dose in Children Immunized with Oral Vaccine: A Randomized Controlled Trial

John J¹, Giri S², Karthikeyan AS², Lata D², Jeyapaul S¹, Rajan AK³, Kumar N², Dhanapal P², Venkatesan J², Mani M², Hanusha J², Raman U², Moses PD³, Abraham A³, Bahl S⁴, Bandyopadhyay AS⁵, Ahmad M⁶, Grassly NC⁷, Kang G².

 

J Infect Dis. 2017 Feb 15;215(4):529-536. doi: 10.1093/infdis/jiw595.

 

https://academic.oup.com/jid/article/215/4/529/2706359

 

Abstract

BACKGROUND:

In 2014, 2 studies showed that inactivated poliovirus vaccine (IPV) boosts intestinal immunity in children previously immunized with oral poliovirus vaccine (OPV). As a result, IPV was introduced in mass campaigns to help achieve polio eradication.

METHODS:

We conducted an open-label, randomized, controlled trial to assess the duration of the boost in intestinal immunity following a dose of IPV given to OPV-immunized children. Nine hundred healthy children in Vellore, India, aged 1-4 years were randomized (1:1:1) to receive IPV at 5 months (arm A), at enrollment (arm B), or no vaccine (arm C). The primary outcome was poliovirus shedding in stool 7 days after bivalent OPV challenge at 11 months.

RESULTS:

For children in arms A, B, and C, 284 (94.7%), 297 (99.0%), and 296 (98.7%), respectively, were eligible for primary per-protocol analysis. Poliovirus shedding 7 days after challenge was less prevalent in arms A and B compared with C (24.6%, 25.6%, and 36.4%, respectively; risk ratio 0.68 [95% confidence interval: 0.53-0.87] for A versus C, and 0.70 [0.55-0.90] for B versus C).

CONCLUSIONS:

Protection against poliovirus remained elevated 6 and 11 months after an IPV boost, although at a lower level than reported at 1 month.