Boosting Immune Responses Following Fractional-Dose Inactivated Poliovirus Vaccine: A Randomized, Controlled Trial

Resik, Sonia; Tejeda, Alina; Dı́az, Manuel; Okayasu, Hiromasa; Sein, Carolyn; Molodecky, Natalie A.; Fonseca, Magilé; Alemany, Nilda; Garcı́a, Gissel; Hung, Lai Heng; Martínez, Yusleidy Correa; Sutter, Roland W.

doi:10.1093/infdis/jiw492

Cited by 16 publications

(10 citation statements)

References 15 publications

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“…Emerging data from Israel indicate that the immune response elicited in the elderly, elicited by a single dose of Pfizer’s mRNA vaccine mediates a degree of protection against infection and transmission 24 , although the age and the fact of having received only a single dose in this time window imply less than optimal antibody levels. “Fractional” dose vaccination has proven beneficial in viral poverty diseases 25 , 26 further supporting the findings of this study.…”

Section: Discussionsupporting

confidence: 86%

Impact of personalized-dose vaccination in Covid-19 with a limited vaccine supply in a 100 day period in the U.S.A.

Hunziker

2021

Preprint

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Background: We aimed at minimizing loss of lives in the Covid-19 pandemic in the USA by identifying optimal vaccination strategies during a 100-day period with limited vaccine supplies. While lethality is highest in the elderly, transmission and case numbers are highest in the younger. A strategy of first vaccinating the elderly is widely used, thought to protect the vulnerable, elderly best. Despite lower immunogenicity in the elderly, mRNA vaccines retain high efficacy, implying that in the younger, reduced vaccine doses might suffice, thereby increasing vaccination counts with a given vaccine supply. Methods: Using published immunogenicity data of the Moderna mRNA-1273 vaccine, we examined the value of tailored-dose vaccination strategies, using a modeling approach incorporating age-related vaccine immunogenicity, social contact patterns, population structure, Covid-19 case and death rates in the USA in late January 2021. An increase if the number of persons that can be vaccinated and a potential reduction of the individual protective efficacy was accounted for. Results: Age-tailored dosing strategies reduced cases faster, shortening the pandemic, reducing the delay to reaching <100′000 cases/day from 64 to 30 days and avoiding 25′000 deaths within 100 days in the USA. In an ′elderly first′ vaccination strategy, mortality is higher even in the elderly. Findings were robust with transmission blocking efficacies of reduced dose vaccination between 30% to 90%. Conclusion: Rapid reduction of Covid-19 case and death rate in the USA in 100 days with a limited vaccine supply is best achieved when personalized, age-tailored dosing for highly effective vaccines is used. Protecting the vulnerable is most effectively achieved by dose tailored vaccination of all population segments, while an ′elderly first′ approach costs more lives, even in the elderly.

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Section: Discussionsupporting

confidence: 86%

Impact of personalized-dose vaccination in Covid-19 with a limited vaccine supply in a 100 day period in the U.S.A.

Hunziker

2021

Preprint

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“…These studies suggest that intradermal fIPV has less ability to boost antibody levels than the regular intramuscular dose, especially when the baseline titers are already high. However, recent studies among adults in Cuba [ 23 ] and among OPV-primed children aged 10 to 12 years in Sri Lanka (O. Mach, WHO, personal communication) found that an fIPV dose was as effective as a full intramuscular dose in boosting both humoral and mucosal immunity among OPV-immunized individuals. This suggests that fIPV through the intradermal route is as effective as IPV administered intramuscularly in boosting individuals with no or lower baseline titers.…”

Section: Summary Of the Scientific Evidencementioning

confidence: 99%

Intradermal Administration of Fractional Doses of Inactivated Poliovirus Vaccine: A Dose-Sparing Option for Polio Immunization

Okayasu¹,

Sein²,

Blanc

et al. 2017

The Journal of Infectious Diseases

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A fractional dose of inactivated poliovirus vaccine (fIPV) administered by the intradermal route delivers one fifth of the full vaccine dose administered by the intramuscular route and offers a potential dose-sparing strategy to stretch the limited global IPV supply while further improving population immunity. Multiple studies have assessed immunogenicity of intradermal fIPV compared with the full intramuscular dose and demonstrated encouraging results. Novel intradermal devices, including intradermal adapters and disposable-syringe jet injectors, have also been developed and evaluated as alternatives to traditional Bacillus Calmette–Guérin needles and syringes for the administration of fIPV. Initial experience in India, Pakistan, and Sri Lanka suggests that it is operationally feasible to implement fIPV vaccination on a large scale. Given the available scientific data and operational feasibility shown in early-adopter countries, countries are encouraged to consider introducing a fIPV strategy into their routine immunization and supplementary immunization activities.

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“…One of the options is to reduce the antigen content of each dose by administering a fractional intradermal (ID) dose of 0.1 mL of IPV, instead of the standard dose of 0.5 mL delivered IM. A number of clinical studies have compared ID delivery of reduced doses of IPV to full-dose IM delivery with variable results depending on the vaccination regimen used [9], [10], [11], [12], [13], [14], [15], [16], [17], [19], [20], [21].…”

Section: Introductionmentioning

confidence: 99%

Vial usage, device dead space, vaccine wastage, and dose accuracy of intradermal delivery devices for inactivated poliovirus vaccine (IPV)

Jarrahian

Rein‐Weston

Saxon

et al. 2017

Vaccine

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If intradermal delivery of IPV is introduced, selection of an intradermal delivery device can have a substantial impact on vaccine wasted during administration, and thus on the required quantity of vaccine that needs to be purchased. An ideal intradermal delivery device should be not only safe, reliable, accurate, and acceptable to users and vaccine recipients, but should also have low dead space, high dose accuracy, and low overall wastage to maximize the potential number of doses that can be withdrawn and delivered.

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Boosting Immune Responses Following Fractional-Dose Inactivated Poliovirus Vaccine: A Randomized, Controlled Trial

Abstract: ACTRN12615000305527.

Cited by 16 publications

References 15 publications

Impact of personalized-dose vaccination in Covid-19 with a limited vaccine supply in a 100 day period in the U.S.A.

Impact of personalized-dose vaccination in Covid-19 with a limited vaccine supply in a 100 day period in the U.S.A.

Intradermal Administration of Fractional Doses of Inactivated Poliovirus Vaccine: A Dose-Sparing Option for Polio Immunization

Vial usage, device dead space, vaccine wastage, and dose accuracy of intradermal delivery devices for inactivated poliovirus vaccine (IPV)

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