Boosting of Mucosal Immunity After Fractional-Dose Inactivated Poliovirus Vaccine

Gamage, Deepa; Mach, Ondrej; Palihawadana, Paba; Yiting, Zhang; Weldon, William C.; Oberste, M. Steven; Gunasena, Sunethra; Sutter, Roland W.

doi:10.1093/infdis/jiy389

Cited by 20 publications

(13 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…While it is clear that at standard doses IPV alone fails to stimulate mucosal antibody responses in the intestine, increases in mucosal immunity have been noted in studies in which a single dose of IPV was given to individuals previously primed by OPV 7 , 31 , 43 – 45 . The mechanism by which IPV boosts intestinal immunity in this context is not well understood but presumably reflects reactivation of polio-specific memory responses established during initial enteric exposure to live virus 7 .…”

Section: Mucosal Immunity To Live and Inactivated Poliovirus Vaccines In Infantsmentioning

confidence: 99%

Mucosal immunity to poliovirus

et al. 2022

View full text Add to dashboard Cite

A cornerstone of the global initiative to eradicate polio is the widespread use of live and inactivated poliovirus vaccines in extensive public health campaigns designed to prevent the development of paralytic disease and interrupt transmission of the virus. Central to these efforts is the goal of inducing mucosal immunity able to limit virus replication in the intestine. Recent clinical trials have evaluated new combined regimens of poliovirus vaccines, and demonstrated clear differences in their ability to restrict virus shedding in stool after oral challenge with live virus. Analyses of mucosal immunity accompanying these trials support a critical role for enteric neutralizing IgA in limiting the magnitude and duration of virus shedding. This review summarizes key findings in vaccine-induced intestinal immunity to poliovirus in infants, older children, and adults. The impact of immunization on development and maintenance of protective immunity to poliovirus and the implications for global eradication are discussed.

show abstract

Section: Mucosal Immunity To Live and Inactivated Poliovirus Vaccines In Infantsmentioning

confidence: 99%

Mucosal immunity to poliovirus

et al. 2022

View full text Add to dashboard Cite

show abstract

“…15,29 Fractional as well as full-dose IPV has also been shown to boost mucosal immunity in those who have previously received the oral vaccine, making it suitable for outbreak control. 10,17 Figure 3: Effects of administration method on type-specific immune responses Differences in the percentage of participants having an immune response to poliovirus type 1, poliovirus type 2, or poliovirus type 3 after the administration of an intradermal fractional dose of inactivated poliovirus vaccine via IDA or DSJI, compared with the reference N&S method. The percentage of children who had an immune response after intradermal fractional dose inactivated poliovirus vaccine was calculated combining the percentage who underwent seroconversion (baseline SNA titres of <8 and a post-vaccination titre of ≥8) with the percentage who were seropositive (SNA≥8) at baseline and had a four-fold rise in SNA titres post-vaccination.…”

Section: Discussionmentioning

confidence: 99%

“…15,16 In OPV-immunised individuals, fIPV also boosts mucosal immunity to a similar degree to full-dose IPV, making it suitable for cVDPV2 outbreaks. 10,17 A key concern with the use of intradermal fIPV in campaigns is the feasibility of delivering intradermal injections in the community on a large scale. Public health personnel across much of sub-Saharan Africa routinely give the BCG vaccine by the intradermal route.…”

Section: Implications Of All the Available Evidencementioning

confidence: 99%

“…5 In contrast, several studies have now shown that IPV boosts mucosal immunity more effectively than additional doses of OPV in those who have previously received OPV. [8][9][10] In April, 2016, a switch from the use of trivalent to bivalent OPV, containing only the Sabin type 1 and type 3 strains, occurred worldwide. The switch aimed to reduce the occurrence of cVDPV, of which more than 85% of cases were attributable to the type 2 vaccine virus at the time.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Intradermal administration of fractional doses of the inactivated poliovirus vaccine in a campaign: a pragmatic, open-label, non-inferiority trial in The Gambia

Bashorun¹,

Hydara²,

Adigweme³

et al. 2022

The Lancet Global Health

Self Cite

View full text Add to dashboard Cite

Background A rapid increase in circulating vaccine-derived poliovirus type 2 outbreaks, and the need to reserve inactivated poliovirus vaccine (IPV) for routine immunisation, has increased the value of fractional dose IPV (fIPV) as a measure to prevent acute flaccid paralysis. However, the intradermal route of administration has been viewed as prohibitive to outbreak response campaigns. We aimed to establish the immunogenicity and safety of administering intradermal fIPV with a disposable syringe jet injector (DSJI) or an intradermal adaptor (IDA) compared with standard administration with a BCG needle and syringe (N&S). MethodsThis pragmatic, non-inferiority trial was undertaken in a campaign setting in communities in The Gambia. Children aged 4-59 months without contraindication to vaccination were eligible. Children were not individually randomly assigned; instead, the vaccination teams were randomly assigned (1:1:1) to one of three administration methods. Parents and the field team were not masked, but laboratory personnel were masked. Baseline demographic and anthropometric data were collected from the participants. Public health officers experienced at intradermal immunisation, and nurses without experience, had 2 h of training on each of the administration methods before the campaign. Participants were vaccinated using the administration method in use by the vaccination team in their community. Poliovirus serum neutralising antibodies (SNA) were measured in children aged 24-59 months before and 4 weeks after vaccination. Adverse events and data on injection quality were collected from all participants. The primary outcome was the type 2 immune response rate (seroconversion in seronegative [SNA titre <8] children plus a 4-fold titre rise in seropositive children). Adjusted differences in the immune response between the DSJI or IDA group versus the N&S group were calculated with 97•5% CIs. A margin of -10% was used to define the non-inferiority of DSJI or IDA compared to N&S. Immunogenicity analysis was done per protocol. The trial is registered with ClinicalTrials.gov NCT02967783 and has been completed. Findings Between Oct 28 and Dec 29, 2016, 3189 children aged 4-59 months were recruited, of whom 3170 were eligible. Over 3 days, 2720 children were vaccinated (N&S, 917; IDA, 874; and DSJI, 929). Among 992 children aged 25-59 months with a baseline SNA available, 90•1% (95% CI 86•1-92•9; 281/312) of those vaccinated using the DSJI had an immune response to type 2 compared with 93•8% (90•6-95•8; 331/353) of those vaccinated with N&S and 96•6% (94•0-98•0; 316/327) of those vaccinated with IDA. All (53/53) type 2 seronegative children seroconverted. For polio type 2, non-inferiority was shown for both the IDA (adjusted difference 0•7% [97•5% CI -3•3 to 4•7], unadjusted difference 2•9% [-0•9 to 6•8]) and DSJI (adjusted difference -3•3% [-8•3 to 1•5], unadjusted difference -3•7% [-8•7 to 1•1]) compared with N&S. Non-inferiority was shown for type 1 and 3 for the IDA and DSJI. Neither injection quality nor the tr...

show abstract

“…Subsequently, seroconversion rates from fractional doses were shown to be adequate but somewhat lower than for full-dose intramuscular injection fractional doses [162,163,247]. Ironically, recent shortages in availability of IPV during transition from tOPV to bOPV [248] and safety issues during vaccine production have restimulated interest in use of fractional doses and new clinical trials for fractional doses, with and without use of adjuvants, and possible use of needle-free devices (non-inclusive example of recent references: [162,163,[249][250][251][252]).…”

Section: Poliovirus Infections At the Level Of The Individual Hostmentioning

confidence: 99%

Polio and Its Epidemiology

Shulman¹

2020

Encyclopedia of Sustainability Science and Technology

View full text Add to dashboard Cite

AFP Acute flaccid paralysis. AFP surveillance Characterization of enteroviruses in stool samples from all AFP cases especially in individuals under 15 years of age to rule in or rule out etiology by polioviruses. AFR or AFRO The African Health Region of the WHO. AGG A PID with agammaglobulinemia. AMR or AMRO The American Health Region of the WHO. aVDPV A vaccine-derived poliovirus isolate whose evolutionary path is unknown or ambiguous. bOPV Bivalent oral polio vaccine (containing serotypes 1 and 3). BSL Biosafety standard level. CAG Containment Advisory Group. C-antigens Refers to the epitopes after poliovirus interacts with CD155 host cell receptor and transitions into a 135S particle. Capsid The protein shell that surrounds a virus particle. Capsomere One of the individual morphological units that makes up the viral capsid. It contains a single copy of viral capsid proteins VP1, VP| 2, VP3, and VP4. CAV Coxsackie A virus. CCID 50 The cell culture infectious dose of a virus that will cause cell death in 50% of replicate cell cultures. CDC US Centers for Disease Control and Prevention. CD155 or PVr The human encoded cell receptor for poliovirus, a member of the immunoglobulin superfamily. cDNA Complimentary DNA (DNA synthesized from RNA by a reverse transcriptase enzyme). CNS Central nervous system. Codon A sequence of three adjacent nucleotides on a strand of DNA or RNA that specifies which specific amino acid will be incorporated into a protein. Codon bias Unequal usage of synonymous codons (different codons that specify the same amino acid). CPE Cytopathic effect. CRE Cis-acting replication element. CVID Common variable immune deficiencya type of primary immune deficiency cVDPV A circulating vaccine-derived poliovirus, that is, a poliovirus that has evolved from vaccine during person-to-person transmission. D-antigens Refers to epitopes on native 150S virions. Lester M. Shulman has retired.

show abstract

Boosting of Mucosal Immunity After Fractional-Dose Inactivated Poliovirus Vaccine

Abstract: Australia New Zealand Clinical Trial Registry ACTRN12616000124437p.

Cited by 20 publications

References 21 publications

Mucosal immunity to poliovirus

Mucosal immunity to poliovirus

Intradermal administration of fractional doses of the inactivated poliovirus vaccine in a campaign: a pragmatic, open-label, non-inferiority trial in The Gambia

Polio and Its Epidemiology

Contact Info

Product

Resources

About