Fractional Doses of Inactivated Poliovirus Vaccine in Oman

Abstract

These data show that fractional doses of inactivated poliovirus vaccine administered intradermally at 2, 4, and 6 months, as compared with full doses of inactivated poliovirus vaccine given intramuscularly on the same schedule, induce similar levels of seroconversion but significantly lower titers. (Current Controlled Trials number, ISRCTN17418767.)

Determination of Depth-Dependent Intradermal Immunogenicity of Adjuvanted Inactivated Polio Vaccine Delivered by Microinjections via Hollow Microneedles

“…Similarly, for polio booster immunization, intradermal 20% IPV dose resulted in either similar (6,13) or inferior (34,35) seroconversion rates in comparison to full intramuscular dose. However, intradermal immunization generally resulted in significantly lowered antibody titers (5,6,(31)(32)(33)(34)(35). These findings were seemingly not dependent on the intradermal immunization method used, because jet injectors (5,6,31,32,34,35), the Mantoux technique (4,35) or HMN arrays (13,33) evenly resulted in either similar or inferior results to full intramuscular dose.…”

“…Furthermore, clinical trials in humans have been performed to investigate IPV dose sparing, by comparison of a 80% reduced IPV dose (20% of full dose) administered intradermally against a full IPV dose administered intramuscularly. For polio prime immunization in newborn infants, intradermal 20% IPV dose resulted in similar (4,5) or inferior (31)(32)(33) seroconversion rates compared to a full intramuscular dose. Similarly, for polio booster immunization, intradermal 20% IPV dose resulted in either similar (6,13) or inferior (34,35) seroconversion rates in comparison to full intramuscular dose.…”

“…Therefore, there is an urgent need for novel intradermal injection methods. Intradermal IPV immunization via jet injectors resulted in seroconversion at reduced doses (5,6). Another novel strategy for intradermal injection is microneedles, which are micron-sized needles (7).…”

Intradermal delivery of vaccines: potential benefits and current challenges

“…One study compared equivalent doses of modified vaccinia Ankara delivered by subcutaneous, intramuscular and intradermal routes; equivalent immune responses and protection against vaccinia-virus challenge were induced with intradermal doses ten-fold lower than those delivered by intramuscular or subcutaneous injection. 10,11 Two recently published trials of intradermal delivery of reduced (20%) doses of inactivated poliovirus vaccines have reported contrasting results: one trial found that reduced intradermal doses administered to infants aged 2, 4 and 6 months induced similar rates of seroconversion but lower mean antibody titres, compared with intramuscular injection; 12 however a similar study administered the vaccine at 6, 10 and 14 weeks of age and observed inferior seroconversion rates with reduced intradermal doses. 13 Trials of intradermal immunization with seasonal and pandemic influenza vaccines have also been reported in the past year.…”

Alternative administration routes and delivery technologies for polio vaccines

“…Serotype 2 showed a statistically significant different, although small, reduction in seroconversion rate after ID delivery (ID: 95.7% vs. IM: 100%). For all serotypes, the median antibody titers were significantly lower in the fractional dose group [21], but it remains unclear whether the differences have practical implications since any detectable titer of neutralizing antibody against poliovirus would be expected to prevent against paralytic disease [38]. Maternal antibodies may interfere with IPV vaccination at very young age [39,40].…”