Host and Viral Factors Affecting the Decreased Immunogenicity of Sabin Type 3 Vaccine after Administration of Trivalent Oral Polio Vaccine to Rural Mayan Children

Maldonado, Yvonne; Peña‐Cruz, Victor; Sanchez, Maria de la Luz; Logan, Laurie; Blandón, S; Cantwell, Michael F.; Matsui, Shigeru; Millan-Velasco, F.; Valdespino, Jósé Luis; Sepúlveda, Jaime

doi:10.1093/infdis/175.3.545

Cited by 48 publications

(38 citation statements)

References 31 publications

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“…[65], [98], [108], [135], [171], [196] [67], [133][134][135], [198][199][200][201] [8], [181], [182], [201], [203], [204] [28], [92], [93], [128], [131], [137], [138], [140], [130], [131], [157], [202] [ [43][44][45], [49], [61][62][63][64][65][66][67][68][69][70], [197] [ [155][156][157] [28], [98], [170][171][172]…”

Section: Conclusion and Future Perspectiveunclassified

“…Concurrent diarrhea has consistently been linked with a reduction in the immunogenicity of OPV [21,130,136]. Several studies have also highlighted the potential inhibitory effect of bacterial or eukaryotic pathogens on OPV, often in the absence of gastrointestinal symptoms [131,137,138]. However, a 3-day course of azithromycin (a broad-spectrum macrolide antibiotic) did not alter the immunogenicity of a subsequent dose of type 3 monovalent OPV among 6-11 month-old infants in India despite reducing the prevalence of bacterial pathogens (including Campylobacter, Salmonella and several pathotypes of E. coli) [28].…”

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Causes of Impaired Oral Vaccine Efficacy in Developing Countries

et al. 2017

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Oral vaccines are less immunogenic when given to infants in low-income compared with high-income countries, limiting their potential public health impact. Here, we review factors that might contribute to this phenomenon, including transplacental antibodies, breastfeeding, histo blood group antigens, enteric pathogens, malnutrition, microbiota dysbiosis and environmental enteropathy. We highlight several clear risk factors for vaccine failure, such as the inhibitory effect of enteroviruses on oral poliovirus vaccine. We also highlight the ambiguous and at times contradictory nature of the available evidence, which undoubtedly reflects the complex and interconnected nature of the factors involved. Mechanisms responsible for diminished immunogenicity may be specific to each oral vaccine. Interventions aiming to improve vaccine performance may need to reflect the diversity of these mechanisms. Enteric pathogens are a substantial threat to public health. This threat takes many forms, from the toxin-producing bacteria (e.g., Vibrio cholerae) and flagellated protozoa (e.g., Giardia lamblia) that colonize the mucosal surface of the small intestine to the enteroviruses that are capable of spreading via the bloodstream to the CNS, causing acute flaccid paralysis (e.g., poliovirus). Each year, enteric pathogens cause hundreds of millions of cases of diarrhea and approximately 800,000 deaths, the vast majority of which occur among children in low-income countries [1]. The most common causes of childhood diarrheal morbidity include rotavirus, Cryptosporidium, enterotoxigenic Escherichia coli and Shigella [2].Vaccines against enteric pathogens are important tools for mitigating this disease burden. Oral vaccines offer several distinct benefits compared with parenteral vaccines. They can be produced in large quantities at relatively low cost, are easy to administer and have the capacity to induce local immunity in the intestinal mucosa, thereby protecting vaccinated individuals against subsequent infection and -by blocking onward transmission -enhancing herd immunity [3,4]. Currently licensed oral vaccines include live-attenuated poliovirus vaccines containing one, two or three serotypes, live-attenuated rotavirus vaccines (Rotarix R , RotaTeq R , Lanzhou lamb rotavirus vaccine [China only] and Rotavac R [India only]), live-attenuated cholera vaccine (CVD 103-HgR or Vaxchora TM ), inactivated cholera vaccines (Dukoral R and Shanchol R ) and live-attenuated typhoid vaccine (Ty21a). Other oral vaccines are in development, including those against Shigella, enterotoxigenic E. coli, Campylobacter and Clostridium difficile, as well as several novel rotavirus vaccine candidates (including the human neonatal vaccine RV3-BB [5] and an oral bovine pentavalent vaccine [6]).Yet oral vaccines have an Achilles' heel -their immunogenicity and efficacy is impaired in low-income countries that experience the greatest burden of enteric disease (Box 1). For example, Rotarix has a 1-year protective efficacy against severe rotavirus-associated gas...

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Section: Conclusion and Future Perspectiveunclassified

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Causes of Impaired Oral Vaccine Efficacy in Developing Countries

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“…26 Three doses of polio vaccine with a polio 1:2:3 virus dose ratio of 10:1:3 produced a low prevalence of antibodies to type 3, and doubling the type 3 component led to a higher antibody production and seroconversion rate. 27 The present study was conducted in flavivirus-naive adults, but children are the main target for vaccination because the incidence of DHF/DSS is the highest in this population. In areas of high endemicity, vaccination at a very young age might protect against the rare but severe DHF/DSS cases seen during infancy.…”

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Safety and immunogenicity of tetravalent live-attenuated dengue vaccines in Thai adult volunteers: role of serotype concentration, ratio, and multiple doses.

Sabchareon¹,

Lang²,

Chanthavanich³

et al. 2002

The American Journal of Tropical Medicine and Hygiene

168

108

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Abstract. Dengue fever, caused by four serotypes of a mosquito-borne virus, is a growing problem in tropical countries. Currently, there is no treatment or vaccine. We evaluated safety and immunogenicity of two doses, given six months apart, of seven formulations of dengue tetravalent live-attenuated vaccine (containing different concentrations of the component viruses) versus placebo in 59 flavivirus-seronegative Thai adults. The first dose was the more reactogenic. Most volunteers experienced clinically moderate fever, headache, myalgia, eye pain or rash 7-11 days after injection, generally lasting three days or less. Modest decreases in platelets and neutrophils were observed. After one dose, 58% of dengue recipients seroconverted (neutralizing antibody level Ն 1:10) against Ն 3 serotypes; 35% seroconverted against all four. After the second dose, seroconversion was 76% and 71%, respectively. All subjects seroconverted to serotype 3 after one dose. Serotype 4 elicited the lowest primary response but the highest increase in seroconversion after the second dose.

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“…In a review of 32 studies from lowerincome countries 27% and 30% of (16). In addition, a reduced immunogenicity of PV3 when compared to PV1 and PV2 has been shown for inactivated poliovirus vaccine (20) and, based on the above-mentioned evidence, presumably the same might be true for live attenuated OPV3.…”

Section: Discussionmentioning

confidence: 99%

83 Seroprevalence of poliovirus antibodies among 7-month-old infants after 4 doses of oral polio vaccine in Sistan-va-Baluchestan, Islamic Republic of Iran

Izadi

Shahmahmoodi

Zahraei

et al. 2015

Easter Mediterr Health J

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Despite high coverage rates of polio vaccine in the Islamic Republic of Iran, the seroconversion rates of infants may be inadequate. This study measured seroprevalence of antibodies against poliovirus serotypes 1 to 3 (PV1, PV2 and PV3) in 7-month-old infants who had received at least 4 doses of trivalent oral polio vaccine. A serosurvey was conducted in 2010 in rural areas of Chabahar, Sistan-va-Baluchestan province. Using cluster sampling, 72 eligible infants were tested for antibody against the 3 poliovirus serotypes according to WHO guidelines. Antibody titres ≥ 1:10 were considered positive. The seropositive rates for antibody against PV1, PV2 and PV3 were 84.7%, 95.8% and 70.8% respectively. Only 63.9% of participants were seropositive for antibodies against all 3 poliovirus serotypes. Except for PV2, the seroprevalence of antibody against the other 2 poliovirus serotypes, especially PV3, was unsatisfactory. Seuls 63,9 % des nourrissons participants étaient séropositifs pour les anticorps dirigés contre les trois sérotypes de poliovirus. À l'exception du sérotype 2 du poliovirus, la séroprévalence des anticorps dirigés contre les deux autres sérotypes, en particulier le sérotype 3, n'était pas satisfaisante.

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Host and Viral Factors Affecting the Decreased Immunogenicity of Sabin Type 3 Vaccine after Administration of Trivalent Oral Polio Vaccine to Rural Mayan Children

Cited by 48 publications

References 31 publications

Causes of Impaired Oral Vaccine Efficacy in Developing Countries

Causes of Impaired Oral Vaccine Efficacy in Developing Countries

Safety and immunogenicity of tetravalent live-attenuated dengue vaccines in Thai adult volunteers: role of serotype concentration, ratio, and multiple doses.

83 Seroprevalence of poliovirus antibodies among 7-month-old infants after 4 doses of oral polio vaccine in Sistan-va-Baluchestan, Islamic Republic of Iran

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