The case for replacing live oral polio vaccine with inactivated vaccine in the Americas

Alfaro-Murillo, Jorge A.; Ávila-Agüero, Marí L; Fitzpatrick, Meagan C.; Crystal, Caroline; Falleiros-Arlant, Luiza-Helena; Galvani, Alison P.

doi:10.1016/s0140-6736(20)30213-0

Cited by 22 publications

(20 citation statements)

References 18 publications

(17 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, OPV has the disadvantages that it is heavily reliant on the cold chain for retention of vaccine potency and OPV has the propensity to revert to wildtype and cause vaccine-derived poliomyelitis [ 3 ]. IPV is much safer as it cannot cause poliomyelitis, but its disadvantages include weak immunogenicity and the need for multiple booster injections, together with high manufacturing costs [ 4 , 5 ]. There is therefore a pressing need to develop more immunogenic and cost-effective IPV vaccines to replace OPV vaccines in global polio eradication programs.…”

Section: Introductionmentioning

confidence: 99%

Advax-CpG Adjuvant Provides Antigen Dose-Sparing and Enhanced Immunogenicity for Inactivated Poliomyelitis Virus Vaccines

2021

View full text Add to dashboard Cite

Global immunization campaigns have resulted in a major decline in the global incidence of polio cases, with wild-type poliovirus remaining endemic in only two countries. Live oral polio vaccine (OPV) played a role in the reduction in polio case numbers; however, the risk of OPV developing into circulating vaccine-derived poliovirus makes it unsuitable for eradication programs. Trivalent inactivated polio virus (TIPV) vaccines which contain formalin-inactivated antigens produced from virulent types 1, 2 and 3 reference polio strains grown in Vero monkey kidney cells have been advocated as a replacement for OPV; however, TIPVs have weak immunogenicity and multiple boosts are required before peak neutralizing titers are reached. This study examined whether the incorporation of the novel polysaccharide adjuvant, Advax-CpG, could boost the immunogenicity of two TIPV vaccines, (i) a commercially available polio vaccine (IPOL®, Sanofi Pasteur) and (ii) a new TIPV formulation developed by Statens Serum Institut (SSI). Mice were immunized intramuscularly based on recommended vaccine dosage schedules and serum antibody titers were followed for 12 months post-immunization. Advax-CpG significantly enhanced the long-term immunogenicity of both TIPV vaccines and had at least a 10-fold antigen dose-sparing effect. An exception was the poor ability of the SSI TIPV to induce serotype type 1 neutralizing antibodies. Immunization with monovalent IPVs suggested that the low type 1 response to TIPV may be due to antigen competition when the type 1 antigen was co-formulated with the type 2 and 3 antigens. This study provides valuable insights into the complexity of the formulation of multivalent polio vaccines and supports the further development of adjuvanted antigen-sparing TIPV vaccines in the fight to eradicate polio.

show abstract

Section: Introductionmentioning

confidence: 99%

Advax-CpG Adjuvant Provides Antigen Dose-Sparing and Enhanced Immunogenicity for Inactivated Poliomyelitis Virus Vaccines

2021

View full text Add to dashboard Cite

show abstract

“… 25 Otherwise, polio vaccination has led to eradicate polio in the Americas; therefore, full doses administration are necessary for proper immunity development. 43 44 It should be noted that MINSA introduced a new polio vaccine schedule since 2013, in which the first and second doses from oral polio vaccine to inactivated polio vaccine were changed, according to posteradication recommendations. 45 In addition, the inadequate coverage of measles vaccine and the recent massive migration of Venezuelans with the absence of the respective public health policies, contributed to the emergence of measles outbreaks since 2018.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, an epidemic alert declared the first case of diphtheria in 20 years in Peru, which reflects the consequences of a suboptimal vaccination coverage 25. Otherwise, polio vaccination has led to eradicate polio in the Americas; therefore, full doses administration are necessary for proper immunity development 43 44. It should be noted that MINSA introduced a new polio vaccine schedule since 2013, in which the first and second doses from oral polio vaccine to inactivated polio vaccine were changed, according to posteradication recommendations 45.…”

Section: Discussionmentioning

confidence: 99%

Spatial distribution, determinants and trends of full vaccination coverage in children aged 12–59 months in Peru: A subanalysis of the Peruvian Demographic and Health Survey

2022

View full text Add to dashboard Cite

ObjectiveTo assess the spatial distribution, trends and determinants of crude full vaccination coverage (FVC) in children aged 12–59 months between 2010 and 2019 in Peru.Design, setting and analysisA cross-sectional study based on the secondary data analysis of the 2010 and 2019 Peruvian Demographic and Health Surveys (DHSs) was conducted. Logit based multivariate decomposition analysis was employed to identify factors contributing to differences in FVC between 2010 and 2019. The spatial distribution of FVC in 2019 was evaluated through spatial autocorrelation (Global Moran’s I), ordinary kriging interpolation (Gaussian process regression) and Bernoulli-based purely spatial scan statistic.Outcome measureFVC, as crude coverage, was defined as having completely received BCG; three doses of diphtheria, pertussis, and tetanus, and polio vaccines; and measles vaccine by 12 months of age.ParticipantsA total of 5 751 and 14 144 children aged 12–59 months from 2010 and 2019 DHSs, respectively, were included.ResultsFVC increased from 53.62% (95% CI 51.75% to 55.49%) in 2010 to 75.86% (95% CI 74.84% to 76.85%) in 2019. Most of the increase (70.39%) was attributable to differences in coefficients effects. Family size, visit of health workers in the last 12 months, age of the mother at first delivery, place of delivery and antenatal care follow-up were all significantly associated with the increase. The trend of FVC was non-linear and increased by 2.22% annually between 2010 and 2019. FVC distribution was heterogeneous at intradepartmental and interdepartmental level. Seven high-risk clusters of incomplete coverage were identified.ConclusionsAlthough FVC has increased in Peru, it still remains below the recommended threshold. The increase of FVC was mainly attributed to the change in the effects of the characteristics of the population. There was high heterogeneity across Peruvian regions with the presence of high-risk clusters. Interventions must be redirected to reduce these geographical disparities.

show abstract

“…18 In fact, demand for IPV and IPV-containing hexavalent vaccines may be much higher as these Gavi forecasts do not include several large middle-income countries not eligible for its support. Alfaro-Murillo et al 19 concluded in 2020 that 21.1 million doses of IPV would be required annually in just the Americas for a three-dose schedule, and that globally between 232.6 million (for a two-dose schedule) and 348.7 million (for a three-dose schedule) would be needed.…”

Section: Meeting Post Polio Eradication Demandmentioning

confidence: 99%

Polio eradication vaccine investment: how do we ensure polio vaccines are available to keep the world polio-free after transmission of wild poliovirus (wPV) has been interrupted?

et al. 2021

View full text Add to dashboard Cite

The case for replacing live oral polio vaccine with inactivated vaccine in the Americas

Cited by 22 publications

References 18 publications

Advax-CpG Adjuvant Provides Antigen Dose-Sparing and Enhanced Immunogenicity for Inactivated Poliomyelitis Virus Vaccines

Advax-CpG Adjuvant Provides Antigen Dose-Sparing and Enhanced Immunogenicity for Inactivated Poliomyelitis Virus Vaccines

Spatial distribution, determinants and trends of full vaccination coverage in children aged 12–59 months in Peru: A subanalysis of the Peruvian Demographic and Health Survey

Polio eradication vaccine investment: how do we ensure polio vaccines are available to keep the world polio-free after transmission of wild poliovirus (wPV) has been interrupted?

Contact Info

Product

Resources

About