The effect of diarrheal disease on bivalent oral polio vaccine (bOPV) immune response in infants in Nepal

Details

• Alternative Title:
  Vaccine
• Personal Author:
  Cardemil, Cristina V. ; Estivariz, Concepcion ; Shrestha, Laxman ; Sherchand, Jeevan B. ; Sharma, Arun ; Gary, Howard E. ; Steven Oberste, M. ; Weldon, William C. ; Bowen, Michael D. ; Vinjé, Jan ; William Schluter, W. ; Anand, Abhijeet ; Mach, Ondrej ; Chu, Susan Y.
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• Description:
  Background: ; A globally-coordinated phase out of all type 2 containing oral polio vaccine (OPV) is planned for April 2016 during which bivalent 1 + 3 OPV (bOPV) will replace trivalent OPV (tOPV) in routine immunization schedules and campaigns. Diarrhea impairs the immune response to tOPV, but the effect of diarrhea on bOPV is unknown. ; Methods: ; Infants aged 6 weeks to 11 months, who had received <3 doses of OPV and had mild-moderate diarrhea or no diarrhea, were recruited at five health facilities in Nepal. Neutralizing antibody titers to poliovirus types 1 and 3 were measured before and 28 days after bOPV administration. The effect of diarrhea and other factors on seroconversion or boosting in antibody titers to poliovirus was assessed by multivariable analysis. ; Results: ; Infants with diarrhea, versus those without diarrhea, had reduced response for poliovirus types 1 (56% 87/156 vs 66% 109/164) and 3 (34% 70/209 vs 52% 122/236). After adjusting for other factors, infants with diarrhea had significantly reduced response for type 3 (odds ratio OR = 0.44, 95% CI 0.29–0.68), as did infants with >5 loose stools per day (OR = 0.36, 95% CI 0.21–0.62). ; Conclusions: ; Diarrhea reduced the immune response to bOPV. Provision of additional doses of polio vaccine is necessary to maintain high population immunity in areas with high prevalence of diarrheal disease. ; Clinical trial registry: ; This study is registered at clinicaltrials.gov as NCT01559636.
• Keywords:
  • Bivalent oral polio vaccine
  • Seroconversion
  • Poliomyelitis
  • Diarrhea
  • Nepal
  • Antibodies, Neutralizing
  • Antibodies, Viral
  • Diarrhea
  • Feces
  • Female
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• Source:
  Vaccine. 34(22):2519-2526
• Pubmed ID:
  27085172
• Pubmed Central ID:
  PMC10552718
• Document Type:
  Journal Article
• Funding:
  001/WHO_/World Health OrganizationInternational/ ; CC999999/ImCDC/Intramural CDC HHSUnited States/
• Volume:
  34
• Issue:
  22
• Download URL:
  https://stacks.cdc.gov/view/cdc/133864/cdc_133864_DS1.pdf
• File Type:
  [PDF - 449.93 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:e791ebc64759627eb9725e418fa45d58b37d959d23f02b102307e808d5cbc1af