Immunogenicity of supplemental doses of poliovirus vaccine for children aged 6–9 months in Moradabad, India: a community-based, randomised controlled trial

Estívariz, Concepción F.; Jafari, Hamid; Sutter, Roland W.; John, T. Jacob; Jain, Vibhor; Agarwal, Ashutosh; Verma, H. K.; Pallansch, Mark A.; Singh, Ajit Pal; Guirguis, Sherine; Awale, Jitendra; Burton, Anthony; Bahl, Sunil; Chatterjee, Arani; Aylward, R. Bruce

doi:10.1016/s1473-3099(11)70190-6

Cited by 94 publications

(64 citation statements)

References 20 publications

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“…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. However, intradermal immunization generally resulted in significantly lowered antibody titers (5,6,(31)(32)(33)(34)(35).…”

Section: Discussionmentioning

confidence: 96%

“…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.…”

Section: Discussionmentioning

confidence: 96%

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

et al. 2016

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Purpose The aim of this study was to investigate the depthdependent intradermal immunogenicity of inactivated polio vaccine (IPV) delivered by depth-controlled microinjections via hollow microneedles (HMN) and to investigate antibody response enhancing effects of IPV immunization adjuvanted with CpG oligodeoxynucleotide 1826 (CpG) or cholera toxin (CT). Methods A novel applicator for HMN was designed to permit depth-and volume-controlled microinjections. The applicator was used to immunize rats intradermally with monovalent IPV serotype 1 (IPV1) at injection depths ranging from 50 to 550 μm, or at 400 μm for CpG and CT adjuvanted immunization, which were compared to intramuscular immunization. Results The applicator allowed accurate microinjections into rat skin at predetermined injection depths (50-900 μm), -volumes (1-100 μL) and -rates (up to 60 μL/min) with minimal volume loss (±1-2%). HMN-mediated intradermal immunization resulted in similar IgG and virus-neutralizing antibody titers as conventional intramuscular immunization. No differences in IgG titers were observed as function of injection depth, however IgG titers were significantly increased in the CpG and CT adjuvanted groups (7-fold).Conclusion Intradermal immunogenicity of IPV1 was not affected by injection depth. CpG and CT were potent adjuvants for both intradermal and intramuscular immunization, allowing effective vaccination upon a minimally-invasive single intradermal microinjection by HMN.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 96%

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

et al. 2016

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“…Furthermore, when administered to children who have received previous doses of OPV, IPV leads to higher than expected seroconversion rates among seronegative people than when IPV is given to vaccine-naive individuals. 18,19 Data indicate that IPV is equivalent to OPV in reducing oral shedding of viruses and thus should reduce oral-oral transmission of polioviruses. However, IPV is inferior to OPV in reducing shedding of virus in the stool, raising concerns about its effectiveness in reducing transmission via the fecal-oral route, thought to be the predominant mode of transmission in developing countries.…”

Section: Ipv As "Insurance"mentioning

confidence: 99%

Eradicating Polio: How the World’s Pediatricians Can Help Stop This Crippling Illness Forever

Orenstein¹

2015

Pediatrics

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The American Academy of Pediatrics strongly supports the Polio Eradication and Endgame Strategic Plan of the Global Polio Eradication Initiative. This plan was endorsed in November 2012 by the Strategic Advisory Group of Experts on Immunization of the World Health Organization and published by the World Health Organization in April 2013. As a key component of the plan, it will be necessary to stop oral polio vaccine (OPV) use globally to achieve eradication, because the attenuated viruses in the vaccine rarely can cause polio. The plan includes procedures for elimination of vaccine-associated paralytic polio and circulating vaccine-derived polioviruses (cVDPVs). cVDPVs can proliferate when vaccine viruses are transmitted among susceptible people, resulting in mutations conferring both the neurovirulence and transmissibility characteristics of wild polioviruses. Although there are 3 different types of wild poliovirus strains, the polio eradication effort has already resulted in the global elimination of type 2 poliovirus for more than a decade. Type 3 poliovirus may be eliminated because the wild type 3 poliovirus was last detected in 2012. Thus, of the 3 wild types, only wild type 1 poliovirus is still known to be circulating and causing disease. OPV remains the key vaccine for eradicating wild polioviruses in polio-infected countries because it induces high levels of systemic immunity to prevent paralysis and intestinal immunity to reduce transmission. However, OPV is a rare cause of paralysis and the substantial decrease in wild-type disease has resulted in estimates that the vaccine is causing more polio-related paralysis annually in recent years than the wild virus. The new endgame strategic plan calls for stepwise removal of the type 2 poliovirus component from trivalent oral vaccines, because type 2 wild poliovirus appears to have been eradicated (since 1999) and yet is the main cause of cVDPV outbreaks and approximately 40% of vaccine-associated paralytic polio cases. The Endgame and Strategic Plan will be accomplished by shifting from trivalent OPV to bivalent OPV (containing types 1 and 3 poliovirus only). It will be necessary to introduce trivalent inactivated poliovirus vaccine (IPV) into routine immunization programs in all countries using OPV to provide population immunity to type 2 before the switch from trivalent OPV to bivalent OPV. The Global Polio Eradication Initiative hopes to achieve global eradication of polio by 2018 with this strategy, after which all OPV use will be stopped. Challenges expected for adding IPV into routine immunization schedules include higher cost of IPV compared with OPV, cold-chain capacity limits, more complex administration of vaccine because IPV requires injections as opposed to oral administration, and inferior intestinal immunity conferred by IPV. The goal of this report is to help pediatricians understand the change in strategy and outline ways that pediatricians can help global polio eradication efforts, including advocating for the resources needed to accomplish polio eradication and for incorporation of IPV into routine immunization programs in all countries.

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“…This strategy enhances immunity to types 1 and 3 in two ways: by improving the immunogenicity of OPV with the removal of type 2 vaccine virus and by enhancing immunity in children who are given both bOPV and IPV during routine infant immunization. 2 Two recent studies in India have shown that IPV administered to children previously given OPV boosts both humoral neutralizing-antibody levels and intestinal mucosal immunity. 3,4 Attention to intestinal immunity has increased because of uncertainty about the extent to which polio may circulate in populations with only IPV-induced immunity.…”

Section: Achieving and Maintaining Polio Eradication -New Strategiesmentioning

confidence: 99%

Achieving and Maintaining Polio Eradication — New Strategies

Modlin

Wenger²

2014

N Engl J Med

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Immunogenicity of supplemental doses of poliovirus vaccine for children aged 6–9 months in Moradabad, India: a community-based, randomised controlled trial

Cited by 94 publications

References 20 publications

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

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

Eradicating Polio: How the World’s Pediatricians Can Help Stop This Crippling Illness Forever

Achieving and Maintaining Polio Eradication — New Strategies

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