Inadequate Poliovirus Immunity Levels in Immunized Illinois Children

Abstract

Antibody titers to poliovirus, measles, and rubella in 504 low-income children in six Il-linois communities were compared with the immunization records of those children. Titers to measles and rubella were, as expected, nearly always present in immunized children, but only one third of children who had received three or more doses of live oral poliovirus vaccine (OPV) had measurable titers to all three polio types. Age, sex, race, age at first OPV, interval between OPVs, and time lapse since last OPV were not found to be significantly related to the absence of polio antibody in immunized children. We conclude that day-to-day immunization practices may result in different immunity levels than published field trial studies of the same vaccines indicate, and that continuing study of vaccine after licensure may be desirable. An unpublished immunity level -. study conducted in the summer of 1971 by the Illinois Department of Public Health and 14 local commu¬ nities revealed that of 1,700 children tested from low-income areas of downstate Illinois, approximately 45% and 60% failed to demonstrate specific antibodies against poliovirus types 1 and 3, respectively. The cur¬ rent study compares the immuniza¬ tion records of some of these same children with their immunity levels in an effort to determine the cause of the demonstrated low immunity lev¬ els against polio. Immunization records and immunity levels for measles and rubella were also exam¬ ined.Of primary concern to polio immu¬ nity level studies is whether oral po¬ liovirus vaccine administration re¬ sults in measurable circulating serum antibodies. Many authors have dem¬ onstrated that it does. Cabasso et al,' in a carefully planned study, reported that two doses of Sabin strain trivalent live oral poliovirus vaccine re¬ sulted one month later in circulating antibodies of at least 1:16 to all three types of polio virus in at least 99% of the children tested. Even two years after the second dose of live oral po¬ liovirus vaccine (OPV), a minimum of 90% of the children who had not re¬ ceived a booster still demonstrated a titer of at least 1:16. Other workers have found similar results.-The current study differs from ear¬ lier ones in that it is retrospective, not prospective. Vaccine storage, reconstitution and administration, and record keeping were performed in the day-to-day manner of medical prac¬ tice without the foreknowledge that the procedure was to be submitted at a later date to serological evaluation. This study, therefore, reflects the re¬ sults of standard immunization proce¬ dures as practiced by the medical communities in six Illinois cities and may be a more accurate measure of the effectiveness of routine immuni¬ zation than are the reports of field trials. Materials and MethodsSerum samples were collected as part of a 14-city testing program that emphasized blood lead determinations.'The population involved in the original lead-testing program consisted almost en¬ tirely of children 1 to 6 years of age from low-income families housed in deteri¬ ...

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