Oral Polio Vaccine Campaigns May Reduce the Risk of Death from Respiratory Infections

Abstract

Oral polio vaccine (OPV) campaigns, but not other campaigns, have been associated with major reductions in child mortality. Studies have shown that OPV reduces the risk of respiratory infections. We analysed the causes of death at 0–2 years of age in Chakaria, a health and demographic surveillance Systems in Bangladesh, in the period 2012–2019 where 13 national campaigns with combinations of OPV (n = 4), vitamin A supplementation (n = 9), measles vaccine (MV) (n = 2), and albendazole (n = 2) were implemented. OPV-only campaigns reduced overall mortality by 30% (95% confidence interval: −10–56%). Deaths from respiratory infections were reduced by 62% (20–82%, p = 0.01) in the post-neonatal period (1–35 months), whereas there was as slight increase of 19% (−37–127%, p = 0.54) for deaths from other causes. There was no benefit of other types of campaigns. Hence, the hypothesis that OPV may have beneficial non-specific effects, protecting particularly against respiratory infections, was confirmed.

Stopping Oral Polio Vaccine (OPV) After Defeating Poliomyelitis in Low- and Middle-Income Countries: Harmful Unintended Consequences? Review of the Nonspecific Effects of OPV

“…The majority of studies came from West Africa; however, studies from Bangladesh showed similar effects [ 32 , 34 , 41 ]. Most studies were natural experiments or RCTs, so adjustments for confounding factors are unlikely to remove the trends ( Supplementary Table 1 ).…”

“…Two RCTs of OPV vs IPV in Bangladesh and Finland found that OPV reduced diarrhea and otitis media, respectively [ 9 ]. In Bangladesh, the mortality reduction associated with C-OPV was linked to prevention of fatal respiratory infections [ 41 ].…”

Post-vaccination serum cytokines levels correlate with breakthrough influenza infections

“…It appears from our work that there is a correlation between breakthrough infections and cytokine levels after LAIV that is affected by concomitant vaccination. There is evidence of non-specific effects, including protection from respiratory disease, from other live vaccines in children 42 , 48 . This would suggest that some aspect of the immune response to the live vaccines is beneficial irrespective of the antigen content.…”

Beneficial non-specific effects of live vaccines against COVID-19 and other unrelated infections

“…All five live attenuated vaccines have the strongest effect on respiratory infections, 5 , 6 , 20 , 59 , 60 , 61 and BCG has a strong effect on sepsis. 5 There has been little research into disease-differential effects of different live attenuated vaccines.…”