Quantity of Vaccine Poliovirus Shed Determines the Titer of the Serum Neutralizing Antibody Response in Indian Children Who Received Oral Vaccine

Giri, Sidhartha; Kumar, Nuthan; Dhanapal, Pavithra; Venkatesan, Jayalakshmi; Kasirajan, Anand; Iturriza‐Gómara, Miren; John, Jacob; Abraham, Asha Mary; Grassly, Nicholas C; Kang, Gagandeep

doi:10.1093/infdis/jix687

Cited by 6 publications

(7 citation statements)

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“…Here we also found a direct correlation between the degree of poliovirus shedding and the development of neutralizing antibody responses, as previously observed 31 . Notably, only 28.6% (4 of 14) of infants generated neutralizing antibodies to all three Sabin types in the current study, lower than the 60% (33 of 55) seroconversion rate previously reported from India 32 and nearly 100% seroconversion rate in Western populations 33 .…”

Section: Discussionsupporting

confidence: 91%

Metagenomic sequencing of stool samples in Bangladeshi infants: virome association with poliovirus shedding after oral poliovirus vaccination

Granados

Bouquet

Hoy-Schulz

et al. 2020

Sci Rep

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The potential role of enteric viral infections and the developing infant virome in affecting immune responses to the oral poliovirus vaccine (OPV) is unknown. Here we performed viral metagenomic sequencing on 3 serially collected stool samples from 30 Bangladeshi infants following OPV vaccination and compared findings to stool samples from 16 age-matched infants in the United States (US). In 14 Bangladeshi infants, available post-vaccination serum samples were tested for polio-neutralizing antibodies. The abundance (p = 0.006) and richness (p = 0.013) of the eukaryotic virome increased with age and were higher than seen in age-matched US infants (p < 0.001). In contrast, phage diversity metrics remained stable and were similar to those in US infants. Non-poliovirus eukaryotic virus abundance (3.68 log10 vs. 2.25 log10, p = 0.002), particularly from potential viral pathogens (2.78log10 vs. 0.83log10, p = 0.002), and richness (p = 0.016) were inversely associated with poliovirus shedding. Following vaccination, 28.6% of 14 infants tested developed neutralizing antibodies to all three Sabin types and also exhibited higher rates of poliovirus shedding (p = 0.020). No vaccine-derived poliovirus variants were detected. These results reveal an inverse association between eukaryotic virome abundance and poliovirus shedding. Overall gut virome ecology and concurrent viral infections may impact oral vaccine responsiveness in Bangladeshi infants.

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Section: Discussionsupporting

confidence: 91%

Metagenomic sequencing of stool samples in Bangladeshi infants: virome association with poliovirus shedding after oral poliovirus vaccination

Granados

Bouquet

Hoy-Schulz

et al. 2020

Sci Rep

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“…Vitamin A deficiency was defined as RBP <0.7 μmol/L at 24 wk ( 14 ). We defined immunological response as protective when participants had anti-diphtheria serum IgG concentrations ≥0.1 IU/ml ( 21 ), anti-tetanus IgG >0.5 IU/ml ( 22 ), anti-Hib IgG >1.0 μg/ml ( 22 ), anti-PnPs IgG ≥0.35 μg/ml ( 23 ), anti-measles IgG ≥0.12 IU/ml ( 24 ) and anti-OPV IgG ≥0.6, ≥2.1 and ≥0.7 IU/ml for S1, 2, and 3 ( 25 ). There is no protective serum concentration established for anti-pertussis IgG ( 22 ).…”

Section: Participants and Methodsmentioning

confidence: 99%

Iron Deficiency Anemia at Time of Vaccination Predicts Decreased Vaccine Response and Iron Supplementation at Time of Vaccination Increases Humoral Vaccine Response: A Birth Cohort Study and a Randomized Trial Follow-Up Study in Kenyan Infants

et al. 2020

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Background: Iron deficiency may impair adaptive immunity and is common among African infants at time of vaccination. Whether iron deficiency impairs vaccine response and whether iron supplementation improves humoral vaccine response is uncertain. Methods: We performed two studies in southern coastal Kenya. In a birth cohort study, we followed infants to age 18 mo and assessed whether anemia or iron deficiency at time of vaccination predicted vaccine response to three-valent oral polio, diphtheria-tetanus-whole cell pertussis-Haemophilus influenzae type b vaccine, ten-valent pneumococcal-conjugate vaccine and measles vaccine. Primary outcomes were anti-vaccine-IgG and seroconversion at age 24 wk and 18 mo. In a randomized trial cohort follow-up, children received a micronutrient powder (MNP) with 5 mg iron daily or a MNP without iron for 4 mo starting at age 7.5 mo and received measles vaccine at 9 and 18 mo; primary outcomes were anti-measles IgG, seroconversion and avidity at age 11.5 mo and 4.5 y. Findings: In the birth cohort study, 573 infants were enrolled and 303 completed the study. Controlling for sex, birthweight, anthropometric indices and maternal Stoffel et al. Iron and Vaccine Response antibodies, hemoglobin at time of vaccination was the strongest positive predictor of: (A) anti-diphtheria and anti-pertussis-IgG at 24 wk (p = 0.0071, p = 0.0339) and 18 mo (p = 0.0182, p = 0.0360); (B) anti-pertussis filamentous hemagglutinin-IgG at 24 wk (p = 0.0423); and (C) anti-pneumococcus 19 IgG at 18 mo (p = 0.0129). Anemia and serum transferrin receptor at time of vaccination were the strongest predictors of seroconversion against diphtheria (p = 0.0484, p = 0.0439) and pneumococcus 19 at 18 mo (p = 0.0199, p = 0.0327). In the randomized trial, 155 infants were recruited, 127 and 88 were assessed at age 11.5 mo and 4.5 y. Compared to infants that did not receive iron, those who received iron at time of vaccination had higher anti-measles-IgG (p = 0.0415), seroconversion (p = 0.0531) and IgG avidity (p = 0.0425) at 11.5 mo. Interpretation: In Kenyan infants, anemia and iron deficiency at time of vaccination predict decreased response to diphtheria, pertussis and pneumococcal vaccines. Primary response to measles vaccine may be increased by iron supplementation at time of vaccination. These findings argue that correction of iron deficiency during early infancy may improve vaccine response.

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“…In 2016, using data from Indian infants 5–11 months old, IC reported that the number of tOPV doses received represented the main determinant of serotype 3 seropositivity [ 104 ], and reported results from a clinical trial that suggested that a 3-day course of azithromycin prior to delivery did not improve the immunogenicity of mOPV3 [ 105 ]. In 2018–19, using this same population, IC reported findings that showed a correlation between the quantity of virus shed and the magnitude of the serum neutralizing antibody response at 21 or 28 days [ 106 ], showed a greater impact on OPV response by enteric viruses than bacterial microbiota [ 107 ], and that did not show an association between seroconversion from one dose of mOPV3 and FUT2 genotype (i.e. single-nucleotide polymorphisms G428A, C302 T, and A385 T) [ 108 ].…”

Section: Summary Of Publications Reviewedmentioning

confidence: 99%

“…Notably, KRI does not recommend the use of IPV for oSIAs in OPV-using countries except when homotypic OPV is not available, because adding IPV to oSIAs is not effective and not cost-effective based on its DEB and integrated modeling [ 64 ]. In contrast, IC suggests that adding IPV may offer some benefit based on statistical modeling of observational data [ 106 , 114 ]. The health and economic benefits of using IPV in routine immunization in OPV-using countries differ substantially before and after homotypic OPV cessation.…”

Section: Themesmentioning

confidence: 99%

Review of poliovirus modeling performed from 2000 to 2019 to support global polio eradication

Thompson¹,

Kalkowska²

2020

Expert Review of Vaccines

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Introduction: Over the last 20 years (2000-2019) the partners of the Global Polio Eradication Initiative (GPEI) invested in the development and application of mathematical models of poliovirus transmission as well as economics, policy, and risk analyses of polio endgame risk management options, including policies related to poliovirus vaccine use during the polio endgame. Areas covered: This review provides a historical record of the polio studies published by the three modeling groups that primarily performed the bulk of this work. This review also systematically evaluates the polio transmission and health economic modeling papers published in English in peerreviewed journals from 2000 to 2019, highlights differences in approaches and methods, shows the geographic coverage of the transmission modeling performed, identified common themes, and discusses instances of similar or conflicting insights or recommendations. Expert opinion: Polio modeling performed during the last 20 years substantially impacted polio vaccine choices, immunization policies, and the polio eradication pathway. As the polio endgame continues, national preferences for polio vaccine formulations and immunization strategies will likely continue to change. Future modeling will likely provide important insights about their costeffectiveness and their relative benefits with respect to controlling polio and potentially achieving and maintaining eradication.

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Quantity of Vaccine Poliovirus Shed Determines the Titer of the Serum Neutralizing Antibody Response in Indian Children Who Received Oral Vaccine

Cited by 6 publications

References 12 publications

Metagenomic sequencing of stool samples in Bangladeshi infants: virome association with poliovirus shedding after oral poliovirus vaccination

Metagenomic sequencing of stool samples in Bangladeshi infants: virome association with poliovirus shedding after oral poliovirus vaccination

Iron Deficiency Anemia at Time of Vaccination Predicts Decreased Vaccine Response and Iron Supplementation at Time of Vaccination Increases Humoral Vaccine Response: A Birth Cohort Study and a Randomized Trial Follow-Up Study in Kenyan Infants

Review of poliovirus modeling performed from 2000 to 2019 to support global polio eradication

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