Abhijeet Anand1, K Zaman2, Concepción F Estívariz3, Mohammad Yunus2, Howard E Gary3, William C Weldon3, Tajul I Bari4, M Steven Oberste3, Steven G Wassilak3, Stephen P Luby5, James D Heffelfinger6, Mark A Pallansch3. 1. Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30033, United States. Electronic address: aanand@cdc.gov. 2. International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68 Shahid Tajuddin Sarani, Dhaka 1212, Bangladesh. 3. Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30033, United States. 4. Expanded Program on Immunization and Surveillance, Mohakhali, Dhaka 1212, Bangladesh. 5. Stanford University, Stanford, CA 94305, United States. 6. Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30033, United States; International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68 Shahid Tajuddin Sarani, Dhaka 1212, Bangladesh.
Abstract
INTRODUCTION:Inactivated poliovirus vaccine (IPV) introduction and phased oral poliovirus vaccine (OPV) cessation are essential for eradication of polio. METHODS:Healthy 6-week old infants in Bangladesh were randomized to one of five study arms: receipt of trivalent OPV (tOPV) or bivalent OPV (bOPV) at ages 6, 10 and 14 weeks, intramuscular IPV or intradermal one-fifth fractional doseIPV (f-IPV) at ages 6 and 14 weeks, or f-IPV at ages 6 and 14 weeks with bOPV at age 10 weeks (f-IPV/bOPV). All participants received tOPV at age 18 weeks. RESULTS: Of 975 infants randomized, 95% (922) completed follow-up. Type 1 seroconversion after 3 doses at 6, 10 and 14 weeks was higher with bOPV compared with tOPV (99% vs 94%, p=0.019). Seroconversions to types 1 and 3 after 2 IPV doses at ages 6 and 14 weeks were no different than after 3 doses of tOPV or bOPV at ages 6, 10 and 14 weeks. A priming response, seroconversion 1 week after IPV at 14 weeks among those who did not seroconvert after IPV at 6 weeks, was observed against poliovirus types 1, 2 and 3 in 91%, 84% and 97%, respectively. Compared with IPV, f-IPV failed non-inferiority tests for seroconversion with 1 or 2 doses and priming after 1 dose. DISCUSSION: The findings demonstrate considerable priming with IPV at age 6 weeks, comparable immunogenicity of tOPV and bOPV, and inferior immunogenicity of one-fifth f-IPV compared with IPV. If IPV induced priming at age 6 weeks is similar to that at age 14 weeks, IPV could be administered at a younger age and possibly with a higher coverage. Published by Elsevier Ltd.
RCT Entities:
INTRODUCTION: Inactivated poliovirus vaccine (IPV) introduction and phased oral poliovirus vaccine (OPV) cessation are essential for eradication of polio. METHODS: Healthy 6-week old infants in Bangladesh were randomized to one of five study arms: receipt of trivalent OPV (tOPV) or bivalent OPV (bOPV) at ages 6, 10 and 14 weeks, intramuscular IPV or intradermal one-fifth fractional dose IPV (f-IPV) at ages 6 and 14 weeks, or f-IPV at ages 6 and 14 weeks with bOPV at age 10 weeks (f-IPV/bOPV). All participants received tOPV at age 18 weeks. RESULTS: Of 975 infants randomized, 95% (922) completed follow-up. Type 1 seroconversion after 3 doses at 6, 10 and 14 weeks was higher with bOPV compared with tOPV (99% vs 94%, p=0.019). Seroconversions to types 1 and 3 after 2 IPV doses at ages 6 and 14 weeks were no different than after 3 doses of tOPV or bOPV at ages 6, 10 and 14 weeks. A priming response, seroconversion 1 week after IPV at 14 weeks among those who did not seroconvert after IPV at 6 weeks, was observed against poliovirus types 1, 2 and 3 in 91%, 84% and 97%, respectively. Compared with IPV, f-IPV failed non-inferiority tests for seroconversion with 1 or 2 doses and priming after 1 dose. DISCUSSION: The findings demonstrate considerable priming with IPV at age 6 weeks, comparable immunogenicity of tOPV and bOPV, and inferior immunogenicity of one-fifth f-IPV compared with IPV. If IPV induced priming at age 6 weeks is similar to that at age 14 weeks, IPV could be administered at a younger age and possibly with a higher coverage. Published by Elsevier Ltd.
Authors: Cynthia J Snider; Khalequ Zaman; Concepcion F Estivariz; Mohammad Yunus; William C Weldon; Kathleen A Wannemuehler; M Steven Oberste; Mark A Pallansch; Steven Gf Wassilak; Tajul Islam A Bari; Abhijeet Anand Journal: Lancet Date: 2019-05-16 Impact factor: 79.321
Authors: Ali F Saleem; Ondrej Mach; Mohammad T Yousafzai; Asia Khan; William C Weldon; M Steven Oberste; Syed S Zaidi; Muhammad M Alam; Farheen Quadri; Roland W Sutter; Anita K M Zaidi Journal: J Infect Dis Date: 2018-01-17 Impact factor: 5.226