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Oral polio vaccine response in the MAL-ED birth cohort study: Considerations for polio eradication strategies.

Publication ,  Journal Article
Pan, WK; Seidman, JC; Ali, A; Hoest, C; Mason, C; Mondal, D; Knobler, SL; Bessong, P; MAL-ED Network Investigators
Published in: Vaccine
January 2019

Immunization programs have leveraged decades of research to maximize oral polio vaccine (OPV) response. Moving toward global poliovirus eradication, the WHO recommended phased OPV-to-IPV replacement on schedules in 2012. Using the MAL-ED prospective birth cohort data, we evaluated the influence of early life exposures impacting OPV immunization by measuring OPV response for serotypes 1 and 3.Polio neutralizing antibody assays were conducted at 7 and 15 months of age for serotypes 1 and 3. Analyses were conducted on children receiving ≥3 OPV doses (n = 1449). History of vaccination, feeding patterns, physical growth, home environment, diarrhea, enteropathogen detection, and gut inflammation were examined as risk factors for non-response [Log2(titer) < 3] and Log2(titer) by serotype using multivariate regression.Serotype 1 seroconversion was significantly higher than serotype 3 (96.6% vs. 89.6%, 15 months). Model results indicate serotypes 1 and 3 failure was minimized following four and six OPV doses, respectively; however, enteropathogen detection and poor socioeconomic conditions attenuated response in both serotypes. At three months of age, bacterial detection in stool reduced serotype 1 and 3 Log2 titers by 0.34 (95% CI 0.14-0.54) and 0.53 (95% CI 0.29-0.77), respectively, and increased odds of serotype 3 failure by 3.0 (95% CI 1.6-5.8). Our socioeconomic index, consisting of Water, Assets, Maternal education, and Income (WAMI), was associated with a 0.79 (95% CI 0.15-1.43) and 1.23 (95% CI 0.34-2.12) higher serotype 1 and 3 Log2 titer, respectively, and a 0.04 (95% CI 0.002-0.40) lower odds of serotype 3 failure. Introduction of solids, transferrin receptor, and underweight were differentially associated with serotype response. Other factors, including diarrheal frequency and breastfeeding practices, were not associated with OPV response.Under real-world conditions, improved vaccination coverage and socio-environmental conditions, and reducing early life bacterial exposures are key to improving OPV response and should inform polio eradication strategies.

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Published In

Vaccine

DOI

EISSN

1873-2518

ISSN

0264-410X

Publication Date

January 2019

Volume

37

Issue

2

Start / End Page

352 / 365

Related Subject Headings

  • Virology
  • Vaccination Coverage
  • Serogroup
  • Poliovirus Vaccine, Oral
  • Poliovirus Vaccine, Inactivated
  • Poliovirus
  • Poliomyelitis
  • Neutralization Tests
  • Male
  • Infant
 

Citation

APA
Chicago
ICMJE
MLA
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Pan, W. K., Seidman, J. C., Ali, A., Hoest, C., Mason, C., Mondal, D., … MAL-ED Network Investigators. (2019). Oral polio vaccine response in the MAL-ED birth cohort study: Considerations for polio eradication strategies. Vaccine, 37(2), 352–365. https://doi.org/10.1016/j.vaccine.2018.05.080
Pan, William K., Jessica C. Seidman, Asad Ali, Christel Hoest, Carl Mason, Dinesh Mondal, Stacey L. Knobler, Pascal Bessong, and MAL-ED Network Investigators. “Oral polio vaccine response in the MAL-ED birth cohort study: Considerations for polio eradication strategies.Vaccine 37, no. 2 (January 2019): 352–65. https://doi.org/10.1016/j.vaccine.2018.05.080.
Pan WK, Seidman JC, Ali A, Hoest C, Mason C, Mondal D, et al. Oral polio vaccine response in the MAL-ED birth cohort study: Considerations for polio eradication strategies. Vaccine. 2019 Jan;37(2):352–65.
Pan, William K., et al. “Oral polio vaccine response in the MAL-ED birth cohort study: Considerations for polio eradication strategies.Vaccine, vol. 37, no. 2, Jan. 2019, pp. 352–65. Epmc, doi:10.1016/j.vaccine.2018.05.080.
Pan WK, Seidman JC, Ali A, Hoest C, Mason C, Mondal D, Knobler SL, Bessong P, MAL-ED Network Investigators. Oral polio vaccine response in the MAL-ED birth cohort study: Considerations for polio eradication strategies. Vaccine. 2019 Jan;37(2):352–365.
Journal cover image

Published In

Vaccine

DOI

EISSN

1873-2518

ISSN

0264-410X

Publication Date

January 2019

Volume

37

Issue

2

Start / End Page

352 / 365

Related Subject Headings

  • Virology
  • Vaccination Coverage
  • Serogroup
  • Poliovirus Vaccine, Oral
  • Poliovirus Vaccine, Inactivated
  • Poliovirus
  • Poliomyelitis
  • Neutralization Tests
  • Male
  • Infant