Enteric infections decreased immunogenicity of oral polio vaccine
Parker E. J Infect Dis. 2014;doi:10.1093/infdis/jiu182.
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April 8, 2014
The presence of enteric infections at the time of vaccination impaired the immunogenicity of the oral poliovirus vaccine, researchers from Imperial College London have found.
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“While the present review validates the potential contribution of enteric infections to impaired oral vaccine performance in low-income settings, further research is required to determine the full extent of this contribution, as well as the best strategies towards overcoming its detrimental effects,” the researchers wrote in The Journal of Infectious Diseases.
The researchers conducted a systematic review of 25 trials on oral polio vaccine. There were 16 studies that focused on the per-dose serological response to the vaccine among those with and without non-polio enteroviruses (NPEV). They found that the presence of NPEVs inhibited the seroconversion rate for type 1 poliovirus (OR=0.44; 95% CI, 0.23-0.84) but not types 2 or 3. They also found that concurrent NPEVs was associated with a decrease in the odds of shedding for serotype 1 (OR=0.5; 95% CI, 0.28-0.89) but not serotypes 2 and 3.
Four trials also focused on the effect of concurrent diarrhea on response to the oral poliovirus vaccine. It was associated with a significant decrease in per-dose seroconversion for types 2 (OR=0.52; 95% CI, 0.34-0.9) and 3 (OR=0.45; 95% CI, 0.26-0.78) but not type 1.
“Further research is warranted to determine the relative influence of particular pathogens, as well as the potential role of the gut microbiota as a whole in shaping [oral poliovirus vaccine] response,” the researchers wrote. “These questions are relevant not only to polio eradication efforts, but to the use of oral vaccines in general.”