Charting the Impact of Maternal Antibodies and Repeat Exposures on Sapovirus Immunity in Early Childhood From a Nicaraguan Birth Cohort

Background Sapovirus is an important cause of acute gastroenteritis in childhood. While vaccines against sapovirus may reduce gastroenteritis burden, a major challenge to their development is a lack of information about natural immunity. Methods We measured sapovirus-specific IgG in serum collected between 2017 and 2020 of mothers soon after delivery and at 6 time points in Nicaraguan children until 3 years of age (n = 112 dyads), using virus-like particles representing 3 sapovirus genotypes (GI.1, GI.2, GV.1). Results Of the 112 children, 16 (14.3%) experienced at least 1 sapovirus gastroenteritis episode, of which GI.1 was the most common genotype. Seroconversion to GI.1 and GI.2 was most common between 5 and 12 months of age, while seroconversion to GV.1 peaked at 18 to 24 months of age. All children who experienced sapovirus GI.1 gastroenteritis seroconverted and developed genotype-specific IgG. The impact of sapovirus exposure on population immunity was determined by antigenic cartography: newborns share their mothers’ broadly binding IgG responses, which declined at 5 months of age and then increased as infants experienced natural sapovirus infections. Conclusions By tracking humoral immunity to sapovirus over the first 3 years of life, this study provides important insights for the design and timing of future pediatric sapovirus vaccines.