August 5, 2020The Journal of Infectious DiseasesOpen Access

One-Year Decline of Poliovirus Antibodies Following Fractional-Dose Inactivated Poliovirus Vaccine

Q: What is the clinical evidence from this study?

Study design: RCT. Population: Poliovirus immunization (n=250). Intervention: Fractional-dose inactivated poliovirus vaccine (fIPV) vs. Full-dose inactivated poliovirus vaccine (IPV). Primary outcome: Seroprevalence of poliovirus type 2 antibodies at 21 months (p=0.004).

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Key result

Fractional-dose inactivated poliovirus vaccine resulted in a poliovirus type 2 antibody seroprevalence of 67% at 21 months compared to 86% with full-dose IPV (P=0.004).

Why the study?

Fractional-dose inactivated poliovirus vaccine is used as a dose-sparing strategy, but data comparing the rate of antibody decline between two doses of fIPV and full IPV were needed.

Does fractional-dose inactivated poliovirus vaccine provide similar seroprevalence and rate of antibody decline compared to full-dose IPV in infants?

Population

Children aged 14 weeks in Karachi, Pakistan

Comparison

2 doses of fIPV vs 2 doses of full IPV

Design

Community-based randomized controlled trial

Follow-up

Age 21 months

Authors

ASAli Faisal SaleemAga Khan University Hospital OMOndrej MachWorld Health Organization MYMohammad Tahir YousafzaiAga Khan University

Discussion

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Implication

Fractional-dose IPV is inferior for durable type 2 seroprevalence; challenges dose-sparing strategies in polio immunization programs.

Study Design

Type

RCT (n=250)

Randomization

randomized

Multicenter

Structured PICO

Does fractional-dose inactivated poliovirus vaccine provide similar seroprevalence and rate of antibody decline compared to full-dose IPV in infants?

Population

250 children aged 14 weeks randomized to receive 2 doses of fractional or full-dose inactivated poliovirus vaccine, with follow-up to 21 months of age.

Intervention

Fractional dose (one-fifth of full intramuscular dose, 0.1 mL) of inactivated poliovirus vaccine (fIPV) administered intradermally. Administered at 14 weeks and 9 months of age (Arm B), or at 9 months of age only (Arm D).

Comparator

Full dose (0.5 mL) of inactivated poliovirus vaccine (IPV) administered intramuscularly. Administered at 14 weeks and 9 months of age (Arm A), or at 9 months of age only (Arm C).

Outcome

Seroprevalence and seroconversion of antibodies to poliovirus type 2surrogate

Main Result

Absolute Event Rate: 67% vs 86%

p-value: p=0.004

Fractional-dose IPV induces a similar slope of neutralizing antibody decay compared to full-dose IPV, supporting its use as a viable dose-sparing strategy.

Limitations

Upper bound of reported titers limited ability to precisely evaluate rate of titer decline
96 subjects excluded due to receiving an extra IPV dose during an outbreak response campaign
Generalizability of type 1 seroprevalence data may be limited

Cite This Study

Saleem et al. (2020) conducted an RCT in Poliovirus immunization (n=250). Fractional-dose inactivated poliovirus vaccine (fIPV) vs. Full-dose inactivated poliovirus vaccine (IPV) was evaluated on Seroprevalence of poliovirus type 2 antibodies at 21 months (p=0.004). Fractional-dose inactivated poliovirus vaccine resulted in a poliovirus type 2 antibody seroprevalence of 67% at 21 months compared to 86% with full-dose IPV (P=0.004).

synapsesocial.com/papers/6a9e902fc017a53f8ef0c5fb https://doi.org/10.1093/infdis/jiaa504

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One-Year Decline of Poliovirus Antibodies Following Fractional-Dose Inactivated Poliovirus Vaccine

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

One-Year Decline of Poliovirus Antibodies Following Fractional-Dose Inactivated Poliovirus Vaccine

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

Also Consider