Sequential administration of IPV and OPV significantly increased seroprevalence to poliovirus type 3 at 10 months compared to OPV alone (96% and 91% vs 80%; P<0.001).
RCT (n=547)
Does sequential use of IPV followed by OPV improve poliovirus seroprevalence and geometric mean titers in infants compared to OPV alone?
Sequential administration of IPV followed by OPV significantly improves seroprevalence for poliovirus type 3 compared to OPV alone, though two OPV doses following 3 IPV doses did not significantly increase seroprevalence for types 2 and 3.
Absolute Event Rate: 96% vs 80%
p-value: p=< .001
Seroprevalence and geometric mean titers (GMTs) were compared at 6 and 10 months after vaccination with monovalent type 1 oral poliovirus vaccine (OPV) at 6 months and trivalent OPV at 7 and 9 months. Group 1 had received 4 doses of OPV, group 2 OPV at birth and 3 doses of OPV and inactivated poliovirus vaccine (IPV), and group 3 placebo at birth and 3 doses of IPV. A total of 547 infants completed the study. At 10 months, seroprevalence to poliovirus type 1 was 98%, 99%, and 98% in groups 1, 2, and 3; 100%, 100%, and 98% to poliovirus type 2; and 80%, 96%, and 91% to poliovirus type 3. Differences in seroprevalence among the groups were significant for poliovirus type 3 (P < .001). Between 6 and 10 months, significant increases in seroprevalence and GMTs occurred for poliovirus type 1 but not for types 2 and 3. Two OPV doses following 3 IPV doses did not significantly increase seroprevalence or raise GMTs for poliovirus types 2 and 3; however, significant increases were found for poliovirus type 1, which may have benefitted from monovalent type 1 administration.
Sutter et al. (1997) conducted an RCT in Poliovirus immunization (n=547). Inactivated poliovirus vaccine (IPV) and oral poliovirus vaccine (OPV) vs. 4 doses of OPV (Group 1) was evaluated on Seroprevalence to poliovirus type 3 at 10 months (p=< .001). Sequential administration of IPV and OPV significantly increased seroprevalence to poliovirus type 3 at 10 months compared to OPV alone (96% and 91% vs 80%; P<0.001).