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Efficacy of inactivated poliovirus vaccine in India

Science  22 Aug 2014:
Vol. 345, Issue 6199, pp. 922-925
DOI: 10.1126/science.1255006

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Two vaccines together are better than one alone

Polio is proving difficult to eradicate. Making the choice between administering a live attenuated vaccine orally (Sabin) or an inactivated vaccine (Salk) by injection has been highly controversial. Patients prefer the Sabin vaccine, but it requires many doses to offer immunity. Jafari et al. tested the two vaccines together in northern India. The injected vaccine significantly reduced virus shedding and boosted intestinal mucosal immunity in children already given the oral vaccine. Thus, using both vaccines could help speed the eventual global demise of polio.

Science, this issue p. 922

Abstract

Inactivated poliovirus vaccine (IPV) is efficacious against paralytic disease, but its effect on mucosal immunity is debated. We assessed the efficacy of IPV in boosting mucosal immunity. Participants received IPV, bivalent 1 and 3 oral poliovirus vaccine (bOPV), or no vaccine. A bOPV challenge was administered 4 weeks later, and excretion was assessed 3, 7, and 14 days later. Nine hundred and fifty-four participants completed the study. Any fecal shedding of poliovirus type 1 was 8.8, 9.1, and 13.5% in the IPV group and 14.4, 24.1, and 52.4% in the control group by 6- to 11-month, 5-year, and 10-year groups, respectively (IPV versus control: Fisher’s exact test P < 0.001). IPV reduced excretion for poliovirus types 1 and 3 between 38.9 and 74.2% and 52.8 and 75.7%, respectively. Thus, IPV in OPV-vaccinated individuals boosts intestinal mucosal immunity.

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