• Vaccine · Nov 2015

    Randomized Controlled Trial

    Early priming with inactivated poliovirus vaccine (IPV) and intradermal fractional dose IPV administered by a microneedle device: A randomized controlled trial.

    • Abhijeet Anand, K Zaman, Concepción F Estívariz, Mohammad Yunus, Howard E Gary, William C Weldon, Tajul I Bari, Steven Oberste M M Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30033, United States., Steven G Wassilak, Stephen P Luby, James D Heffelfinger, and Mark A Pallansch.
    • Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30033, United States. Electronic address: aanand@cdc.gov.
    • Vaccine. 2015 Nov 27; 33 (48): 6816-22.

    IntroductionInactivated poliovirus vaccine (IPV) introduction and phased oral poliovirus vaccine (OPV) cessation are essential for eradication of polio.MethodsHealthy 6-week old infants in Bangladesh were randomized to one of five study arms: receipt of trivalent OPV (tOPV) or bivalent OPV (bOPV) at ages 6, 10 and 14 weeks, intramuscular IPV or intradermal one-fifth fractional dose IPV (f-IPV) at ages 6 and 14 weeks, or f-IPV at ages 6 and 14 weeks with bOPV at age 10 weeks (f-IPV/bOPV). All participants received tOPV at age 18 weeks.ResultsOf 975 infants randomized, 95% (922) completed follow-up. Type 1 seroconversion after 3 doses at 6, 10 and 14 weeks was higher with bOPV compared with tOPV (99% vs 94%, p=0.019). Seroconversions to types 1 and 3 after 2 IPV doses at ages 6 and 14 weeks were no different than after 3 doses of tOPV or bOPV at ages 6, 10 and 14 weeks. A priming response, seroconversion 1 week after IPV at 14 weeks among those who did not seroconvert after IPV at 6 weeks, was observed against poliovirus types 1, 2 and 3 in 91%, 84% and 97%, respectively. Compared with IPV, f-IPV failed non-inferiority tests for seroconversion with 1 or 2 doses and priming after 1 dose.DiscussionThe findings demonstrate considerable priming with IPV at age 6 weeks, comparable immunogenicity of tOPV and bOPV, and inferior immunogenicity of one-fifth f-IPV compared with IPV. If IPV induced priming at age 6 weeks is similar to that at age 14 weeks, IPV could be administered at a younger age and possibly with a higher coverage.Published by Elsevier Ltd.

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