Mucosal immunity after vaccination with monovalent and trivalent oral poliovirus vaccine in India.
BACKGROUND
Persistent wild-poliovirus transmission, particularly in India, has raised questions about the degree of mucosal immunity induced by oral poliovirus vaccine (OPV) in tropical countries.


METHODS
Excretion of vaccine poliovirus after challenge with OPV was measured in stool samples collected from children identified by the acute flaccid paralysis surveillance program in India during 2005-2007. The effectiveness of trivalent and monovalent OPV against excretion of each poliovirus type was estimated.


RESULTS
Vaccine poliovirus was isolated from 4994 (5.2%) of 96,641 children with 2 stool samples. The relative odds of excreting challenge poliovirus among children with 5 reported previous doses of trivalent OPV compared with 0 previous doses was 0.24 (95% confidence interval [CI], 0.12-0.45), 0.08 (95% CI, 0.04-0.14), and 0.40 (95% CI, 0.19-0.85) for serotypes 1, 2, and 3, respectively, but the relative odds increased to 0.62 (95% CI, 0.44-0.88), 0.44 (95% CI, 0.20-0.99), and 0.66 (95% CI, 0.41-1.06), respectively, in the northern states of Uttar Pradesh and Bihar. In these 2 states, the relative odds of excretion of serotype 1 was 0.32 (95% CI, 0.26-0.41) after 5 doses of type 1 monovalent OPV.


CONCLUSIONS
The mucosal immunity induced by OPV in India varies by location, serotype, and vaccine formulation. These findings have implications for global eradication and the potential role played by inactivated vaccine in this setting.
Grassly
Nicholas C
NC
Department of Infectious Disease Epidemiology, Imperial College London, United Kingdom. n.grassly@imperial.ac.uk
Jafari
Hamid
H
Bahl
Sunil
S
Durrani
Sunita
S
Wenger
Jay
J
Sutter
Roland W
RW
Aylward
R Bruce
RB
D002675:Child, Preschool; D005243:Feces / Q000821:virology*; D005260:Female; D006801:Humans; D018928:Immunity, Mucosal; D007194:India; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D017955:Poliovirus / Q000302:isolation & purification*; D011055:Poliovirus Vaccine, Oral / Q000276:immunology*; D017201:Virus Shedding / Q000276:immunology*
D011055:Poliovirus Vaccine, Oral