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Achieving High Immunogenicity Against Poliovirus With Fractional Doses of Inactivated Poliovirus Vaccine in Ecuador

19 Pages Posted: 15 Nov 2021

See all articles by Gabriel Trueba

Gabriel Trueba

Universidad San Francisco de Quito (USFQ)

Vishali Jeyaseelan

World Health Organization (WHO) - Polio Eradication Department

Lazaro Lopez

Universidad San Francisco de Quito (USFQ)

Bernardo A. Mainou

Government of the United States of America - Division of Viral Diseases

Yiting Zhang

Government of the United States of America - Division of Viral Diseases

Alvaro Whittembury

Pan American Health Organization

Alfredo Jose Olmedo Valarezo

Pan American Health Organization

Gonzalo Baquero

National Polio Certification Commission

Rosa Romero de Aguinaga

National Polio Certification Commission

Lucia Jeannete Zurita Salinas

National Polio Certification Commission

Maria Gabriela Santacruz Mancheno

Ministry of Public Health (Ecuador)

Diana Elizabeth Medina Chacho

Ministry of Public Health (Ecuador)

Emmanuelle Quentin

Universidad UTE

Ana Elena Chevez

Pan American Health Organization - Immunization Unit

Gloria Rey-Benito

Pan American Health Organization - Immunization Unit

Ondrej Mach

World Health Organization (WHO) - Polio Eradication Department

More...

Abstract

Background: In January 2018, Ecuador changed its routine immunization schedule by replacing one full dose of inactivated poliovirus vaccine (IPV) administered intramuscularly at 2 months of age with two doses of fractional IPV (1/5th of full dose, fIPV) administered intradermally at 2 and 4 months of age; bivalent oral poliovirus vaccine (serotypes 1 and 3, bOPV) continues to be used. We compared seroprevalence and titers of polio antibodies achieved by the past and the current immunization schedules.

Methods: This was a cross-sectional serological survey in children in Ecuador who received bOPV and either one IPV dose in 2017 or two fIPV doses in 2018. One blood sample was collected between October 2020 and March 2021 and analysed for presence of poliovirus neutralizing antibodies at CDC, Atlanta by microneutralization assay.

Findings: We obtained 321 analyzable samples from 329 (97·6%) enrolled children (160 received IPV and 161 fIPV). For serotype 2, seroprevalence was 50.0% (CI95%= 44·2-55·8%) for IPV and 83·2% (CI95%=78·5-87·1%) for fIPV recipients (p<0·001). Median antibody titers for serotype 2 were significantly lower for IPV than for fIPV recipients (3·0, CI95%= 3 – 3·5 vs. 4·8, CI95%= 4·5 – 5·2, p<0·001). Seroprevalence for serotypes 1 and 3 was above 90% and was not significantly different between IPV and fIPV recipients.

Interpretation: Ecuador achieved significantly better poliovirus serotype 2 immunogenicity with two fIPV doses than with one IPV dose, while preserving vaccine supply and reducing costs. Our data provide further evidence that fIPV is a beneficial and cost-effective option in polio immunization.

Funding Information: The World Health Organization to the University of San Francisco.

Declaration of Interests: All authors – no conflict of interest declared.

Ethics Approval Statement: The protocol was reviewed and approved by the Human Research Ethics Committee - CEISH-USFQ and by the Ethics Review Committee at the WHO in Geneva. After obtaining informed consent the children were enrolled.

Suggested Citation

Trueba, Gabriel and Jeyaseelan, Vishali and Lopez, Lazaro and Mainou, Bernardo A. and Zhang, Yiting and Whittembury, Alvaro and Olmedo Valarezo, Alfredo Jose and Baquero, Gonzalo and Romero de Aguinaga, Rosa and Zurita Salinas, Lucia Jeannete and Santacruz Mancheno, Maria Gabriela and Medina Chacho, Diana Elizabeth and Quentin, Emmanuelle and Chevez, Ana Elena and Rey-Benito, Gloria and Mach, Ondrej, Achieving High Immunogenicity Against Poliovirus With Fractional Doses of Inactivated Poliovirus Vaccine in Ecuador. Available at SSRN: https://ssrn.com/abstract=3963779 or http://dx.doi.org/10.2139/ssrn.3963779

Gabriel Trueba

Universidad San Francisco de Quito (USFQ) ( email )

Diego de Robles y Vía Interoceánic
Campus Cumbayá
QUITO, PICHINCHA 17-1200-84
Ecuador

Vishali Jeyaseelan

World Health Organization (WHO) - Polio Eradication Department ( email )

Geneva
Switzerland

Lazaro Lopez

Universidad San Francisco de Quito (USFQ) ( email )

Diego de Robles y Vía Interoceánic
Campus Cumbayá
QUITO, PICHINCHA 17-1200-84
Ecuador

Bernardo A. Mainou

Government of the United States of America - Division of Viral Diseases ( email )

Atlanta
United States

Yiting Zhang

Government of the United States of America - Division of Viral Diseases ( email )

Atlanta
United States

Alvaro Whittembury

Pan American Health Organization ( email )

Washington, DC
United States

Alfredo Jose Olmedo Valarezo

Pan American Health Organization ( email )

Washington, DC
United States

Gonzalo Baquero

National Polio Certification Commission ( email )

Ecuador

Rosa Romero de Aguinaga

National Polio Certification Commission ( email )

Ecuador

Lucia Jeannete Zurita Salinas

National Polio Certification Commission ( email )

Ecuador

Maria Gabriela Santacruz Mancheno

Ministry of Public Health (Ecuador) ( email )

Quito
Ecuador

Diana Elizabeth Medina Chacho

Ministry of Public Health (Ecuador) ( email )

Quito
Ecuador

Emmanuelle Quentin

Universidad UTE ( email )

Calle Rumipamba s/n
entre Bourgeois y Atahualpa
Quito, Pichincha
Ecuador
+593 98 149 6522 (Phone)

HOME PAGE: http://https://orcid.org/0000-0001-5600-2361

Ana Elena Chevez

Pan American Health Organization - Immunization Unit ( email )

Washington
United States

Gloria Rey-Benito

Pan American Health Organization - Immunization Unit ( email )

Washington
United States

Ondrej Mach (Contact Author)

World Health Organization (WHO) - Polio Eradication Department ( email )

Geneva
Switzerland

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