Immunity and field efficacy of type 2-containing polio vaccines after cessation of trivalent oral polio vaccine: A population-based serological study in Pakistan
Background: In Pakistan and other countries using oral polio vaccine (OPV), immunity to type 2 poliovirus is now maintained by a single dose of inactivated polio vaccine (IPV) in routine immunization, supplemented in outbreak settings by monovalent OPV type 2 (mOPV2) and IPV. While well-studied in c...
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doaj-5e5791b7d05e4a52bb7044c7727c86952020-11-25T03:56:12ZengElsevierVaccine: X2590-13622020-08-015100067Immunity and field efficacy of type 2-containing polio vaccines after cessation of trivalent oral polio vaccine: A population-based serological study in PakistanArie Voorman0Muhammad Atif Habib1Imtiaz Hussain2Rana Muhammad Safdar3Jamal A. Ahmed4William C. Weldon5Imran Ahmed6Muhammad Umer7Jeffrey Partridge8Sajid Bashir Soofi9Polio Program, Global Development, Bill & Melinda Gates Foundation, USADepartment of Pediatrics & Child Health, The Aga Khan University, PakistanDepartment of Pediatrics & Child Health, The Aga Khan University, PakistanPolio National Emergency Operations Center, Govt of Pakistan, PakistanPolio Eradication Program, World Health Organization, PakistanDivision of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, USADepartment of Pediatrics & Child Health, The Aga Khan University, PakistanDepartment of Pediatrics & Child Health, The Aga Khan University, PakistanPolio Program, Global Development, Bill & Melinda Gates Foundation, USA; Corresponding authors.Department of Pediatrics & Child Health, The Aga Khan University, Pakistan; Corresponding authors.Background: In Pakistan and other countries using oral polio vaccine (OPV), immunity to type 2 poliovirus is now maintained by a single dose of inactivated polio vaccine (IPV) in routine immunization, supplemented in outbreak settings by monovalent OPV type 2 (mOPV2) and IPV. While well-studied in clinical trials, population protection against poliovirus type 2 achieved in routine and outbreak settings is generally unknown. Methods: We conducted two phases of a population-based serological survey of 7940 children aged 6–11 months old, between November 2016 and October 2017 from 13 polio high-risk locations in Pakistan. Results: Type 2 seroprevalence was 50% among children born after trivalent OPV (tOPV) withdrawal (April 2016), with heterogeneity across survey areas. Supplementary immunization activities (SIAs) with mOPV2 followed by IPV improved population immunity, varying from 89% in Pishin to 64% in Killa Abdullah, with little observed marginal benefit of subsequent campaigns. In the other high-risk districts surveyed, a single SIA with IPV was conducted and appeared to improve immunity to 57% in Karachi to 84% in Khyber. Conclusions: Our study documents declining population immunity following trivalent OPV withdrawal in Pakistan, and wide heterogeneity in the population impact of supplementary immunization campaigns. Differences between areas, attributable to vaccination campaign coverage, were far more important for type 2 humoral immunity than the number of vaccination campaigns or vaccines used. This emphasizes the importance of immunization campaign coverage for type 2 outbreak response in the final stages of polio eradication. Given the declining type 2 immunity in new birth cohorts it is also recommended that 2 or more doses of IPV should be introduced in the routine immunization program of Pakistan.http://www.sciencedirect.com/science/article/pii/S2590136220300140 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Arie Voorman Muhammad Atif Habib Imtiaz Hussain Rana Muhammad Safdar Jamal A. Ahmed William C. Weldon Imran Ahmed Muhammad Umer Jeffrey Partridge Sajid Bashir Soofi |
spellingShingle |
Arie Voorman Muhammad Atif Habib Imtiaz Hussain Rana Muhammad Safdar Jamal A. Ahmed William C. Weldon Imran Ahmed Muhammad Umer Jeffrey Partridge Sajid Bashir Soofi Immunity and field efficacy of type 2-containing polio vaccines after cessation of trivalent oral polio vaccine: A population-based serological study in Pakistan Vaccine: X |
author_facet |
Arie Voorman Muhammad Atif Habib Imtiaz Hussain Rana Muhammad Safdar Jamal A. Ahmed William C. Weldon Imran Ahmed Muhammad Umer Jeffrey Partridge Sajid Bashir Soofi |
author_sort |
Arie Voorman |
title |
Immunity and field efficacy of type 2-containing polio vaccines after cessation of trivalent oral polio vaccine: A population-based serological study in Pakistan |
title_short |
Immunity and field efficacy of type 2-containing polio vaccines after cessation of trivalent oral polio vaccine: A population-based serological study in Pakistan |
title_full |
Immunity and field efficacy of type 2-containing polio vaccines after cessation of trivalent oral polio vaccine: A population-based serological study in Pakistan |
title_fullStr |
Immunity and field efficacy of type 2-containing polio vaccines after cessation of trivalent oral polio vaccine: A population-based serological study in Pakistan |
title_full_unstemmed |
Immunity and field efficacy of type 2-containing polio vaccines after cessation of trivalent oral polio vaccine: A population-based serological study in Pakistan |
title_sort |
immunity and field efficacy of type 2-containing polio vaccines after cessation of trivalent oral polio vaccine: a population-based serological study in pakistan |
publisher |
Elsevier |
series |
Vaccine: X |
issn |
2590-1362 |
publishDate |
2020-08-01 |
description |
Background: In Pakistan and other countries using oral polio vaccine (OPV), immunity to type 2 poliovirus is now maintained by a single dose of inactivated polio vaccine (IPV) in routine immunization, supplemented in outbreak settings by monovalent OPV type 2 (mOPV2) and IPV. While well-studied in clinical trials, population protection against poliovirus type 2 achieved in routine and outbreak settings is generally unknown. Methods: We conducted two phases of a population-based serological survey of 7940 children aged 6–11 months old, between November 2016 and October 2017 from 13 polio high-risk locations in Pakistan. Results: Type 2 seroprevalence was 50% among children born after trivalent OPV (tOPV) withdrawal (April 2016), with heterogeneity across survey areas. Supplementary immunization activities (SIAs) with mOPV2 followed by IPV improved population immunity, varying from 89% in Pishin to 64% in Killa Abdullah, with little observed marginal benefit of subsequent campaigns. In the other high-risk districts surveyed, a single SIA with IPV was conducted and appeared to improve immunity to 57% in Karachi to 84% in Khyber. Conclusions: Our study documents declining population immunity following trivalent OPV withdrawal in Pakistan, and wide heterogeneity in the population impact of supplementary immunization campaigns. Differences between areas, attributable to vaccination campaign coverage, were far more important for type 2 humoral immunity than the number of vaccination campaigns or vaccines used. This emphasizes the importance of immunization campaign coverage for type 2 outbreak response in the final stages of polio eradication. Given the declining type 2 immunity in new birth cohorts it is also recommended that 2 or more doses of IPV should be introduced in the routine immunization program of Pakistan. |
url |
http://www.sciencedirect.com/science/article/pii/S2590136220300140 |
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