Abstract
A fractional dose of inactivated poliovirus vaccine (fIPV) administered by the intradermal route delivers one fifth of the full vaccine dose administered by the intramuscular route and offers a potential dose-sparing strategy to stretch the limited global IPV supply while further improving population immunity. Multiple studies have assessed immunogenicity of intradermal fIPV compared with the full intramuscular dose and demonstrated encouraging results. Novel intradermal devices, including intradermal adapters and disposable-syringe jet injectors, have also been developed and evaluated as alternatives to traditional Bacillus Calmette–Guérin needles and syringes for the administration of fIPV. Initial experience in India, Pakistan, and Sri Lanka suggests that it is operationally feasible to implement fIPV vaccination on a large scale. Given the available scientific data and operational feasibility shown in early-adopter countries, countries are encouraged to consider introducing a fIPV strategy into their routine immunization and supplementary immunization activities.
Highlights
A series of clinical studies, many conducted within the past 5 years, have evaluated the humoral immunity of fIPV administered intradermally through a variety of vaccine delivery devices compared with a full intramuscular dose when provided as primary vaccination in a 2or 3-dose series using different vaccination schedules
The studies found that cumulative seroconversion rates (a ≥4-fold increase over the expected decline in maternally derived antibody titers) for all polio serotypes following the complete vaccination series were comparable between the fIPV and intramuscular IPV groups when there was less interference with maternal antibody
Geometric mean titers (GMTs) for type 2 poliovirus were 94.0 among infants in the fIPV group and 132.5 in the full-dose group. These results suggest that immunity induced by fIPV likely lasts as long as immunity induced by full-dose IPV
Summary
Humoral Immune Responses Humoral immunity (antibody response) protects an individual from paralytic disease. A series of clinical studies, many conducted within the past 5 years, have evaluated the humoral immunity of fIPV (using 0.1 mL, one fifth of the full 0.5-mL dose) administered intradermally through a variety of vaccine delivery devices (eg, Bacillus Calmette–Guérin [BCG] needles and syringes, hollow microneedles, needle-free jet injectors) compared with a full intramuscular dose when provided as primary vaccination in a 2or 3-dose series using different vaccination schedules These studies—conducted in Cuba [12, 13], Oman [14], Philippines [15], and Bangladesh [16]—evaluated immunogenicity by examining seroconversion rates and antibody levels following vaccination.
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