Abstract
BackgroundMaternal poliovirus antibodies could provide passive immunity to the newborns from poliovirus infection during their first few months of life, but they may impair the immune responses of infants to the poliovirus vaccine as well. In our study, we pooled the data from three clinical trials of the inactivated poliovirus vaccine (IPV) based on Sabin strains to investigate the effect of maternal poliovirus antibodies on the immune responses of infants to poliovirus vaccines.MethodsThere were five groups in the pooled analysis, including low-dose Sabin IPV, medium-dose Sabin IPV, high-dose Sabin IPV, control Sabin IPV, and control Salk IPV groups. We reclassified the infants in different groups according to their maternal poliovirus antibodies by two methods, the first one included maternal antibody negative (< 1:8) and maternal antibody positive (≥1:8), and the second one included maternal antibody titer < 1:8, 1:8 ~ < 1:32 and ≥ 1:32. Then, we compared the geometric mean titers (GMTs), geometric mean antibody fold increases (GMIs) and seroconversion rates of poliovirus type-specific neutralizing antibodies after vaccination among participants with different maternal poliovirus antibody levels.ResultsThe GMTs and GMIs of three types of poliovirus antibodies after vaccination in maternal antibody negative participants were significantly higher than those in maternal antibody positive participants. The seroconversion rates of type II and type III poliovirus antibodies in maternal antibody positive participants were significantly lower than those in maternal antibody negative participants. Among participants with maternal antibody titer < 1:8, 1:8 ~ < 1:32 and ≥ 1:32, the GMTs and GMIs of three types of poliovirus antibodies after vaccination showed a tendency to decline with the increasing of maternal antibody levels. The seroconversion rates of three types of poliovirus antibodies in participants with maternal antibody titer ≥1:32 were significantly lower than those in participants with maternal antibody titer < 1:8 and 1:8 ~ < 1:32.ConclusionsMaternal poliovirus antibodies interfered with the immune responses of infants to poliovirus vaccines, and a high level of maternal antibodies exhibited a greater dampening effect.Trial registrationClinicalTrials.govNCT04264598 February 11, 2020; ClinicalTrials.govNCT04264546 February 11, 2020; ClinicalTrials.govNCT03902054 April 3, 2019. Retrospectively registered.
Highlights
Maternal poliovirus antibodies could provide passive immunity to the newborns from poliovirus infection during their first few months of life, but they may impair the immune responses of infants to the poliovirus vaccine as well
We compared the geometric mean titers (GMTs), geometric mean antibody fold increases (GMIs) and seroconversion rates of poliovirus typespecific neutralizing antibodies after vaccination among participants with different maternal poliovirus antibody levels, to investigate the effect of maternal poliovirus antibodies on the immune responses of infants to poliovirus vaccines
In the investigational Sabin inactivated poliovirus vaccine (IPV), control Sabin IPV and control Salk IPV groups, the effect of maternal poliovirus antibodies on poliovirus vaccines were consistent, this suggested that this effect may be a common problem in IPV
Summary
Maternal poliovirus antibodies could provide passive immunity to the newborns from poliovirus infection during their first few months of life, but they may impair the immune responses of infants to the poliovirus vaccine as well. We pooled the data from three clinical trials of the inactivated poliovirus vaccine (IPV) based on Sabin strains to investigate the effect of maternal poliovirus antibodies on the immune responses of infants to poliovirus vaccines. Since 2000, the United States has replaced OPV with IPV to eliminate the risk of vaccine-derived polio [5], while OPV is still used in some parts of the world, especially in developing countries, because of its cheapness. The production and quality control of Salk IPV require at least a biosafety level 3 containment facility, while those of IPV based on Sabin strains will have a lower biosafety risk, and increase the availability and affordability of IPV in the low- or middle-income countries [6, 7]
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