Epidemiology Unit, Ministry of Health, Colombo, Sri Lanka.
Polio Eradication Department, World Health Organization, Geneva, Switzerland.
J Infect Dis. 2019 May 24;219(12):1887-1892. doi: 10.1093/infdis/jiz026.
In July 2016, Sri Lanka replaced 1 intramuscular dose of inactivated poliovirus vaccine (IPV) with 2 doses of intradermal fractional-dose IPV (fIPV) in its routine immunization schedule. We carried out a survey of seroprevalence of antipolio antibodies in children who received 2 fIPV doses and compared it with those who received 1 full IPV dose.
Children born between March and December 2016 were randomly selected from 3 Sri Lankan districts (Colombo, Badulla, and Anuradhapura). Serum samples were collected and tested for presence of neutralizing antibodies to poliovirus types 1, 2, and 3.
Seroprevalence of antipolio antibodies was 100% in all districts for poliovirus type 1 and poliovirus type 3; it ranged between 90% and 93% for poliovirus type 2 (PV2) in children who received 1 full IPV dose and between 78% and 100% in those receiving 2 fIPV doses (P = .22). The median reciprocal titers of anti-PV2 antibodies were similar in children who received full-dose IPV and those who received fIPV (1:64 vs 1:45, respectively; P = .11).
Our study demonstrated not only that Sri Lanka succeeded in maintaining very high primary immunization coverage also but that it is feasible for a national immunization program to implement fIPV immunization and achieve high coverage with intradermal application. The seroprevalence of anti-PV2 antibodies did not decrease after the introduction of fIPV.
2016 年 7 月,斯里兰卡在常规免疫计划中用 2 剂皮内分剂量脊髓灰质炎灭活疫苗(fIPV)替代 1 剂肌内脊髓灰质炎灭活疫苗(IPV)。我们对接受 2 剂 fIPV 剂量的儿童的抗脊灰抗体血清阳性率进行了调查,并将其与接受 1 剂全剂量 IPV 的儿童进行了比较。
从斯里兰卡的 3 个地区(科伦坡、巴杜勒和阿努拉德普勒)随机选择 2016 年 3 月至 12 月出生的儿童。采集血清样本,检测对脊灰病毒 1、2、3 型的中和抗体。
在所有地区,接受 1 剂全剂量 IPV 的儿童脊灰病毒 1 型和 3 型的抗脊灰抗体血清阳性率均为 100%;脊灰病毒 2 型(PV2)的血清阳性率在接受 1 剂全剂量 IPV 的儿童中为 90%至 93%,在接受 2 剂 fIPV 的儿童中为 78%至 100%(P=0.22)。接受全剂量 IPV 和 fIPV 的儿童抗-PV2 抗体的中位数倒数滴度相似(分别为 1:64 和 1:45;P=0.11)。
本研究不仅表明,斯里兰卡成功地保持了非常高的基础免疫覆盖率,而且国家免疫规划实施 fIPV 免疫和通过皮内接种实现高覆盖率是可行的。在引入 fIPV 后,抗-PV2 抗体的血清阳性率并未下降。