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印度小剂量灭活脊髓灰质炎疫苗的免疫原性。

Immunogenicity of Fractional Dose Inactivated Poliovirus Vaccine in India.

机构信息

Office of the WHO Representative to India, New Delhi, India.

World Health Organization, Geneva, Switzerland.

出版信息

J Pediatric Infect Dis Soc. 2022 Feb 23;11(2):60-68. doi: 10.1093/jpids/piab091.

Abstract

INTRODUCTION

Following the withdrawal of Sabin type 2 from trivalent oral poliovirus vaccine (tOPV) in 2016, the introduction of ≥1 dose of inactivated poliovirus vaccine (IPV) in routine immunization was recommended, either as 1 full dose (0.5mL, intramuscular) or 2 fractional doses of IPV (fIPV-0.1mL, intradermal). India opted for fIPV. We conducted a comparative assessment of IPV and fIPV.

METHODS

This was a 4-arm, open-label, multicenter, randomized controlled trial. Infants were enrolled and vaccines administered according to the study design, and the blood was drawn at age 6, 14, and 18 weeks for neutralization testing against all 3 poliovirus types.

RESULTS

Study enrolled 799 infants. The seroconversion against type 2 poliovirus with 2 fIPV doses was 85.8% (95% confidence interval [CI]: 80.1%-90.0%) when administered at age 6 and 14 weeks, 77.0% (95% CI: 70.5-82.5) when given at age 10 and 14 weeks, compared to 67.9% (95% CI: 60.4-74.6) following 1 full-dose IPV at age 14 weeks.

CONCLUSION

The study demonstrated the superiority of 2 fIPV doses over 1 full-dose IPV in India. Doses of fIPV given at 6 and 14 weeks were more immunogenic than those given at 10 and 14 weeks. Clinical Trial Registry of India (CTRI). Clinical trial registration number was CTRI/2017/02/007793.

摘要

引言

2016 年,三价口服脊髓灰质炎疫苗(tOPV)中撤下萨宾型 2 后,建议在常规免疫中引入至少 1 剂灭活脊髓灰质炎疫苗(IPV),可以是 1 全剂量(0.5 毫升,肌肉注射)或 2 半剂量的 IPV(fIPV-0.1 毫升,皮内注射)。印度选择了 fIPV。我们对 IPV 和 fIPV 进行了比较评估。

方法

这是一项四臂、开放标签、多中心、随机对照试验。根据研究设计招募婴儿并接种疫苗,并在 6、14 和 18 周龄时抽取血液进行针对所有 3 种脊髓灰质炎病毒类型的中和抗体检测。

结果

该研究纳入了 799 名婴儿。当在 6 周和 14 周龄时接种 2 剂 fIPV 时,针对 2 型脊髓灰质炎病毒的血清转化率为 85.8%(95%置信区间[CI]:80.1%-90.0%),当在 10 周和 14 周龄时接种时,血清转化率为 77.0%(95% CI:70.5-82.5),而在 14 周龄时接种 1 剂全剂量 IPV 时,血清转化率为 67.9%(95% CI:60.4-74.6)。

结论

该研究表明,在印度,2 剂 fIPV 优于 1 剂全剂量 IPV。在 6 周和 14 周龄时接种的 fIPV 剂量比在 10 周和 14 周龄时接种的剂量更具免疫原性。印度临床试验注册中心(CTRI)。临床试验注册号为 CTRI/2017/02/007793。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/76a1/8865014/bac55c8df716/piab091f0001.jpg

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