Global Virus Network, Middle East Region, Shiraz, Iran.
R&D Headquarters, Petroleum Industry Health Organization, Shiraz, Iran.
JAMA Netw Open. 2021 Nov 1;4(11):e2135044. doi: 10.1001/jamanetworkopen.2021.35044.
Live attenuated vaccines may provide short-term protection against infectious diseases through stimulation of the innate immune system.
To evaluate whether passive exposure to live attenuated poliovirus is associated with diminished symptomatic infection with SARS-CoV-2.
DESIGN, SETTING, AND PARTICIPANTS: In a longitudinal cohort study involving 87 923 people conducted between March 20 and December 20, 2020, the incidence of COVID-19 was compared between 2 groups of aged-matched women with and without exposure to live attenuated poliovirus in the oral polio vaccine (OPV). Participants were people receiving health care services from the Petroleum Industry Health Organization and residing in 2 cities in Iran (ie, Ahwaz and Shiraz). Participants were women aged 18 to 48 years whose children were aged 18 months or younger and a group of age-matched women from the same residence who had had no potential exposure to OPV.
Indirect exposure to live attenuated poliovirus in OPV.
Symptomatic COVID-19, diagnosed by reverse transcription-polymerase chain reaction.
After applying the inclusion and exclusion criteria, 419 mothers (mean [SD] age, 35.5 [4.9] years) indirectly exposed to the OPV and 3771 age-matched women (mean [SD] age, 35.7 [5.3] years) who had no exposure to OPV were available for analysis. COVID-19 was diagnosed in 1319 of the 87 923 individuals in the study population (151 per 10 000 population) during the study period. None of the mothers whose children received OPV developed COVID-19 after a median follow-up of 141 days (IQR, 92-188 days; range, 1-270 days); 28 women (0.74%; 95% CI, 0.47%-1.02%) in the unexposed group were diagnosed with COVID-19 during the 9 months of the study. Point-by-point comparison of the survival curves of the exposed and unexposed groups found that indirect exposure to OPV was significantly associated with decreased COVID-19 acquisition; probability of remaining without infection was 1.000 (95% CI, 1.000-1.000) in the exposed group vs 0.993 (95% CI, 0.990-0.995) in the unexposed group after 9 months (P < .001).
In this cohort study, indirect exposure to live attenuated poliovirus was associated with decreased symptomatic infection with COVID-19. Further study of the potential protective effect of OPV should be conducted, especially in nations where OPV is already in use for polio prevention and specific COVID-19 vaccines are delayed, less affordable, or fail to meet demand.
减毒活疫苗可通过刺激先天免疫系统提供针对传染病的短期保护。
评估被动接触减毒脊髓灰质炎病毒是否与 SARS-CoV-2 的症状性感染减少有关。
设计、地点和参与者：在一项涉及 2020 年 3 月 20 日至 12 月 20 日期间进行的 87923 人的纵向队列研究中，比较了两组年龄匹配的女性，一组在口服脊髓灰质炎疫苗（OPV）中接触过减毒脊髓灰质炎病毒，另一组未接触过。参与者是从伊朗石油工业健康组织接受医疗服务并居住在两个城市（即阿瓦兹和设拉子）的人。参与者是年龄在 18 至 48 岁之间的女性，其子女年龄在 18 个月或以下，另一组年龄匹配的女性来自同一住所，没有接触过 OPV 的可能性。
OPV 中减毒脊髓灰质炎病毒的间接接触。
通过逆转录-聚合酶链反应诊断的有症状 COVID-19。
在应用纳入和排除标准后，419 名间接接触 OPV 的母亲（平均[SD]年龄，35.5[4.9]岁）和 3771 名年龄匹配的未接触 OPV 的女性（平均[SD]年龄，35.7[5.3]岁）可进行分析。在研究期间，研究人群中 87923 名个体中有 1319 人（151 人/10000 人）被诊断出患有 COVID-19。在中位数随访 141 天（IQR，92-188 天；范围，1-270 天）后，接受 OPV 的儿童中没有母亲患 COVID-19；在未暴露组中，有 28 名女性（0.74%；95%CI，0.47%-1.02%）在研究期间被诊断出患有 COVID-19。暴露组和未暴露组的生存曲线的逐点比较发现，OPV 的间接接触与 COVID-19 的获得显著相关；在 9 个月后，未暴露组的感染率为 0.993（95%CI，0.990-0.995），而暴露组为 1.000（95%CI，1.000-1.000）（P <.001）。
在这项队列研究中，减毒脊髓灰质炎病毒的间接接触与 COVID-19 的症状性感染减少有关。应进一步研究 OPV 的潜在保护作用，特别是在已经使用 OPV 预防小儿麻痹症且特定 COVID-19 疫苗延迟、价格昂贵或无法满足需求的国家。
