Poliovirus shedding after the first and second doses of trivalent polio vaccines in newborns

Main Article Content

Viramitha K. Rusmil
Meita Dhamayanti
Sunarjati Soedigdo Adi
Imam Megantara

Abstract

Background The trivalent oral polio vaccine (tOPV) produced by Bio Farma consists of three live, attenuated poliovirus serotypes (1, 2, and 3). The tOPV stimulates the formation of secretory IgA (sIgA) on the intestinal wall and lumen. The existence of sIgA is considered giving immunity in the intestines, it could prevent the spread of viral replication and thus inhibit the transmission of the polio virus.
Objective To determine the differences in shedding after each of the first two tOPV immunizations in newborns.
Methods This one-way repeated measure study was conducted in newborns from three primary health centers in Bandung, West Java. After administering tOPV to newborns, we assessed the shedding of poliovirus in their stool specimens at 30 days after the first dose and 7 days after the second dose. Data was analyzed using McNemar test with 95% confidence intervals (CI) to differentiate the shedding of poliovirus after the first and second doses.
Results Of 150 children, 128 subjects completed the study. At 30 days after the first tOPV dose, 26 subjects (20.3%) were negative for shedding of poliovirus in stool specimens. Of the 102 subjects who had poliovirus isolated from their stools, the serotypes comprised of polio 1: 10.9%, polio 2: 14.8%, polio 3: 45.3%, polio 1 and 3: 3.1%, polio 2 and 3: 4.7%, and polio 1,2, and 3: 0.8%. At 7 days after the second tOPV dose, there was a significant increase in subjects negative for shedding of poliovirus (78 subjects; 60.9%). Statistical analysis revealed significantly decreased shedding of poliovirus in stool specimens between the first and second doses of tOPV (P<0.05 ).
Conclusion There is a significantly decreased number of subjects with shedding of poliovirus in stool specimens 7 days after the second tOPV dose than at 30 days after the first tOPV dose.

Article Details

How to Cite
1.
Rusmil VK, Dhamayanti M, Adi S, Megantara I. Poliovirus shedding after the first and second doses of trivalent polio vaccines in newborns. PI [Internet]. 31Jul.2015 [cited 18Oct.2019];55(4):219-3. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/31
Section
Articles
Received 2015-12-02
Accepted 2015-12-02
Published 2015-07-31

References

1. Departemen Kesehatan Republik Republik Indonesia. Pedoman penyelenggaraan imunisasi. Jakarta: Depkes RI; 2000. p. 2–3.
2. Ismail S, Hadinegoro SR. Program pengembangan imunisasi. In: Ranuh IGM, Soeyitno H, Hadinegoro SRS, Kartasasmita C, Ismoedijanto, Soedjatmiko, editors. Buku pedoman imunisasi di Indonesia. 4th ed. Jakarta: Satgas imunisasi IDAI; 2011. p. 29-73.
3. Departemen Kesehatan Republik Indonesia. Pekan imunisasi nasional (PIN) polio dan Sub PIN polio 2006. Jakarta: Depkes RI; 2006. p. 1–2.
4. Simoes EAF. Polioviruses. In: Behrman RE, Kliegman RM, Jensen HB, editors. Nelson textbook of pediatrics. 19th ed. Philadelphia: Saunders; 2011. p. 1081–8.
5. World Health Organization. 24 million children to be immunized to prevent outbreak from spreading across Asia [cited 2007 July 29]. Available from: http://www.who.int/mediacentre/news/releases/2005/pr37/en/
6. WHO. The immunological basis for immunization series. Module 6: poliomyelitis. Geneva: WHO; 1996. p. 5–20.
7. Sutter RW, Kew OM, Cochi SL. Poliovirus vaccine-live. In: Plotkin SA, Orenstein WA, Offit PA, editors. Vaccines. 5th ed. Philadelphia: WB Saunders; 2008. p. 631–85.
8. Laassri M, Lottenbach K, Belshe R, Wolff M, Rennels M, Plotkin S, et al. Effect of different vaccination schedules on excretion of oral poliovirus vaccine strains. J Infect Dis. 2005;192:2092–8.
9. International Conference Harmonization ICH Guidance E10: choice of control group and related issues in clinical trials. [cited 2008 June 18]. Available from: http://www.ich.org/fileadmin/ICH/Guidelines/E10/pdf
10. International Conference on Harmonization ICH Guidelines E5. Ethnic factors in the acceptability of foreign clinical data. [cited 2008 June 18]. Available from: http://www.ich.org/LOB/media/MEDIA436.pdf
11. International Conference on Harmonization ICH Guidelines E2A. Clinical safety data management definition and standards for expected reporting. [cited 2008 June 18]. Available from: http://private.ich.org/LOB/media/MEDIA436/pdf
12. Badan Pengawas Obat dan Makanan. Depkes RI. Pedoman cara uji klinik yang Baik (CUKB) di Indonesia, Jakarta: Badan POM; 2001. p. 17–20.
13. WHO. Polio Lab Network, quarterly update. Geneva: WHO;2007. p. 1–4.
14. WHO. Polio laboratory manual. 4th ed. Geneva: WHO Document Production Services; 2004. p. 81–100.
15. Bio Farma National Polio Laboratory, ITD result, version 2007. [Brosur].
16. World Health Organization. Global polio eradication initiative: Annual Report 2011. Geneva: WHO; 2012.
17. Grassly NC, Jafari H, Bahl S, Durrani S, Wenger J, Sutter RW, et al. Asymptomatic wild-type poliovirus infection in India among children with previous oral poliovirus vaccination. J Infect Dis. 2010;201:1535–43.
18. Sutter RW, Suleiman AJ, Malankar P, Al-Khusaiby SA, Mehta F, Clements GB, et al. Trial of a supplemental dose of four poliovirus vaccines. N Engl J Med. 2000;343:767–73.
19. Grassly NC, Jafari H, Bahl S, Sethi R, Deshpande JM, Wolff C, et al. Waning intestinal immunity after vaccination with oral poliovirus vaccines in India. J Infect Dis. 2012;205:1554–61.
20. Grassly NC, Jafari H, Bahl S, Durrani S, Wenger J, Sutter RW, et al. Mucosal immunity after vaccination with monovalent and trivalent oral poliovirus vaccine in India. J Infect Dis. 2009;200:794–801.