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Bivalent poliovirus vaccine induced more immunity than trivalent vaccine
Sutter RS. Lancet. 2010;doi:10.1016/S0140-6736(10)61230-5.
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A bivalent oral poliovirus vaccine for types 1 and 3 poliovirus was superior to a trivalent oral poliovirus vaccine for types 1, 2 and 3 poliovirus in newborn babies, according to a WHO study reported in The Lancet. The same bivalent vaccine was non-inferior to monovalent oral poliovirus vaccines for types 1 and 3 poliovirus.
In the randomized, double blind, controlled trial, which was conducted in India, 900 newborn babies were randomly assigned to one of five vaccine groups: type 1 monovalent vaccine; type 2 monovalent vaccine; type 3 monovalent vaccine; types 1 and 3 bivalent vaccine; or types 1, 2 and 3 trivalent vaccine.
The infants were given one vaccine dose immediately after randomization. After 30 days, blood samples were taken from the infants to test for seroconversion, and the infants were given a second dose. At 60 days, another serum sample was taken from the infants. The primary endpoint was seroconversion after one dose, and the secondary endpoint was seroconversion after two doses.
The cumulative seroconversion was 90% for the type 1 monovalent and 86% for the bivalent vaccines, but 63% for the trivalent vaccine. Seroconversion to type 2 poliovirus did not differ between the monovalent type 2 vaccine and the trivalent vaccine after either dose. The cumulative seroconversion to type 3 poliovirus was 84% for the monovalent type 3 vaccine and 74% for the bivalent vaccine, but 52% for the trivalent vaccine.
“The major advantages of the bivalent vaccine according to [the advisory committee on poliomyelitis eradication] is that it will enhance individual and population immunity simultaneously for both poliovirus types 1 and 3, without any serious loss in immunogenicity compared with the monovalent oral poliovirus vaccine,” the researchers wrote. “Bivalent oral poliovirus vaccine is already being used on a large scale to increase population immunity against and accelerate the elimination of the final chains of transmission of these two remaining wild polioviruses, especially in areas where both poliovirus types 1 and 3 co-circulate.”
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