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Intradermal inactivated poliovirus vaccine may be considered in low-resource settings
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Fractional-dose inactivated poliovirus vaccine administered intradermally by a needle-free device resulted in lower seroconversion rates than full-dose vaccine administered intramuscularly, but could be considered as an antigen-sparing strategy in low-resouce settings, according to published study results.
Researchers from several international sites conducted the study at three maternity hospitals and 15 vaccination sites in five districts of Camagüey Province, Cuba from August 2006 to March 2007.
The immunogenicity and reactogenicity of fractional-dose IPV (0.1 mL, or one-fifth of a full dose) administered intradermally via a needle-free jet injector device was compared with full doses administered intramuscularly. The aim was to evaluate strategies for making the inactivated vaccine affordable in developing countries.
There were 471 infants, 364 of whom fulfilled the study requirements. Participants were randomly assigned at birth to one of the two groups and were administered the vaccine at 6, 10 and 14 weeks. Baseline data indicated that there were no significant differences between the two groups.
Thirty days after completing the three-dose schedule, 52.9% of infants in the fractional-dose vaccine arm seroconverted for poliovirus type 1, 85.0% seroconverted for type 2 and 69.0% seroconverted for type 3 (P<.001). Among infants in the full-dose arm, 30-day results indicated that 89.3% seroconverted for type 1, 95.5% seroconverted for type 2 and 98.9% seroconverted for type 3 (P<.001).
The median titers of each poliovirus serotype were lower in the intradermal arm than in the intramuscular arm.
Minor local adverse events were reported, but no moderate or serious events occurred.
The researchers said that the study results demonstrate “the feasibility of fractional doses of IPV given intradermally as an antigen-sparing strategy” and also show that “IPV given to infants at 6, 10 and 14 weeks of age results in suboptimal immunogenicity (especially for the fractional-dose arm).”
Resik S. J Infect Dis. 2010;201:1344-1352.