Rapid Disappearance of Poliovirus Type 2 (PV2) Immunity in Young Children Following Withdrawal of Oral PV2-Containing Vaccine in Vietnam

J Infect Dis. 2019 Jul 2;220(3):386-391. doi: 10.1093/infdis/jiz124.

Abstract

Background: Due to global shortage of inactivated poliovirus vaccine and withdrawal of oral vaccine containing poliovirus type 2 (PV2), a PV2-containing vaccine was not used in Vietnam May 2016 to October 2018. We assessed the population immunity gap to PV2.

Methods: A cross-sectional survey in children aged 1-18 months was carried out in January 2018. One blood sample per child was analyzed for presence of poliovirus neutralizing antibodies. In children with detectable anti-PV2 antibodies, a second sample was analyzed 4 months later to distinguish between passive (maternally derived) and active (induced by secondary transmission or vaccination) immunity.

Results: Sera were obtained from 1106/1110 children. Seroprevalence of PV2 antibodies was 87/368 (23.6%) at age 1-7 months, 27/471 (5.7%) at 8-15 months, and 19/267 (7.1%) at 16-18 months. Seroprevalence declined with age in the 1-7 months group; in the 8-18 months group there was no significant change with age. Four months later, 11/87 (14%), 9/27 (32%), and 12/19 (37%) remained seropositive in 1-7, 8-15, and 16-18 months age groups, respectively.

Conclusions: We found declining immunity to PV2, suggesting Vietnam is at risk for an outbreak of type 2 vaccine-derived poliovirus following virus importation or new emergence.

Keywords: Vietnam; eradication; poliomyelitis; vaccination.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antibodies, Neutralizing / immunology
  • Antibodies, Viral / immunology
  • Child, Preschool
  • Cross-Sectional Studies
  • Disease Outbreaks / prevention & control
  • Female
  • Humans
  • Infant
  • Male
  • Poliomyelitis / immunology
  • Poliovirus / immunology*
  • Poliovirus Vaccine, Inactivated / immunology*
  • Poliovirus Vaccine, Oral / immunology*
  • Seroepidemiologic Studies
  • Vaccination / methods
  • Vietnam

Substances

  • Antibodies, Neutralizing
  • Antibodies, Viral
  • Poliovirus Vaccine, Inactivated
  • Poliovirus Vaccine, Oral