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Review
. 2015;14(8):1113-23.
doi: 10.1586/14760584.2015.1052800. Epub 2015 Jul 9.

Impact of inactivated poliovirus vaccine on mucosal immunity: implications for the polio eradication endgame

Edward Pk Parker  1 , Natalie A Molodecky, Margarita Pons-Salort, Kathleen M O'Reilly, Nicholas C Grassly
Affiliations
Review

Impact of inactivated poliovirus vaccine on mucosal immunity: implications for the polio eradication endgame

Edward Pk Parker et al. Expert Rev Vaccines. 2015.

Abstract

The polio eradication endgame aims to bring transmission of all polioviruses to a halt. To achieve this aim, it is essential to block viral replication in individuals via induction of a robust mucosal immune response. Although it has long been recognized that inactivated poliovirus vaccine (IPV) is incapable of inducing a strong mucosal response on its own, it has recently become clear that IPV may boost immunity in the intestinal mucosa among individuals previously immunized with oral poliovirus vaccine. Indeed, mucosal protection appears to be stronger following a booster dose of IPV than oral poliovirus vaccine, especially in older children. Here, we review the available evidence regarding the impact of IPV on mucosal immunity, and consider the implications of this evidence for the polio eradication endgame. We conclude that the implementation of IPV in both routine and supplementary immunization activities has the potential to play a key role in halting poliovirus transmission, and thereby hasten the eradication of polio.

Keywords: environmental surveillance; eradication; inactivated poliovirus vaccine; mucosal immunity; oral poliovirus vaccine; poliovirus.

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Figures

Figure 1.
Figure 1.
Map of global inactivated poliovirus vaccine use and planned dates for its introduction. Data source: WHO/IVB Database, as of 1 May 2015. Map production: Immunization Vaccines and Biologicals (IVB), WHO.
Figure 2.
Figure 2.
Schematic representation of serum and secretory antibody responses following administration of IPV to OPV- or IPV-primed individuals. Primary immunization with OPV induces both a humoral response (serum IgG) and a mucosal response (intestinal and nasopharyngeal IgA), whereas IPV induces only a humoral response and potentially a limited mucosal response in the nasopharynx. However, following the waning of OPV-induced mucosal immunity, administration of IPV is capable of boosting both humoral and mucosal immunity in OPV-primed individuals. The same boosting of humoral immunity does not occur among individuals without prior OPV exposure.
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References

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