Seroprevalence of antibody against poliovirus in inner-city preschool children. Implications for vaccination policy in the United States
R. T. Chen, S. Hausinger, A. S. Dajani, M. Hanfling, A. L. Baughman, M. A. Pallansch and P. A. Patriarca
National Immunization Program, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
OBJECTIVES--To assess susceptibility to poliomyelitis in selected
inner-city preschool children in the United States and to estimate the
contribution of secondary spread of live attenuated oral poliovirus vaccine
virus to type-specific immunity. DESIGN--Cross-sectional seroprevalence
study. METHODS--Serum neutralizing antibody levels against poliovirus types
1, 2, and 3 were analyzed according to vaccination status, age, and other
sociodemographic variables. SETTING--Hospital and satellite clinics serving
inner-city populations in Houston, Tex, and Detroit, Mich, 1990 to 1991.
PARTICIPANTS--A total of 526 children aged 12 to 47 months seeking medical
care were enrolled in the seroprevalence study; 144 children aged 12 to 35
months without a history of previous oral poliovirus vaccination were
enrolled in the secondary spread study. RESULTS--Seropositive rates were
similar in children in both cities, ranging from about 80% for types 1 and
3 in 12- to 23-month-old children to more than 90% in those aged 36 to 47
months. The most important predictor of seropositivity was the number of
doses of oral poliovirus vaccine received (P < .01), with levels
approximately 90% for all 3 serotypes among children who had received 3 or
more doses. In children likely to have been unvaccinated, seropositive
rates ranged from 9% to 18% for poliovirus types 1 and 3 and from 29% to
42% for type 2; secondary spread of vaccine virus appeared to have occurred
among children who had previously received 1 dose or less but not those
with 2 or more doses. CONCLUSIONS--Levels of immunity to poliovirus among
inner-city preschoolers are high and may be predicted by the number of
doses of oral poliovirus vaccine received. Secondary spread of the vaccine
virus plays a modest role in increasing polio immunity in inner-city
populations, especially against types 1 and 3. This role will decrease in
importance if the recently attained high levels of immunization coverage in
the United States are sustained and if the risk of importation of wild
poliovirus continues to diminish.
The Risks, Costs, and Benefits of Possible Future Global Policies for Managing Polioviruses
Thompson et al.
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ABSTRACT
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Jenkins and Modlin
Pediatrics 2006;118:611-618.
ABSTRACT
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A Dynamic Model of Poliomyelitis Outbreaks: Learning from the Past to Help Inform the Future
Duintjer Tebbens et al.
Am J Epidemiol 2005;162:358-372.
ABSTRACT
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Yang et al.
J. Virol. 2003;77:8366-8377.
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Community-Acquired Poliovirus Infection in Children with Primary Immunodeficiencies in Tunisia
Triki et al.
J. Clin. Microbiol. 2003;41:1203-1211.
ABSTRACT
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Parental Opinions Regarding Poliomyelitis Immunizations
Epee-Bounya et al.
CLIN PEDIATR 2001;40:435-440.
ABSTRACT
Polio vaccine: is it time for a change? • Commentary
Finn et al.
Arch. Dis. Child. 1998;78:571-574.
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Poliomyelitis Prevention: Recommendations for Use of Inactivated Poliovirus Vaccine and Live Oral Poliovirus Vaccine
Committee on Infectious Diseases
Pediatrics 1997;99:300-305.
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DOES ORAL POLIOVIRUS VACCINE WORK FOR INNER-CITY CHILDREN?
JWatch General 1996;1996:4-4.
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