Oral polio vaccine influences the immune response to BCG vaccination. A natural experiment

Oral polio vaccine (OPV) is recommended to be given at birth together with BCG vaccine. While we were conducting two trials including low-birth-weight (LBW) and normal-birth-weight (NBW) infants in Guinea-Bissau, OPV was not available during some periods and therefore some infants did not receive OP...

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Bibliographic Details
Published in:PloS one 2010-05, Vol.5 (5), p.e10328-e10328
Main Authors: Sartono, Erliyani, Lisse, Ida M, Terveer, Elisabeth M, van de Sande, Paula J M, Whittle, Hilton, Fisker, Ane B, Roth, Adam, Aaby, Peter, Yazdanbakhsh, Maria, Benn, Christine S
Format: Article
Language:English
Subjects:
Antigens
Babies
Bacillus Calmette-Guerin vaccine
Basic Medicine
BCG
BCG Vaccine - immunology
BCG Vaccine - therapeutic use
Birth
Birth weight
Chemotherapy
Children
Cicatrix - immunology
Cytokines
Cytokines - biosynthesis
Cytokines - immunology
Guinea-Bissau
Hemodialysis
Humans
Immune response
Immune system
Immunity - immunology
Immunology/Immune Response
In vivo methods and tests
Infant, Low Birth Weight - immunology
Infant, Newborn
Infants
Infections
Infectious Diseases
Interferon
Interleukin 10
Interleukin 13
Low-birth-weight
Medical and Health Sciences
Medicin och hälsovetenskap
Medicinska och farmaceutiska grundvetenskaper
Microbiology in the medical area
Mikrobiologi inom det medicinska området
Mortality
Mothers
Mutation
Mycobacterium
Mycobacterium bovis - immunology
Newborn babies
Parasitology
Pediatrics and Child Health
Poliomyelitis
Poliovirus Vaccine, Oral - immunology
Public Health and Epidemiology/Immunization
Regression analysis
Regression coefficients
Tuberculin - immunology
Tuberculosis
Vaccination
Vaccines
Vitamin A
γ-Interferon
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Description
Summary:Oral polio vaccine (OPV) is recommended to be given at birth together with BCG vaccine. While we were conducting two trials including low-birth-weight (LBW) and normal-birth-weight (NBW) infants in Guinea-Bissau, OPV was not available during some periods and therefore some infants did not receive OPV at birth, but only BCG. We investigated the effect of OPV given simultaneously with BCG at birth on the immune response to BCG vaccine. We compared the in vitro and the in vivo response to PPD in the infants who received OPV and BCG with that of infants who received BCG only. At age 6 weeks, the in vitro cytokine response to purified protein derivate (PPD) of M. Tuberculosis was reduced in LBW and NBW infants who had received OPV with BCG. In a pooled analysis receiving OPV with BCG at birth was associated with significantly lower IL-13 (p = 0.041) and IFN-gamma (p = 0.004) and a tendency for lower IL-10 (p = 0.054) in response to PPD. Furthermore, OPV was associated with reduced in vivo response to PPD at age 2 months, the prevalence ratio (PR) of having a PPD reaction being 0.75 (0.58-0.98), p = 0.033, and with a tendency for reduced likelihood of having a BCG scar (0.95 (0.91-1.00), p = 0.057)). Among children with a scar, OPV was associated with reduced scar size, the regression coefficient being -0.24 (-0.43-0.05), p = 0.012. This study is the first to address the consequences for the immune response to BCG of simultaneous administration with OPV. Worryingly, the results indicate that the common practice in low-income countries of administering OPV together with BCG at birth may down-regulate the response to BCG vaccine.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0010328