Long-term immunity to poliovirus in children immunized with live attenuated and enhanced-potency inactivated trivalent poliovirus vaccines

Eighty-six children who completed immunization with the two trivalent poliovirus vaccines, live attenuated (OPV) and enhanced potency inactivated (EIPV), in one of four schedules (OPV-OPV-OPV, EIPV-EIPV-EIPV, EIPV-OPV-OPV, and EIPV-EIPV-OPV) at 1 year of age were monitored serologically over the subsequent 4 years and challenged with OPV at 5 years of age. Each of the immunization groups exhibited an initial 10- to 100-fold decline in neutralizing antibody to poliovirus types 1, 2, and 3 during the first 2 years of follow-up; thereafter antibody titers stabilized. The EIPV-EIPV-OPV group maintained the highest antibody levels throughout the observation period, including the response to OPV challenge at 5 years of age. These data suggest that immunization with OPV, EIPV, and combinations of the two vaccines confers long-term immunity. Optimal systemic immunity was associated with two or more doses of EIPV.