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Journal of Virology, September 2009, p. 8693-8704, Vol. 83, No. 17
0022-538X/09/$08.00+0     doi:10.1128/JVI.02388-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.

Shedding of Vaccine Viruses with Increased Antigenic and Genetic Divergence after Vaccination of Newborns with Monovalent Type 1 Oral Poliovirus Vaccine{triangledown} ,{dagger}

Sabine van der Sanden,1,2* Mark A. Pallansch,3 Jan van de Kassteele,1 Nasr El-Sayed,4 Roland W. Sutter,5 Marion Koopmans,1,2 and Harrie van der Avoort1

National Institute for Public Health and the Environment (RIVM), Antonie van Leeuwenhoeklaan 9, 3721 MA Bilthoven,1 Erasmus Medical Center, Rotterdam, The Netherlands,2 Centers for Disease Control and Prevention (CDC), Atlanta, Georgia,3 Ministry of Health and Population (MOHP), Cairo, Egypt,4 World Health Organization, Geneva, Switzerland5

Received 18 November 2008/ Accepted 3 June 2009

For the final stages in the eradication of poliovirus type 1 (P1), the World Health Organization advocates the selective use of monovalent type 1 oral poliovirus vaccine (mOPV1). To compare the immunogenicity of mOPV1 with that of trivalent OPV (tOPV) in infants, a study was performed in Egypt in 2005. Newborns were vaccinated with mOPV1 or tOPV immediately after birth and were challenged with mOPV1 after 1 month. Vaccination with mOPV1 at birth resulted in significantly higher seroconversion against P1 viruses and lower excretion of P1 viruses than vaccination with tOPV. Intratypic differentiation of the viruses shed by the newborns revealed the presence of remarkably high numbers of antigenically divergent (AD) P1 isolates, especially in the mOPV1 study group. The majority of these AD P1 isolates (71%) were mOPV1 challenge derived and were shed by newborns who did not seroconvert to P1 after the birth dose. Genetic characterization of the viruses revealed that amino acid 60 of the VP3 region was mutated in all AD P1 isolates. Isolates with substitution of residue 99 of the VP1 region had significantly higher numbers of nonsynonymous mutations in the VP1 region than isolates without this substitution and were preferentially shed in the mOPV1 study group. The widespread use of mOPV1 has proven to be a powerful tool for fighting poliovirus circulation in the remaining areas of endemicity. This study provides another justification for the need to achieve high vaccination coverage in order to prevent the circulation of AD strains.

* Corresponding author. Mailing address: National Institute for Public Health and the Environment, RIVM, P.O. Box 1, 3720 BA Bilthoven, The Netherlands. Phone: 31-30274-4073. Fax: 31-30274-4418. E-mail: Sabine.van.der.Sanden{at}rivm.nl

{triangledown} Published ahead of print on 10 June 2009.

{dagger} Supplemental material for this article may be found at http://jvi.asm.org/.

Journal of Virology, September 2009, p. 8693-8704, Vol. 83, No. 17
0022-538X/09/$08.00+0     doi:10.1128/JVI.02388-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.





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