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Vaccine. 2015 Jun 4;33(24):2842-8. doi: 10.1016/j.vaccine.2014.07.088. Epub 2014 Aug 12.

Effect of multiple, simultaneous vaccines on polio seroresponse and associated health outcomes.

Author information

1
Operational Infectious Diseases Department, Naval Health Research Center, McClelland & Patterson Roads, Gate 4 / Bldg 315, San Diego, CA 92106 USA. Electronic address: michael.broderick@med.navy.mil.
2
PPLB/DVD/NCIRD Centers for Disease Control and Prevention, 1600 Clifton Road NE, Mailstop G-17, Atlanta, GA 30333 USA.
3
Operational Infectious Diseases Department, Naval Health Research Center, McClelland & Patterson Roads, Gate 4 / Bldg 315, San Diego, CA 92106 USA.

Abstract

BACKGROUND:

Administration of multiple simultaneous vaccines to infants, children, and military recruits is not uncommon. However, little research exists to examine associated serological and health effects, especially in adults.

METHOD:

We retrospectively examined 416 paired serum specimens from U.S. military subjects who had received the inactivated polio vaccine (IPV) alone or in combination with either 1 other vaccine (<3 group) or 4 other vaccines (>4 group). Each of the 2 groups was subdivided into 2 subgroups in which Tdap was present or absent.

RESULTS:

The >4 group was associated with a higher proportion of polio seroconversions than the <3 group (95% vs. 58%, respectively, p<0.01). Analysis of the <3 subgroup that excluded Tdap vs. the >4 subgroup that excluded Tdap showed no difference between them (p>0.1). However, the >4 subgroup that included Tdap had significantly more seroconversions than either the <3 subgroup that excluded Tdap or the >4 subgroup that excluded Tdap (p<0.01). Overall, at least 98% of subjects were at or above the putative level of seroprotection both pre- and post-vaccination, yet at least 81% of subjects seroconverted. In an analysis of 400 of the subjects in which clinic in- and outpatient encounters were counted over the course of 1 year following vaccinations, there was no significant difference between the 2 groups (p>0.1).

CONCLUSION:

A combination of >4 vaccines including IPV appeared to have an immunopotentiation effect on polio seroconversion, and Tdap in particular was a strong candidate for an important role. The dose of IPV we studied in our subjects, who already had a high level of seroprotection, acted as a booster. In addition, there appear to be no negative health consequences from receiving few versus more multiple simultaneous vaccinations.

KEYWORDS:

IPV; Multiple vaccinations; Polio vaccine; Simultaneous vaccination; Td; Tdap

PMID:
25131729
DOI:
10.1016/j.vaccine.2014.07.088
[Indexed for MEDLINE]

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