Augmented immune responses to a booster dose of oral cholera vaccine in Bangladeshi children less than 5 years of age: Revaccination after an interval of over three years of primary vaccination with a single dose of vaccine

Fahima Chowdhury, Taufiqur Rahman Bhuiyan, Afroza Akter, Md Saruar Bhuiyan, Ashraful Islam Khan, Imam Tauheed, Tasnuva Ahmed, Jannatul Ferdous, Pinki Dash, Salima Raiyan Basher, Al Hakim, Julia Lynch, Jerome H Kim, Jean-Louis Excler, Deok Ryun Kim, John D Clemens, Firdausi Qadri, Fahima Chowdhury, Taufiqur Rahman Bhuiyan, Afroza Akter, Md Saruar Bhuiyan, Ashraful Islam Khan, Imam Tauheed, Tasnuva Ahmed, Jannatul Ferdous, Pinki Dash, Salima Raiyan Basher, Al Hakim, Julia Lynch, Jerome H Kim, Jean-Louis Excler, Deok Ryun Kim, John D Clemens, Firdausi Qadri

Abstract

We have earlier reported that a single dose of oral cholera vaccine (OCV) is protective in adults and children ≥5 years of age and sustained for 2 years. We enrolled participants (n = 240) from this study, between March-September 2017, over 3 years after receiving a primary single dose. Immune responses were measured in placebo group (Primary Immunization group: PI) and compared with those who received a single dose (Booster Immunization group: BI). The children were 4 to <5 years, 5 to <18 years and adults >18 years. Blood was collected at day 0 (before vaccination) and after receiving 1st and 2nd doses of OCV. Overall, the BI and PI groups showed vibriocidal antibody response after 1st and 2nd dose of vaccination in all age groups to V. cholerae O1 and O139. Young children in the BI group showed significantly higher vibriocidal antibody response two weeks after receiving the first dose as compared to PI group to LPS. Elevated plasma IgA responses to LPS after the first dose were observed among the BI group compared to the PI group among the young children. Mucosal antibody responses measured in fecal extracts showed similar increases as that of vibriocidal and LPS responses in the BI group. These results suggest a single boosting dose of OCV generated immune response in primed population >5 years of age who had earlier received OCV. However, young children who had received OCV earlier, boosting after a single dose, resulted in increased immune responses compared to the PI group. Further studies are needed to assess protection obtained from different strategies, especially for young children and to determine the numbers of primary and booster doses needed. In addition, more information is needed regarding the optimum interval between primary and booster doses to plan future interventions for cholera control. ClinicalTrials.gov Identifier: NCT02027207.

Keywords: Augmented immune response; Booster dose; Oral Cholera Vaccine (OCV); Primary dose; Shanchol.

Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Copyright © 2019 The Authors. Published by Elsevier Ltd.. All rights reserved.

Figures

Fig. 1
Fig. 1
Disposition of study participants.
Fig. 2
Fig. 2
Plasma vibriocidal antibody responses in boosted (BI) and primary (PI) immunized group against different serotypes in all ages (A: O1 Inaba; B: O1 Ogawa; C: O139). The straight line () indicates the boosted (BI) immunized group and dotted line () indicates primary immunized group (PI) at different days before (D0) and after (D3, D14, D17, D28, D42) vaccination. The points indicate geometric mean titre (GMT) of vibriocidal antibody response and the standard error of mean.
Fig. 3
Fig. 3
Vibriocidal plasma antibody responses. Responses were shown in children under 5 years of age who previously received a single dose of OCV 3 years earlier and revaccinated with two doses of OCV, comparatively with children who did not receive OCV earlier.
Fig. 4
Fig. 4
Lipopolysaccharide (LPS)-specific plasma antibody responses in young children. Immunoglobulin A (IgA), IgG and IgM antibody responses were measured against Ogawa, Inaba and O139.
Fig. 5
Fig. 5
LPS-specific IgA antibody responses. Responses were observed in fecal extracts in young children against LPS Ogawa and Inaba.

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Source: PubMed

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