The immunological effects of oral polio vaccine provided with BCG vaccine at birth: a randomised trial

Kristoffer Jarlov Jensen, Hanne Sophie Karkov, Najaaraq Lund, Andreas Andersen, Helle Brander Eriksen, Amarildo Gomes Barbosa, Bjørn Kantsø, Peter Aaby, Christine Stabell Benn

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review


BACKGROUND: Vaccines may have non-specific effects. An observational study from Guinea-Bissau suggested that oral polio vaccine at birth (OPV0) provided with Bacillus Calmette-Guérin (BCG) vaccine was associated with down-regulation of the immune response to BCG vaccine 6 weeks later. Based on the previous finding, we wanted to test our a priori hypothesis that OPV would dampen the immune response to BCG, and secondarily to test immune responses to other antigens.

METHODS: The study was conducted at the Bandim Health Project in Guinea-Bissau in 2009-2010. Infants were randomised to OPV0+BCG versus BCG alone at birth, and subsequently randomised to have a blood sample taken at 2, 4 or 6 weeks post-randomisation. Excreted levels of cytokines (IL-2, IL-5, IL-10, TNF-α and IFN-γ) were measured from whole blood in vitro stimulations with a panel of recall vaccine antigens (BCG, PPD, OPV), mitogen (PHA) or innate agonists (LPS, Pam3cys, PolyI:C). Additionally, we measured the local reaction to BCG, white blood cell distribution, C-reactive protein (CRP) and retinol-binding protein (RBP). Cytokine production was analysed as the prevalence ratios of responders above the median.

RESULTS: Blood samples from 430 infants (209 OPV0+BCG; 221 BCG alone) were analysed. There were no strong differences in effects 2, 4 and 6 weeks post-randomisation and subsequent analyses were performed on the pooled data. As hypothesised, receiving OPV0+BCG versus BCG alone was associated with significantly lower prevalence of IFN-γ responses to PPD (prevalence ratio (PR): 0.84 (0.72-0.98)) and reduced IL-5 to PPD (PR: 0.78 (0.64-0.96)). No effects were observed for CPR, RBP, white blood cell distribution, or BCG scar prevalence.

CONCLUSION: The results corroborate that OPV attenuates the immune response to co-administered BCG at birth.

Udgave nummer45
Sider (fra-til)5949-56
StatusUdgivet - 14. okt. 2014



Jensen, K. J., Karkov, H. S., Lund, N., Andersen, A., Eriksen, H. B., Barbosa, A. G., Kantsø, B., Aaby, P., & Benn, C. S. (2014). The immunological effects of oral polio vaccine provided with BCG vaccine at birth: a randomised trial. Vaccine, 32(45), 5949-56.