Low Rate of Response to Enhanced Inactivated Polio Vaccine in Preterm Infants with Chronic Illness

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Abstract
To study whether chronically ill, preterm infants have an adequate antibody response to enhanced inactivated polio vaccine (e-IPV), we randomly assigned seventeen preterm infants, who were hospitalized at two months of age, to receive either e-IPV, at two and four months of age, or oral polio vaccine (OPV) upon discharge from the hospital and two months later. Antibody to polio virus was measured on the days when the first and second doses of vaccine were given and two months after the second dose. Among 13 subjects from whom three sets of serologic titers were obtained, one of five immunized with e-IPV had titers ≤ 8 to all three subtypes of polio virus, whereas seven of eight immunized with OPV had titers ≤ 8 to all three subtypes (P=0.03 by Fisher's exact test). Thus chronically ill preterm infants cannot be assured of immunity to polio virus after vaccination with e-IPV at two and four months of age.