Background. Oral poliovirus vaccine (OPV) is less immunogenic in low-or middle-income than in high-income countries. We tested whether bacterial and viral components of the intestinal microbiota are associated with this phenomenon. Methods. We assessed the prevalence of enteropathogens using TaqMan array cards 14 days before and at vaccination in 704 Indian infants (aged 6-11 months) receiving monovalent type 3 OPV (CTRI/2014/05/004588). Nonpolio enterovirus (NPEV) serotypes were identifed by means of VP1 sequencing. In 120 infants, the prevaccination bacterial microbiota was characterized using 16S ribosomal RNA sequencing. Results. We detected 56 NPEV serotypes on the day of vaccination. Concurrent NPEVs were associated with a reduction in OPV seroconversion, consistent across species (odds ratio [95% confdence interval], 0.57 [.36-.90], 0.61 [.43-.86], and 0.69 [.41-1.16] for species A, B, and C, respectively). Recently acquired enterovirus infections, detected at vaccination but not 14 days earlier, had a greater interfering effect on monovalent type 3 OPV seroresponse than did persistent infections, with enterovirus detected at both time points (seroconversion in 44 of 127 infants [35%] vs 63 of 129 [49%]; P =.02). Te abundance of specifc bacterial taxa did not differ signifcantly according to OPV response, although the microbiota was more diverse in nonresponders at the time of vaccination. Conclusion. Enteric viruses have a greater impact on OPV response than the bacterial microbiota, with recent enterovirus infections having a greater inhibitory effect than persistent infections.
Bibliographical noteFunding Information:
Potential conflicts of interests. M. I. G. received support from an Institutional Strategic Support Fund Wellcome Trust grant awarded to the University of Liverpool and the Health Protection Research Unit in Gastrointestinal Infections, National Institute for Health Research at the University of Liverpool (grant NIHR HPRU 2012-10038). All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.
Disclaimer. The views expressed are those of the authors and do not necessarily represent those of the National Institute for Health Research or Public Health England. The funder had no role in the study design, data collection, data analysis, data interpretation, or writing of the report. Financial support. This study was funded by the Bill and Melinda Gates Foundation (grant OPP1039135 to N. C. G. and G. K.).
- 16S rRNA
- Bacterial microbiota
- Next generation sequencing
- Nonpolio enteroviruses