We evaluated the efficacy of Japan's vaccination policy, a 2-dose administration of live oral poliovirus vaccine (OPV) against wild and virulent vaccine-derived poliovirus (VDPV) type 1, 2, 3 strains, by investigating the neutralizing antibody titers of residents in Toyama Prefecture, Japan. Seropositivities against the virulent type 1 and 2 strains were more than 90%, but the values against the virulent type 3 strains were approximately 60%. Also, while geometric mean antibody titers against virulent type 1 and 2 strains were more than 180, those against the virulent type 3 strains were 58-59, and 9-12, in particular, at 10 to 19 y of age. A booster dose of the vaccine for the type 3 virus is recommended for adolescents. However, high herd immunity against type 1, 2 and 3 viruses has been maintained for these 22 y, although the seropositivity against type 3 virus was always lower than other types. Our results suggest that Japan's vaccination policy might be enough to prevent an epidemic of poliomyelitis caused by wild and virulent VDPV type 1, 2, 3 strains, even though the titers against type 3 viruses were the lowest.
"In a study using a monoclonal antibody toward a vaccine strain, substitutions in the VP1 region did affect neutralization (Wiegers et al., 1989). However, these vaccine-derived strains could still be neutralized by polyclonal antiserum (Matsuura et al., 2000), or be prevented under well-maintained herd immunity (Iwai et al., 2008). Our model suggests that susceptible host density exceeds the threshold around the time t c ≈ Lp/R 0 after the cessation of OPV (e.g., t c = 140 weeks when life expectancy L = 1/u = 4000 weeks, immunization fraction p = 0.7 and basic reproductive ratio R 0 = 20). "
[Show abstract][Hide abstract] ABSTRACT: Live vaccination against polio has effectively prevented outbreaks in most developed countries for more than 40 years, and there remain only a few countries where outbreaks of poliomyelitis by the wild strain still threaten the community. It is expected that worldwide eradication will be eventually achieved through careful surveillance and a well-managed immunization program. The present paper argues, however, that based on a simple stochastic model the risk of outbreak by a vaccine-derived strain after the cessation of vaccination is quite high, even if many years have passed since the last confirmed case. As vaccinated hosts are natural reservoirs for virulent poliovirus, the source of the risk is the vaccination itself, employed to prevent the outbreaks. The crisis after stopping vaccination will emerge when the following two conditions are met: the susceptible host density exceeds the threshold for epidemics and the vaccinated host density remains large enough to ensure the occurrence of virulent mutants in the population. Our estimates for transmission, recovery, and mutation rates, show that the probability of an outbreak of vaccine-derived virulent viruses easily exceeds 90%. Moreover, if a small fraction of hosts have a longer infectious period, as observed in individuals with innate immunodeficiency, the risk of an outbreak rises significantly. Under such conditions, successful global eradication of polio is restricted to a certain range of parameters even if inactivated polio vaccine (IPV) is extensively used after the termination of live vaccination.
Frontiers in Microbiology 05/2012; 3:178. DOI:10.3389/fmicb.2012.00178 · 3.99 Impact Factor
"Despite the potential advantages and historical clinical applications for more than half a century, the concept of live attenuated rabies vaccines has been neglected from consideration of future development. Live vaccines in humans for many other diseases, such as polio , measles , mumps , rubella , herpes  , Japanese encephalitis , and yellow fever  have been well accepted. However, the idea of a live rabies vaccine for humans has been deemed unacceptable, due to possible residual virulence, especially in immune-compromised populations, or the adverse effects related to impurities in the old nerve-tissue vaccines (NTVs). "
[Show abstract][Hide abstract] ABSTRACT: While current rabies post-exposure prophylaxis (PEP) is highly effective, it is costly and the vaccination regimen is complicated, requiring both inactivated vaccines and immunoglobulins. A one-dose rabies vaccine for human PEP remains a long-term goal. Here, we describe development of a highly attenuated rabies virus ERAg3m, with a mutation in the glycoprotein (G) gene and a switch of the G gene with the matrix protein gene in the viral genome. After a one-dose intramuscular vaccination, the ERAg3m virus protected 100% of mice and hamsters from lethal challenge. In co-infections, using a lethal dose of street rabies virus mixed with ERAg3m, 100% of hamsters and 90% of mice survived and were protected against subsequent infection. A mock co-infection, using inactivated commercial human rabies vaccine and a lethal dose of street rabies virus, protected 100% and 40% of hamsters and mice, respectively. In co-infections, when vaccine was administrated in the left leg and challenge virus in the right leg, the ERAg3m virus protected 40% of mice, while the inactivated vaccine showed no protection. Therefore, live attenuated rabies virus when given pre-exposure or co-infected with street rabies virus, is capable of preventing rabies in two different animal models. Overall, this highly attenuated live rabies virus offered better protection than the inactivated vaccine.
[Show abstract][Hide abstract] ABSTRACT: Human communities defend themselves against specific infectious agents in a way that extends beyond the simple sum of the immune status of its individuals. By analogy with individual immunity to specific agents, the community level of immunity may vary from complete susceptibility to full protection. Herd immunity has been used to name this community property, which is the result of evolution through natural selection, leading to relationships between two species, typical of prey-predator systems. Varying uses of the term herd immunity led to the use of other expressions, such as herd protection, herd effect and community immunity. Knowledge derived from observational studies and models on herd immunity has supported decisions on the choice of vaccines and vaccination strategies for the benefit of populations. This knowledge is most likely to be extended in the future, with far-reaching effects.
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