Predictors of Oral Rotavirus Vaccine Immunogenicity in Rural Zimbabwean Infants

Overview

Journal Vaccine

Specialty Allergy & Immunology

Date 2020 Feb 24

PMID 32088018

Citations 6

Authors

James A Church

Bernard Chasekwa

Sandra Rukobo

Margaret Govha

Benjamin Lee

Marya P Carmolli

Robert Ntozini

Kuda Mutasa

Monica M McNeal

Florence D Majo

Naume V Tavengwa

Beth D Kirkpatrick

Lawrence H Moulton

Jean H Humphrey

Andrew J Prendergast

Affiliations

Soon will be listed here.

Abstract

Background: Oral rotavirus vaccines (RVV) have poor immunogenicity in low-income countries, for reasons that remain unclear. This study identified the determinants of RVV immunogenicity among infants in rural Zimbabwe.

Methods: Anti-rotavirus IgA titres were measured among a sub-group of infants enrolled in the Sanitation Hygiene Infant Nutrition Efficacy (SHINE) trial (NCT01824940). SHINE was a cluster-randomized trial of improved infant and young child feeding, and improved water, sanitation and hygiene (WASH) in two rural Zimbabwean districts. Infants received RVV as part of the national immunisation programme. Among HIV-unexposed infants in the non-WASH trial arms, we evaluated associations between potential risk factors (vaccine schedule and dose, maternal and infant nutritional status, infant diarrhoea, and household environment) and RVV immunogenicity (seroconversion, seropositivity and geometric mean titres) using multivariable regression.

Results: Among 219 infants with seroconversion data, 43 (20%) successfully seroconverted and 176 (80%) failed to seroconvert to RVV. Seroconversion was positively associated with a higher length-for-age Z-score (LAZ) around the time of vaccination (adjusted RR 1.27 (95% CI 1.04, 1.55), P = 0.021), and negatively associated with concurrent OPV and RVV administration (adjusted RR 0.36 (0.19, 0.71), P = 0.003). Among 472 infants with post-vaccination titres, a higher LAZ score was associated with increased seropositivity (aRR 1.21 (95% CI 1.06, 1.38), P = 0.004), and higher birthweight was associated with increased IgA titres (0.45 (95%CI 0.18, 1.09) U/mL greater per 100 g gain in birthweight; P = 0.001).

Conclusions: Infant ponderal and linear growth were positively associated with RVV immunogenicity, while concurrent administration of OPV was negatively associated with RVV immunogenicity. Together, these findings suggest that improving foetal growth and separating RVV and OPV administration are plausible approaches to increasing RVV immunogenicity.

Citing Articles

Association of Anti-Rotavirus IgA Seroconversion with Growth, Environmental Enteric Dysfunction and Enteropathogens in Rural Pakistani Infants.

Ahmed S, Iqbal J, Sadiq K, Umrani F, Rizvi A, Kabir F Vaccine. 2022; 40(25):3444-3451.

PMID: 35534310 PMC: 9168439. DOI: 10.1016/j.vaccine.2022.04.032.

Impact of maternal antibodies and microbiota development on the immunogenicity of oral rotavirus vaccine in African, Indian, and European infants.

Parker E, Bronowski C, Sindhu K, Babji S, Benny B, Carmona-Vicente N Nat Commun. 2021; 12(1):7288.

PMID: 34911947 PMC: 8674366. DOI: 10.1038/s41467-021-27074-1.

Plasma Rotavirus-specific IgA and Risk of Rotavirus Vaccine Failure in Infants in Malawi.

Pollock L, Bennett A, Jere K, Mandolo J, Dube Q, Bar-Zeev N Clin Infect Dis. 2021; 75(1):41-46.

PMID: 34788820 PMC: 9402641. DOI: 10.1093/cid/ciab895.

TLR genetic variation is associated with Rotavirus-specific IgA seroconversion in South African Black infants after two doses of Rotarix vaccine.

Miya T, Groome M, de Assis Rosa D Vaccine. 2021; 39(48):7028-7035.

PMID: 34740476 PMC: 8678908. DOI: 10.1016/j.vaccine.2021.10.051.

The fecal microbiome and rotavirus vaccine immunogenicity in rural Zimbabwean infants.

Robertson R, Church J, Edens T, Mutasa K, Geum H, Baharmand I Vaccine. 2021; 39(38):5391-5400.

PMID: 34393020 PMC: 8423000. DOI: 10.1016/j.vaccine.2021.07.076.

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