Oral polio vaccine response in breast fed infants with malnutrition and diarrhea

Rashidul Haque, Cynthia Snider, Yue Liu, Jennie Z. Ma, Lei Liu, Uma Nayak, Josyf C. Mychaleckyj, Poonum Korpe, Dinesh Mondal, Mamun Kabir, Masud Alam, Mark Pallansch, M. Steven Oberste, William Weldon, Beth D. Kirkpatrick, William A. Petri

Research output: Contribution to journalArticlepeer-review

48 Scopus citations


Oral vaccines for polio (OPV) and rotavirus are less effective in children in the developing world. The reasons for this are not well understood. We tested for risk factors for poor response to OPV in infants from an urban slum of Dhaka, Bangladesh. Diminished serum neutralizing response to OPV, but not failure of intramuscularly administered vaccines, was associated with malnutrition, diarrhea, and shorter breastfeeding duration. Children with malnutrition (WAZ <-2) had significantly lower OPV 3 titers (p= 0.029). Children who had 2 or more diarrhea episodes during the 1st months of life were more than twice as likely to experience OPV failure as those who had 1 diarrhea episode or no diarrhea (p= 0.0245). In contrast, each additional month in exclusive breastfeeding was associated with an increase in OPV 3 titer by 0.41 (p= 0.0072) and 0.16 (p= 0.0065) at the 25th and 50th percentiles of OPV 3 titers respectively. These data are consistent with a defect in induction of immunity in the gut for OPV but not parenteral vaccines, a defect that may be amenable to intervention in part via promotion of exclusive breastfeeding.

Original languageEnglish
Pages (from-to)478-482
Number of pages5
Issue number4
StatePublished - Jan 16 2014


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