{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T18:19:28Z","timestamp":1784744368489,"version":"3.55.0"},"reference-count":56,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2023,9,1]],"date-time":"2023-09-01T00:00:00Z","timestamp":1693526400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill &amp; Melinda Gates Foundation","doi-asserted-by":"publisher","award":["INV OPP1211074"],"award-info":[{"award-number":["INV OPP1211074"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>The oral poliovirus vaccine (OPV) has been the mainstay of polio eradication, especially in low-income countries, and its use has eliminated wild poliovirus type 2. However, the inactivated poliovirus vaccine (IPV) is safer than OPV, as IPV protects against paralytic poliomyelitis without producing adverse reactions. The present study compared mucosal and humoral responses to poliovirus vaccines administered to previously OPV-immunized children to assess the immunity gap in children in areas of high poliovirus transmission. A cluster-randomized trial was implemented in three high-risk districts of Pakistan\u2014Karachi, Kashmore, and Bajaur\u2014from June 2013 to May 2014. This trial was community-oriented and included three arms, focusing on healthy children below five years of age. The study involved the randomization of 387 clusters, of which 360 were included in the final analysis. The control arm (A) received the routine polio program bivalent poliovirus vaccine (bOPV). The second arm (B) received additional interventions, including health camps providing routine vaccinations and preventive maternal and child health services. In addition to the interventions in arm B, the third arm (C) was also provided with IPV. Blood and stool samples were gathered from children to evaluate humoral and intestinal immunity. The highest levels of poliovirus type 1 serum antibodies were observed in Group C (IPV + OPV). The titers for poliovirus type 2 (P2) and poliovirus type 3 (P3) were noticeably higher in those who had received a routine OPV dose than in those who had not across all study groups and visits. Providing an IPV booster after at least two OPV doses could potentially fill immunity gaps in regions where OPV does not show high efficacy. However, IPV only marginally enhances humoral immunity and fails to offer intestinal immunity, which is critical to stop the infection and spread of live poliovirus in populations that have not been exposed before.<\/jats:p>","DOI":"10.3390\/vaccines11091444","type":"journal-article","created":{"date-parts":[[2023,9,1]],"date-time":"2023-09-01T08:19:39Z","timestamp":1693556379000},"page":"1444","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Does IPV Boost Intestinal Immunity among Children under Five Years of Age? An Experience from Pakistan"],"prefix":"10.3390","volume":"11","author":[{"given":"Muhammad Atif","family":"Habib","sequence":"first","affiliation":[{"name":"Centre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4192-8406","authenticated-orcid":false,"given":"Sajid Bashir","family":"Soofi","sequence":"additional","affiliation":[{"name":"Centre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, Pakistan"},{"name":"Department of Pediatrics & Child Health, Aga Khan University, Karachi 74800, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0079-3330","authenticated-orcid":false,"given":"Imtiaz","family":"Hussain","sequence":"additional","affiliation":[{"name":"Centre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Imran","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Centre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zamir","family":"Hussain","sequence":"additional","affiliation":[{"name":"Trust for Vaccines and Immunization, Karachi 74400, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rehman","family":"Tahir","sequence":"additional","affiliation":[{"name":"Trust for Vaccines and Immunization, Karachi 74400, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saeed","family":"Anwar","sequence":"additional","affiliation":[{"name":"Prime Institute of Public Health, Peshawar 25160, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Cousens","sequence":"additional","affiliation":[{"name":"London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0637-599X","authenticated-orcid":false,"given":"Zulfiqar A.","family":"Bhutta","sequence":"additional","affiliation":[{"name":"Centre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, Pakistan"},{"name":"Centre for Global Child Health, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,9,1]]},"reference":[{"key":"ref_1","unstructured":"(2020, March 30). 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