Effect of multiple, simultaneous vaccines on polio seroresponse and associated health outcomes

Vaccine
Volume 33, Issue 24, Pages 2735-2850 (4 June 2015)
http://www.sciencedirect.com/science/journal/0264410X/33
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Effect of multiple, simultaneous vaccines on polio seroresponse and associated health outcomes
Original Research Article
Pages 2842-2848
Michael P. Broderick, M. Steven Oberste, Deborah Moore, Sandra Romero-Steiner, Christian J. Hansen, Dennis J. Faix
Abstract
Background
Administration of multiple simultaneous vaccines to infants, children, and military recruits is not uncommon. However, little research exists to examine associated serological and health effects, especially in adults.
Method
We retrospectively examined 416 paired serum specimens from U.S. military subjects who had received the inactivated polio vaccine (IPV) alone or in combination with either 1 other vaccine (4 group). Each of the 2 groups was subdivided into 2 subgroups in which Tdap was present or absent.
Results
The >4 group was associated with a higher proportion of polio seroconversions than the 4 subgroup that excluded Tdap showed no difference between them (p > 0.1). However, the >4 subgroup that included Tdap had significantly more seroconversions than either the 4 subgroup that excluded Tdap (p < 0.01). Overall, at least 98% of subjects were at or above the putative level of seroprotection both pre- and post-vaccination, yet at least 81% of subjects seroconverted. In an analysis of 400 of the subjects in which clinic in- and outpatient encounters were counted over the course of 1 year following vaccinations, there was no significant difference between the 2 groups (p > 0.1).
Conclusion
A combination of >4 vaccines including IPV appeared to have an immunopotentiation effect on polio seroconversion, and Tdap in particular was a strong candidate for an important role. The dose of IPV we studied in our subjects, who already had a high level of seroprotection, acted as a booster. In addition, there appear to be no negative health consequences from receiving few versus more multiple simultaneous vaccinations.