Results of a clinical study of polio vaccine: the Buffalo experience.

Serum-neutralizing, nasopharyngeal-neutralizing and nasopharyngeal IgA antibodies were determined in 123 infants immunized with either live (oral) poliovirus vaccine (OPV-OPV-OPV) (Group A), inactivated poliovirus vaccine (IPV-IPV-IPV) (Group B) or combinations of the two trivalent poliovirus vaccines: IPV-OPV-OPV (Group C) or IPV-IPV-OPV (Group D). Nearly 100% of individuals formed serum-neutralizing antibodies. The highest geometric mean titer of antibody to polioviruses 1, 2 and 3 occurred in groups D, C and B, respectively. Local neutralizing and IgA antibody responses were detected in 41 to 88% and 75 to 100%, respectively. Peak geometric mean titer of nasopharyngeal antibodies differed minimally between immunization groups. Based on these data, it appears that a vaccine schedule with the combination of IPV and OPV would be ideal. It is uncertain whether a combination schedule is feasible in a highly mobile and heterogeneous population, such as that found in the United States.