Immunogenicity and safety of Sabin-strain inactivated poliovirus vaccine in infants: a systematic review and meta-analysis

Clinical Snapshot

Key Findings

• P Value: Not explicitly reported

• Effect Size: Non-inferiority demonstrated: PV1 RR 1.00, PV2 RR 1.02, PV3 RR 1.00

• Primary Outcome: Seroconversion rates for poliovirus types 1, 2, and 3

• Nnt Or Sensitivity: 100% seroconversion achieved for both vaccines across all serotypes

• Confidence Interval: 95% CI ranges from 0.98-1.07 across poliovirus types

Clinical Application

High feasibility due to lower biosafety requirements for sIPV production and storage Relevant to Australian National Immunisation Program; TGA approval would be required for sIPV introduction; cost-effectiveness analysis needed for PBS consideration Healthy infants receiving primary IPV vaccination series in routine immunization programs

Abstract

BACKGROUND: Poliomyelitis remains a threat to children under five despite global vaccination efforts. The Sabin-strain inactivated poliovirus vaccine (sIPV) has emerged as a safer alternative to conventional Salk-strain IPV (cIPV) due to lower biosafety requirements. This systematic review and meta-analysis evaluated the immunogenicity and safety of sIPV compared with cIPV in healthy infants completing the primary IPV series. METHODS: PubMed, Embase, Scopus, and Cochrane Library were searched for RCTs. Outcomes included seroconversion rates, seroprotection rates, geometric mean titers (GMTs), and adverse events. Data were pooled using random-effects models, and evidence certainty was assessed using RoB 2.0 and GRADE. RESULTS: Seven RCTs with 4646 infants were included. Seroconversion rates were comparable: PV1 100% (RR 1.00, 95% CI 1.00-1.01), PV2 102% (RR 1.02, 95% CI 0.98-1.07), PV3 100% (RR 1.00, 95% CI 0.99-1.01). GMTs were higher for sIPV after PV1 (MD 1.50, 95% CI 0.98-2.02) and PV2 (MD 0.52, 95% CI 0.06-0.98). Local adverse events were similar (OR 1.27, 95% CI 0.95-1.71), while systemic adverse events were higher with cIPV (OR 1.36, 95% CI 1.15-1.60). Fever (OR 1.50, 95% CI 1.20-1.87) and allergic reactions (OR 2.19, 95% CI 1.02-4.69) were slightly more frequent with sIPV. CONCLUSIONS: sIPV provides immunogenicity comparable to cIPV with an acceptable safety profile in infants. Its lower biosafety requirements support its use in global polio eradication programs.

References

1. 1.Hussain, M., Hassan, M., Athar, M., Khan, S., Azam, M. T., Rathi, D., & Nawaz, J. (2026). Immunogenicity and safety of Sabin-strain inactivated poliovirus vaccine in infants: a systematic review and meta-analysis. Vaccine, 128643. https://doi.org/10.1016/j.vaccine.2026.128643