Study: Chronic Intestinal Disease Causes Oral Vaccines to Fail

Researchers in the US and India have published new data demonstrating a link between vaccine failure among infants and malnutrition that leads to chronic intestinal disease. Environmental enteropathy (EE)—an intestinal illness common in low-income countries—exhibited a statistically significant factor in causing certain vaccines to fail.

In this study, researchers used data from 700 infants from slums in Dhaka, Bangladesh, who were all followed from birth out to 2 years, with half of the study group randomized to receive vaccines.

(Karail slum in Gulshan, Dhaka. Photo by Aditya Kabir—Wikimedia Commons)

The analysis showed 9.5% of infants demonstrated what was called “stunted” growth at the study’s enrollment and this proportion increased to 27.6% at the 52-week mark. Meanwhile, oral polio vaccines failed in 20.2% of study group infants, with a 68.5% failure rate for rotavirus vaccines in the same sample.

Concurrently, 12-week stool samples were analyzed for biomarkers of EE, with the majority of infants exhibiting signs of EE and several of these biomarkers demonstrating abnormally high values in the study population.

The statistical analysis demonstrated a strong association between EE and vaccine failure/underperformance, the authors noted, whereas EE predicted infants who were malnourished.

“These results are of significance at the level of public health. Interventions focusing on EE, systemic inflammation, and improvement of maternal health could be predicted to make an impact on child health through improved oral vaccine response and nutrition,” the investigators wrote in their published analysis.

“We have discovered that oral vaccine failure is likely the result of some of the same pathological processes that drive malnutrition, increasing the need for multifaceted interventions. The identification of systemic and enteric inflammatory clusters emphasizes the necessity of multi-pronged intervention strategies to EE to fully address malnutrition and oral vaccine failure.”

The full report was published in the November issue of EBioMedicine.

—Drew Amorosi

Reference:

Naylor C, Lu M, Haque R, et al., and the PROVIDE study teams. Environmental enteropathy, oral vaccine failure, and growth faltering in infants in Bangladesh. EBioMedicine 2015;2(11):1759–1766.