In The Netherlands the
inactivated poliovirus vaccine (IPV) is used for protection against
poliomyelitis. It is not clear if parenteral vaccination with IPV can lead to priming of the mucosal immune system. We developed and evaluated
enzyme-linked
immunosorbent assays for the detection of poliovirus serotype-specific
immunoglobulin A (
IgA) and
secretory IgA antibodies. Using these assays we examined the kinetics of the
IgA response in sequential serum samples from 15
poliomyelitis patients after natural
infection with serotype 3 poliovirus. In 36% of the patients
IgA remained present for up to 5 months postinfection. Furthermore, we examined, in an IPV-vaccinated population, the presence of
IgA antibodies in sera from young children (4 to 12 years of age; n = 177), sera from older children (between 13 and 15 years of age; n = 123), sera from healthy blood donors (n = 66), and sera from naturally immune elderly persons (n = 54). The seroprevalence of
IgA to all three serotypes was low in young vaccinated children (5 to 7%), and the seroprevalence of
IgA types 2 and 3 was low in older vaccinated children (2 to 3%). The seroprevalence of
antibodies to type 1 was significantly higher (18%) in older children than in younger children. This higher seroprevalence is most likely explained by the persistence of
IgA following
infection with the serotype 1 wild-type poliovirus strain during the 1978 epidemic. In healthy adults, the seroprevalence of type 1- and type 2-specific
IgA was significantly higher than that in young children. These results suggest that at least part of the
IgA found in the older population is induced by
infections unrelated to the IPV vaccination schedule. Finally, we found that parenteral vaccination with IPV was able to boost
secretory IgA responses in 74 to 87% of a naturally exposed elderly population (n = 54). While the presence of
secretory IgA in IPV-vaccinated persons has been documented previously, our findings suggest that mucosal priming with live virus is necessary to obtain an
IgA response after IPV booster vaccination.