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. 2022 Mar 17;17(3):e0265562.
doi: 10.1371/journal.pone.0265562. eCollection 2022.

Use of oral polio vaccine and the incidence of COVID-19 in the world

Farrokh Habibzadeh  1   2 , Konstantin Chumakov  3 , Mohammad M Sajadi  4   5 , Mahboobeh Yadollahie  6 , Kristen Stafford  4   5 , Ashraf Simi  2 , Shyamasundaran Kottilil  4   5 , Iman Hafizi-Rastani  2 , Robert C Gallo  4   5
Affiliations

Use of oral polio vaccine and the incidence of COVID-19 in the world

Farrokh Habibzadeh et al. PLoS One. .

Abstract

Background: Several live attenuated vaccines were shown to provide temporary protection against a variety of infectious diseases through stimulation of the host innate immune system.

Objective: To test the hypothesis that countries using oral polio vaccine (OPV) have a lower cumulative number of cases diagnosed with COVID-19 per 100,000 population (CP100K) compared with those using only inactivated polio vaccine (IPV).

Methods: In an ecological study, the CP100K was compared between countries using OPV vs IPV. We used a random-effect meta-analysis technique to estimate the pooled mean for CP100K. We also used negative binomial regression with CP100K as the dependent variable and the human development index (HDI) and the type of vaccine used as independent variables.

Results: The pooled estimated mean CP100K was 4970 (95% CI 4030 to 5900) cases per 100,000 population for countries using IPV, significantly (p<0.001) higher than that for countries using OPV-1580 (1190 to 1960). Countries with higher HDI prefer to use IPV; those with lower HDI commonly use OPV. Both HDI and the type of vaccine were independent predictors of CP100K. Use of OPV compared to IPV could independently decrease the CP100K by an average of 30% at the mean HDI of 0.72.

Conclusions: Countries using OPV have a lower incidence of COVID-19 compared to those using IPV. This might suggest that OPV may either prevent SARS-CoV-2 infection at individual level or slow down the transmission at the community level.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. The distribution of COVID-19 incidence rate in each country.
The fill color reflects the cumulative number of cases diagnosed with the disease per 100,000 population. The countries’ border color shows the type of polio vaccine used in each country. Complete data were not available for gray areas. Made with Natural Earth (https://www.naturalearthdata.com/).
Fig 2
Fig 2. Distribution of data points as well as the box and whisker plot indicating the cumulative number of cases diagnosed with COVID-19 per 100,000 population stratified by the type of polio vaccine used in each country.
The horizontal line in the middle of each box indicates the median. The notch represents the 95% confidence interval of the median. The bottom and top borders of the box show the 25th and 75th percentiles, respectively. The lower whisker indicates the smallest data point within 1.5 times the interquartile range (IQR) less than the 25th percentile; the upper whisker indicates the largest point within 1.5 × IQR greater than the 75th percentile. Points greater than the upper whisker and smaller than the lower whisker were considered outliers. All outliers were included in data analyses.
Fig 3
Fig 3. Distribution of studied continuous variables and their correlation with each other.
Values are Spearman’s ρ. The median age (MedianAge), life expectancy at birth (LifeExpect), and the gross domestic product per capita (GDPperCapita), all had a significant (p<0.001) high correlation with the human development index (HDI).
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The authors received no specific funding for this work.