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. Method(s): 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. Result(s): 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. Conclusion(s): 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.Copyright © 2026 Elsevier Ltd. All rights are reserved, including those for text and data mining, AI training, and similar technologies.
