Long Term Follow up of the Lived Attenuated Japanese Encephalitis Vaccine (SA-14-14-2) Efficacy in Children of the four hyper-endemic Provinces of Northern Thailand, 2016.

Abstract Background. In Thailand, Japanese encephalitis appears with a higher incidence of the Northern region (0.0/100,000 cases/year) as compared to the central southern region of the country (0.01/100,000/year). Also, all Japanese encephalitis virus (JEV) recently isolated strains in country belong to the genotype I and III.Methods. In order to evaluate the long-term efficacy of the newly developed live attenuated SA 14-14-2 Japanese encephalitis vaccine in Thailand, the immune response in children was studied after a second immunization campaign. Following 2012 immunization campaign, a second JEV immunization vaccine was delivered to children among four provinces of the Northern Region of Thailand. For each province, the recipients were identified accordingly to the two vaccine campaigns time including the children who received the second dose of vaccine: 1/ less than one year before the present study (N=30 by province); 2/ more than one year before the present study (N=70 by province). Altogether, a total of 400 children were enrolled in this project. After receiving the second vaccine dose, blood samples were collected and tested for JEV (Genotypes I and III) neutralizing antibodies following a standard procedure of LLC-MK2 infected cells.Results. All recipient presented neutralizing antibodies cross reacting against the prevalent JEV genotypes I (SM1 JEV strain) and genotype III ( SA 14-14-2 and Beijing JEV strains). Most of the children from the first group had a seroconversion rate of 94.2% against homologous (i.e. GIII). Among them, an optimal rate of 100% seroconversion was find at the Phayao Province against both heterologous (GI) and homologous (GIII) JEV strains. Geometric Mean Titer (GMT ) of neutralizing antibody against SM1, SA 14-14-2 JEV, and Beijing JEV strains were consistently high, respectively as 239±50, 323±201.2 and 177±36.7. For the second group, seroconversion rate was lower against SM1, SA 14-14-2 and Beijing JEV strains with a rate of 94.3, 90% and 86.8% with respectively a GMT of 154±32, 90±23 and 82±13.6.Conclusion. Although, the immunity appears to decrease within the period of 2.5 years, neutralizing antibody rate are consistent to protect against the JEV infection. Nevertheless, a long-term follow up is suitable to evaluate an eventual third dose opportunity.