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Persistence of MenC antibody better when supported with Hib-MenC-TT booster dose
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The persistence of the serogroup C Neisseria meningitides antibody is better when reinforced with a booster shot of Hib-MenC-TT, researchers in Europe found.
Researchers drew blood samples from children previously enrolled in an open-label, multicenter, randomly assigned controlled trial in which they were immunized at ages 2, 3 and 4 months with DTPa-IPV-Hib (Pediacel, Sanofi-Pasteur) and MenC-CRM (Meningitec, Pfizer) or DTPa-IPV (Infanrix-IPV, GlaxoSmithKline) and Hib-MenC-TT (Menitorix, GlaxoSmithKline). The samples were taken in study visits at nine centers in Poland and one in Oxford, United Kingdom, in 2007 and 2008.
Samples were drawn at 1 and 2 years following a booster dose of Hib-MenC-TT at 12 to 15 months of age. Blood samples were also drawn at the time of the second year follow-up dose, from a separate age-matched control group enrolled in the UK that did not receive a booster. The original study of 473 children was randomly assigned on a 3:1 basis to either the Hib-MenC-TT group or the MenC-CRM group. Children with a confirmed history of infection with Haemophilus influenzae type b, serogroup C Neisseria meningitides or Bordetella pertussis were excluded from the original study.
Both groups were immunized at age 12 to 15 months with Hib-MenC-TT along with a combined measles, mumps, rubella vaccine (Priorix, GSK Biologicals). The control group were vaccinated, according to the routine immunizations schedule, with three doses of a MenC conjugate vaccine and a Hib containing vaccine (Pediacel) at approximately 2, 3 and 4 months of age that was not followed by a booster dose at 1 year of age.
In 271 children between the ages of 12 and 18 months, following the Hib-MenC-TT booster, MenC bactericidal titers above the protective threshold (rSBA>1:8) was found in 89% of the Hib-MenC-TT group and 69.5% of the MenC-CRM group. The Hib correlate for long-term protection was found in 94.9% and 82.5% of the two groups, respectively.
In 379 participants at year 2 (age: 39-43 months, 25-31 months post-Hib-MenC-TT), including 72 in the control group, persistence of MenC antibodies was found in 67.1% of the Hib-MenC-TT group and 40.5% of the MenC-CRM group, compared with 44.1% of the control group. The Hib correlate for long-term protection was found in 89%, 74.7% and 38.9% of the respective groups.
“This study has demonstrated that the administration of a Hib-MenC-TT booster vaccine at 12 months of age to children previously immunized with MenC-CRM197 in early infancy results in only a transient rise in MenC-specific bactericidal antibodies. The protection afforded by this booster may therefore be insufficient to procide protection through adolescence and beyond. On-going protection of children and young people against MenC disease may require either a re-evaluation of the vaccine schedule or additional boosters, possibly in adolescence,” researchers wrote.
For more information:
- Khatami A. Pediatr Infect Dis J. 2011; 30:197-202.
Disclosures: The study was supported by Glaxo SmithKline Biologicals. Two authors are employed by GSK Biologicals, but no authors have received direct payment from GSK Biologicals. Also supported by the Oxford Partnership Comprehensive Biomedical Research Centre with funding from the NIHR Biomedical Research Centre Programme, which also provides support to the Oxford Vaccine Group. The researchers received financial assistance from GSK Biologicals to attend conferences and received honoraria for giving lectures. Pollard acts as chief and principal investigator for clinical trials conducted on behalf of Oxford University, sponsored by Novartis Vaccines, GlaxoSmithKline, Sanofi-Aventis, Sanofi-Pasteur MSD and Pfizer Vaccines.