Evaluation of Group C Meningococcal Polysaccharide Vaccine in Marine Recruits, San Diego, California1

Devine, Leonard F.; Pierce, Willard E.; Floyd, Thomas M.; Rhode, Solon L.; Edwards, Earl A.; Siess, Eugene E.; Peckinpaugh, R. O.

doi:10.1093/oxfordjournals.aje.a121176

Cited by 32 publications

(18 citation statements)

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“…For example, with Hib conjugate vaccines, a detectable antibody response post-polysaccharide boosting is present after 4 to 5 days (29), while responses following a primary series take up to 7 days (25). Pneumococcal conjugate vaccines (27), and even MenC polysaccharide vaccines (4,12), reduce nasopharyngeal carriage of strains contained in the vaccine and therefore clearly provide a degree of mucosal immunity; this is further reinforced by recent pneumococcal conjugate vaccine efficacy data from the United States (5). Until more data are available it is difficult to correlate the seriousness or speed of an invasive infection with the relative protection afforded by memory.…”

Section: Discussionmentioning

confidence: 99%

“…The original licensure in the United States in the 1970s, however, was based upon classic randomized efficacy trials (4,16). Serogroup C polysaccharide vaccines have been shown to be efficacious in those over 2 years of age and to reduce carriage of serogroup C meningococci in the short term (4,12), although they are poorly immunogenic and not protective in those under 2 years of age (35).…”

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confidence: 99%

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Serological Basis for Use of Meningococcal Serogroup C Conjugate Vaccines in the United Kingdom: Reevaluation of Correlates of Protection

Borrow

Andrews²,

Miller³

2001

Infect Immun

297

194

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The antibody data supporting the use of meningococcal serogroup C conjugate (MCC) vaccines in the United Kingdom were generated by serum bactericidal assay (SBA) using rabbit complement (rSBA). This may give higher titers than those obtained with human complement (hSBA), for which the "gold standard" correlate of protection for meningococcal C disease is a titer of >4. Comparison of rSBA and hSBA titers in sera from unvaccinated adults with an rSBA titer of >8 showed that for 93% (27 of 29) the titer was >4 by hSBA, confirming natural protection. Furthermore, sera from MCC vaccinees showed that an rSBA titer of <8 or >128 discriminated susceptibility and protection well (85% with rSBA titers of <8 had hSBA titers of <4, and 99% with rSBA titers of >128 had hSBA titers of >4). However, discrimination was poor in the rSBA titer range 8 to 64, with only 60% having hSBA titers of >4. In such cases we propose that protection can be assumed if there is a fourfold rise in titer between pre-and postvaccination sera or if there is a characteristic booster response to a polysaccharide challenge dose with, if available, evidence of antibody avidity maturation or an hSBA titer of result >4. Applying these criteria to toddlers, 10 to 40% of whom had titers in the range 8 to 64 after a single dose of MCC vaccine, showed that 94% had a fourfold rise in titer, including 98% of those in the titer range 8 to 64. In addition, of those with titers of <128 post-MCC vaccination, 90% had titers of >128 after a 10-g polysaccharide booster dose, compared with only 7% of unprimed age-matched toddlers given a full 50-g dose. Furthermore, the increase in geometric mean avidity index pre-and postbooster was independent of post-primary MCC titer. These results indicated that the majority of toddlers with an rSBA titer between 8 and 64, and some of those with an hSBA result of <4, have mounted a protective immune response with the induction of immunological memory.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Serological Basis for Use of Meningococcal Serogroup C Conjugate Vaccines in the United Kingdom: Reevaluation of Correlates of Protection

Borrow

Andrews²,

Miller³

2001

Infect Immun

297

194

View full text Add to dashboard Cite

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“…In contrast to preexisting serum antibodies that may immediately neutralize invading bacteria, anamnestic responses require the reactivation of memory B cells and their differentiation into antibody-producing cells. This process is not instantaneous, and its kinetics are of particular interest for meningococcal infections, in which invasion and disease may follow just days after bacterial exposure and admission to intensive care, and death frequently follows within 24 h of onset (11,12,14).…”

Section: Discussionmentioning

confidence: 99%

Early Appearance of Bactericidal Antibodies after Polysaccharide Challenge of Toddlers Primed with a Group C Meningococcal Conjugate Vaccine: What Is Its Role in the Maintenance of Protection?

Tsai

Borrow

Gnehm

et al. 2006

Clin Vaccine Immunol

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The contribution of memory responses after meningococcal vaccination to protection may depend on the rapidity of the response. Toddlers were challenged with a licensed polysaccharide (PS) vaccine 1 year after vaccination with a single dose of meningococcal group C-CRM 197 conjugate (MCC) vaccine at the age of 12 to 15 months. Bactericidal antibodies and immunoglobulin G (IgG) antibodies detected by an enzyme-linked immunosorbent assay (ELISA) were measured before challenge and 4, 7, 14, or 21 Days later ("Days" refer to treatment groups, "days" to sampling days). Among 281 subjects in the intent-to-treat population, 173 per-protocol (PP) subjects were challenged with 10 g PS antigen and 103 others with a 50-g PS vaccinating dose. Capsular PS-specific ELISA IgG titers were negligible in baseline samples and increased only twofold within 4 days of PS administration. In contrast, the proportion of PP subjects with serum bactericidal antibody (SBA) titers of >1:8 or >1:128 increased, respectively, from 41% and 16% before challenge to 84% and 74% at Day 4 and to 100% and 97% at Day 7. Recipients of 50 g PS responded with similar kinetics but showed a trend toward higher antibody levels. Unexpectedly, 69% of subjects bled on days 2 to 3 already had achieved SBA titers of >1:8. The majority of toddlers previously immunized with MCC and challenged 1 year later with PS antigen mounted protective levels of bactericidal antibody within 2 to 4 days.

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“…Twelve studies involved controlled trials (Gotschlich et al 1969;Artenstein et al 1970;Devine et al 1970;Wenzel et al 1973;Makela et al 1975;Wahdan et al 1977;Greenwood et al 1978;Sivonen 1981;Blakebrough et al 1983;Bjune 1992;Boslego et al 1995;Perkins et al 1998), 10 studies evaluated carriage preand post-vaccination (Bosmans et al 1980;Masterton et al 1988;Dimartino et al 1990;Stroffolini et al 1990;Maiden et al 2002;Fernandez et al 2003;Djibo et al 2004;Eslami-Nejad et al 2005;Caugant et al 2006;Mueller et al 2006) and seven were cross-sectional surveys carried out post-vaccination (Hassan-King et al 1988;Neal et al 1998;Smith et al 1999;Aceitero 2000;Cardenosa et al 2001;Dominguez et al 2001;Pavlopoulou et al 2004).…”

Section: Description Of Studies Reviewedmentioning

confidence: 99%

Systematic review: Impact of meningococcal vaccination on pharyngeal carriage of meningococci

Dellicour

Greenwood

2007

Tropical Med Int Health

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Summaryobjective To investigate the effect of meningococcal vaccines on pharyngeal carriage of meningococci. methods Systematic review. MEDLINE and EMBASE were searched for relevant studies. Controlled trials and observational studies which used comparison groups or compared carriage rates before and after vaccination were included in the review.results Twenty-nine studies satisfied the inclusion criteria. Twenty-five studies reported the effect of a polysaccharide vaccine, one the effect of a serogroup C conjugate vaccine and three the impact of serogroup B outer-membrane vaccines on overall and ⁄ or serogroup-specific meningococcal carriage rates. Ten studies of meningococcal polysaccharide vaccines found reduced serogroup-specific carriage; seven of these focussed on high-risk groups and had a short follow-up period. Only one of five studies of civilian populations in Africa showed a significantly reduced carriage. Many studies had methodological shortcomings. The one study which assessed the effect of a meningococcal conjugate vaccine on carriage showed a significant impact. Three studies of serogroup B outer-membrane protein vaccines showed no effect on carriage.conclusions A few well-designed trials of the impact of meningococcal vaccines on carriage have been undertaken. Such studies should be an essential component of the evaluation of new meningococcal vaccines, particularly those introduced to control epidemic meningococcal disease in Africa.keywords meningococcal meningitis, vaccination, carrier state, herd immunity

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Evaluation of Group C Meningococcal Polysaccharide Vaccine in Marine Recruits, San Diego, California1

Cited by 32 publications

References 0 publications

Serological Basis for Use of Meningococcal Serogroup C Conjugate Vaccines in the United Kingdom: Reevaluation of Correlates of Protection

Serological Basis for Use of Meningococcal Serogroup C Conjugate Vaccines in the United Kingdom: Reevaluation of Correlates of Protection

Early Appearance of Bactericidal Antibodies after Polysaccharide Challenge of Toddlers Primed with a Group C Meningococcal Conjugate Vaccine: What Is Its Role in the Maintenance of Protection?

Systematic review: Impact of meningococcal vaccination on pharyngeal carriage of meningococci

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