KINETICS OF BOOSTER RESPONSES TO HAEMOPHILUS INFLUENZAE TYPE B CONJUGATE AFTER COMBINED DIPHTHERIA-TETANUS-ACELLULAR PERTUSSIS-HAEMOPHILUS INFLUENZAE TYPE b VACCINATION IN INFANTS

Pichichero, Michael E.; Voloshen, Timothy; Passador, Sherry

doi:10.1097/00006454-199912000-00019

Cited by 25 publications

(7 citation statements)

References 11 publications

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“…The length of this delay is unknown, but is likely to be different in naïve from that in subjects primed by MCC vaccine. 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).…”

Section: Discussionmentioning

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

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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%

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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“…Binding of PS to circulating antibody immediately after its administration also could have contributed to an acute reduction of total antibody levels, possibly reflected to a greater extent in the ELISA (23). It has also been hypothesized that repeat polysaccharide epitopes could cross-link T-cell an- (21,29). In one study assessing secondary responses to a polyribosylribitol phosphate (PRP) challenge in a small group of toddlers previously immunized with Hib-conjugate vaccines in infancy, PRP-specific IgG remained at the baseline level at Day 3 and significantly increased only between Days 4 to 5 and Day 7 (29).…”

Section: Discussionmentioning

confidence: 99%

“…It has also been hypothesized that repeat polysaccharide epitopes could cross-link T-cell an- (21,29). In one study assessing secondary responses to a polyribosylribitol phosphate (PRP) challenge in a small group of toddlers previously immunized with Hib-conjugate vaccines in infancy, PRP-specific IgG remained at the baseline level at Day 3 and significantly increased only between Days 4 to 5 and Day 7 (29). This pattern suggested that the time required for the reactivation of memory B cells into plasma cells was at least 4 days.…”

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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“…Case-cohort Germany (1998)(1999)(2000)(2001)(2002) 2-3-4 (11-15) 96.7 (87.7-99.1) 98.5 (94.5-99.6) [53] DTPw-Hib Community, randomized (35,264 vaccinees)…”

Section: Postprimary Postboostermentioning

confidence: 99%

“…Studies of antibody kinetics following disease and vaccination with Hib conjugate vaccines suggest that serum IgG antibody responses are not detectable earlier than 3-4 days following antigen exposure, even in individuals who are primed [94][95][96]. This might be particularly important if the antibody is poorly functional because of impaired avidity maturation.…”

Section: Environmental and Population Factorsmentioning

confidence: 99%

Combination vaccines containing DTPa–Hib: impact of IPV and coadministration of CRM197 conjugates

Dagan

Poolman

Zepp

2008

Expert Review of Vaccines

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Vaccination with diphtheria-tetanus-acellular pertussis (DTPa)-Haemophilus influenzae type b (Hib) combinations generally elicits anti-polyribosyl-ribitol-phosphate (PRP) antibody concentrations of more than 0.15 microg/ml, a criterion that is linked to the protection of infants against Hib disease. In the UK, vaccination with DTPa3-Hib elicited atypically low anti-PRP antibody levels and was associated with breakthrough Hib cases. While the absence of a toddler booster is considered to be a key factor explaining the lowered control of Hib disease, we propose that the coadministration of serogroup C Neisseria meningitidis conjugate vaccine (MenC)-CRM197, which coincided with the introduction of DTPa3-Hib in the UK, may have played a role. However, other data suggest that the response to Hib after DTPa(HBV) inactivated polio vaccine (IPV)-Hib combinations is not affected by the coadministration of CRM197, which we postulate to be attributed to the presence of IPV. These observations underline the need to carefully evaluate upcoming pediatric conjugate vaccines for possible interference effects on the coadministered antigens, with particular attention to hepatitis B and Hib-tetanus toxoid.

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KINETICS OF BOOSTER RESPONSES TO HAEMOPHILUS INFLUENZAE TYPE B CONJUGATE AFTER COMBINED DIPHTHERIA-TETANUS-ACELLULAR PERTUSSIS-HAEMOPHILUS INFLUENZAE TYPE b VACCINATION IN INFANTS

Cited by 25 publications

References 11 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?

Combination vaccines containing DTPa–Hib: impact of IPV and coadministration of CRM197 conjugates

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