Protecting the most vulnerable age group: a review of MenACWY-TT immunogenicity and safety in infants

Abstract

Introduction: Neisseria meningitidis causes invasive meningococcal disease (IMD), with the highest incidence observed in infants and young children. Meningococcal serogroups A, B, C, W, X, and Y account for almost all IMD cases worldwide. Available meningococcal vaccines targeting serogroups A, C, W, and Y (MenACWY) include those conjugated to diphtheria toxoid (MenACWY-D), diphtheria protein cross-reactive material 197 (MenACWY-CRM 197 ), and tetanus toxoid (MenACWY-TT). MenACWY-TT is indicated for use starting at 6 weeks of age. Areas covered: This review discusses data from the four primary studies assessing MenACWY-TT safety and immunogenicity in infants, which evaluated a variety of dosing schedules, short-term and longterm outcomes, and impact of coadministration on the immunogenicity of routine childhood vaccines. Remaining gaps in the field are addressed. Expert opinion: Robust data support the use of MenACWY-TT in infants starting as early as 6 weeks of age. MenACWY-TT was safe and well tolerated in infants, was immunogenic after priming and booster, and demonstrated persistent immunogenicity. Lower persistence for serogroup A relative to other serogroups based on serum bactericidal assays (SBAs) using human complement appears to be a class effect of MenACWY conjugate vaccines. Correlates of protection other than SBA are being explored, including immunologic responses associated with different carrier proteins. ARTICLE HISTORY

Preventing invasive meningococcal disease in early infancy

“…76 It is expected that within the coming years, MenACWY vaccines will replace MenC vaccines within infant vaccination programs, particularly in middle- and high-income countries to broaden the range of protection. 85 Moreover, adolescent meningococcal vaccination, including primary vaccination and a booster dose, is already recommended in the United Kingdom and in some European member states. 76 , 86 Overall, depending on country and vaccine, the earliest age that a meningococcal vaccine series is recommended to begin is at 2 months, knowing that some protection likely occurs after just one dose.…”

Journal of Preventive Medicine and Hygiene, Vol. 62 No. 1s1 (2021): Health Technology Assessment (HTA) sull’introduzione di coorti aggiuntive per la vaccinazione contro il meningococco con vaccini quadrivalenti coniugati in Italia

“…Nella revisione di Martinón-Torres et al sono riportati i risultati di 4 studi clinici di fase II e III condotti su un totale di 3294 bambini [ 34 ].…”

“…Nella revisione di Martinòn-Torres et al [ 34 ], sono riportati i risultati di immunogenicità e sicurezza degli studi clinici di fase II e III su MenACWY-TT testato su un totale di 3294 bambini.…”