Reduced reactogenicity of primary vaccination with DT3aP-HBV-IPV/Hib compared with DT2aP-HBV-IPV-Hib among infants: Mathematical projections in six countries

Abstract

The hexavalent vaccines DT3aP-HBV-IPV/Hib and DT2aP-HBV-IPV-Hib are routinely used for primary immunization of infants against diphtheria, tetanus, pertussis, hepatitis B virus, poliomyelitis, and Haemophilus influenzae type b. A recent publication showed that after primary immunization with these vaccines, the odds ratios of adverse reactions (ARs) were significantly lower for DT3aP-HBV-IPV/Hib than for DT2aP-HBV-IPV-Hib. Our aim is to understand the impact of the various reactogenicity profiles at country level by comparing the ARs induced by one dose of DT3aP-HBV-IPV/Hib versus DT2aP-HBV-IPV-Hib in the primary infant immunization course. A mathematical projection tool was developed to simulate vaccination of infants with both vaccines in six countries: Austria, the Czech Republic, France, Jordan, Spain, and the Netherlands. Proportions of three local and five systemic ARs of interest for both vaccines were based on findings from a previous meta-analysis of ARs in infants. The absolute risk reductions calculated ranged from 3.0% (95% confidence interval [CI]: 2.8%–3.2%) for “Swelling at the injection site, any grade” to 10.0% (95% CI: 9.5%–10.5%) for “Fever, any grade.” The difference in occurrence of the AR “Fever, any grade” between vaccines in 2020 ranged from over 7,000 in Austria to over 62,000 in France. Over 5 years, this would amount to a reduction of over 150,000 ARs in Austria and over 1.4 million ARs in France when using DT3aP-HBV-IPV/Hib instead of DT2aP-HBV-IPV-Hib. In conclusion, the estimated numbers of ARs following hexavalent vaccination in six countries showed that vaccination of infants with DT3aP-HBV-IPV/Hib could lead to fewer ARs than vaccination with DT2aP-HBV-IPV-Hib.

Reactogenicity of Primary Vaccination with Hexavalent Vaccines in Infants: Mathematical Projections in Four Southeast Asian Countries

“…To explore the impact of such differences in reactogenicity profiles, a decision-support tool was developed to investigate the burden of adverse reactions to DT3aP-HBV-IPV/Hib vaccine compared with DT2aP-HBV-IPV-Hib vaccine if implemented in a NIP (George et al, 2023). A previous publication has estimated the potential impact in six countries (Austria, Czech Republic, France, Jordan, Spain and the Netherlands) (George et al, 2023).…”

“…To explore the impact of such differences in reactogenicity profiles, a decision-support tool was developed to investigate the burden of adverse reactions to DT3aP-HBV-IPV/Hib vaccine compared with DT2aP-HBV-IPV-Hib vaccine if implemented in a NIP (George et al, 2023). A previous publication has estimated the potential impact in six countries (Austria, Czech Republic, France, Jordan, Spain and the Netherlands) (George et al, 2023). The objective of the present study was to compare the impact of adverse reactions after a single dose of the primary series of DT3aP-HBV-IPV/Hib vaccine versus DT2aP-HBV-IPV-Hib vaccine in the infant populations of four countries in Southeast Asia, Indonesia, Malaysia, the Philippines and Thailand.…”