Serotype-Specific Hyporesponsiveness to Pneumococcal Conjugate Vaccine in Infants Carrying Pneumococcus at the Time of Vaccination

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• 作者：Merja V&#xe4 ; kev&#xe4 ; inen ; Anu Soininen ; Marilla Lucero ; Hanna Nohynek ; Kari Auranen ; P. Helena M&#xe4 ; kel&#xe4 ; Gail Williams ; Helena K&#xe4 ; yhty ; ARIVAC Consortium
• 刊名：The Journal of Pediatrics
• 出版年：2010
• 出版时间：November 2010
• 年：2010
• 卷：157
• 期：5
• 页码：778-783.e1
• 全文大小：327 K

文摘

Objective

To determine whether pneumococcal carriage at the time of 11-valent pneumococcal conjugate vaccine (PCV-11) administration interferes with immune response in infants.

Study design

A total of 1111 Filipino infants recruited into an immunogenicity and carriage study, nested in an efficacy trial, received PCV-11 or saline solution placebo at 6, 10, and 14 weeks of age. Antibody concentrations to the most frequently carried vaccine serotypes 6B, 19F, and 23F were measured by enzyme immunoassay from sera obtained at 18 weeks and 9 months of age. Serotype-specific antibody concentration was compared between groups of children among PCV-11 recipients stratified according to their carriage status at 6 weeks of age.

Results

Antibody concentrations to 6B, 19F, and 23F were significantly lower at 18 weeks and 9 months of age among children who were carriers of the specific serotype at 6 weeks of age than among non-carriers of the serotype. The hyporesponsiveness was specific to the carried serotype. The specific antibody concentrations induced by PCV-11 among carriers did not differ significantly from those in placebo recipients, whereas the differences were highly significant among noncarriers.

Conclusions

Pneumococcal carriage, prevalent in Filipino infants, interferes with serotype-specific immune response to primary series of PCV and has potential implications for immunization programs.