title: Comparison of active and combined passive/active immunization of Navajo children against Haemophilus influenzae type b.
abstract: In a high risk Navajo population we compared the immunogenicity of a new Haemophilus influenzae type b mutant-diphtheria toxic conjugate vaccine (HbOC) with simultaneous active (HbOC) and passive immunization with bacterial polysaccharide immunoglobulin prepared from adults immunized with H. influenzae b, pneumococcal and meningococcal vaccines. Only 7 of 26 (27%) 2-month-olds had an increase in H. influenzae b capsular polysaccharide antibody after a single dose of HbOC, a proportion similar to that of saline controls (9 of 25, 36%). After a second HbOC dose at 4 months 88% had antibody concentrations of 0.15 microgram or more, and after a third dose at 6 months all had antibody levels greater than or equal to 0.15 microgram/ml. The group receiving both HbOC and bacterial polysaccharide immunoglobulin at 2 months uniformly had H. influenzae b CP antibody concentrations of greater than or equal to 0.15 microgram/ml at 4 months (P less than 0.001 relative to "HbOC alone" group) and subsequently responded similarly to second and third doses of HbOC vaccine as did also the "HbOC alone" group. We conclude that combined passive/active immunization with bacterial polysaccharide immunoglobulin and HbOC at 2 months maintains antibody at concentrations thought to be protective (greater than or equal to 0.15 microgram/ml) without interfering with the active antibody response to second and third doses of HbOC at 4 and 6 months of age.
authors.affiliation: Department of International Health, Johns Hopkins University School of Hygiene and Public Health, Baltimore, MD 21205.
authors.forename: G W
authors.initials: GW
authors.lastname: Letson
authors.forename: M
authors.initials: M
authors.lastname: Santosham
authors.forename: R
authors.initials: R
authors.lastname: Reid
authors.forename: C
authors.initials: C
authors.lastname: Priehs
authors.forename: B
authors.initials: B
authors.lastname: Burns
authors.forename: A
authors.initials: A
authors.lastname: Jahnke
authors.forename: S
authors.initials: S
authors.lastname: Gahagan
authors.forename: L
authors.initials: L
authors.lastname: Nienstadt
authors.forename: C
authors.initials: C
authors.lastname: Johnson
authors.forename: D
authors.initials: D
authors.lastname: Smith
mesh_terms: D016667:Bacterial Capsules; D001428:Bacterial Vaccines / Q000008:administration & dosage*; D004168:Diphtheria Toxoid / Q000008:administration & dosage*; D006192:Haemophilus Infections / Q000276:immunology / Q000517:prevention & control*; D018073:Haemophilus Vaccines; D006193:Haemophilus influenzae / Q000276:immunology*; D006801:Humans; D007114:Immunization; D007116:Immunization, Passive; D007198:Indians, North American; D007223:Infant; D011135:Polysaccharides, Bacterial; D012307:Risk Factors
chemical_list: D001428:Bacterial Vaccines; D004168:Diphtheria Toxoid; D018073:Haemophilus Vaccines; C044237:Haemophilus influenzae type b polysaccharide vaccine; C052180:Haemophilus influenzae type b-polysaccharide vaccine-diphtheria toxoid conjugate; D011135:Polysaccharides, Bacterial