[Reflections on the effectiveness of the new combined vaccines].
The combination vaccines are very useful to reduce the number of contacts required to immunize a child fully and to improve the vaccine coverage. Recently the new combinations between Haemophilus Influenzae vaccine (PRP-T) and pertussis vaccines in D-T-P (IVP) combined vaccines have suggested interferences with immunogenicity for PRP-T vaccines. The interference for pertussis antibodies is not significative. The depression of antiPRP antibodies is shown with the whole-cell pertussis vaccine, but the level of antibodies is related to a good protective efficacy. Inversely, when PRP-T vaccine is combined with acellular pertussis vaccines, the antibodies levels are lower, especially the number of children with a level higher than 1 mcg/ml. At the present time, these combinations between PRP-T vaccines and acellular pertussis vaccines are not recommended for primary immunization in infants in France. Such constations emphasize the necessity to perform wide comparative trials to test immunogenicity for all the next combinations between old and new vaccines. A decrease in immunogenicity of combination vaccines is acceptable as long as protective efficacy is preserved. It is possible that the growing number of new vaccines to combine will be limited to keep a clinical efficacy.
Hôpital d'enfants Armand Trousseau, Paris.
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D002986:Clinical Trials as Topic; D005602:France; D018073:Haemophilus Vaccines; D016896:Treatment Outcome; D017778:Vaccines, Combined
D018073:Haemophilus Vaccines; D017778:Vaccines, Combined