title: DT5aP-Hib-IPV and MCC vaccines: preterm infants' response to accelerated immunisation.
abstract: OBJECTIVE
  To describe the immune response of preterm infants to combined diphtheria/tetanus/5 component acellular pertussis-Haemophilus influenzae type b inactivated polio vaccine (DT5aP-Hib-IPV) and meningococcal serogroup C conjugate vaccine (MCC) under accelerated schedule. To compare results with term infants immunised with DT5aP-Hib-IPV and with historical data from preterm infants immunised with a DT3 component aP-Hib vaccine.
  
  
  METHODS
  Prospective observational study in preterm infants born at <32 weeks gestation with comparison to contemporary cohort of term infants. DT5aP-Hib-IPV and MCC vaccines were given at 2, 3, and 4 months.
  
  
  RESULTS
  Fifty preterm infants (mean gestational age 28.5 weeks) completed the study. After three doses of vaccines Hib polysaccharide IgG geometric mean concentration (GMC) was 1.21 microg/ml with 80% > or =0.15 microg/ml; MCC serum bactericidal assay geometric mean titre (GMT) was 1245 with 100% > or =8. All infants achieved protective titres to diphtheria, tetanus, and the three poliovirus types with > or =80% achieving protective rises in IgG against the five pertussis antigens.
  
  
  CONCLUSIONS
  Preterm infants immunised with DT5aP-Hib-IPV and MCC vaccines show IgG responses to Hib and MCC greater than seen historically in both term and preterm infants with a DT3aP-Hib vaccine, and for pertussis antigens and poliovirus type 1 responses similar to that seen in term infants immunised with DT5aP-Hib-IPV. Responses to poliovirus types 2 and 3 are reduced, but all infants achieved protective titres.
authors.affiliation: Department of Paediatrics, St Mary's Hospital, Portsmouth PO3 6AD, UK. marts@doctors.org.uk
authors.forename: M H
authors.initials: MH
authors.lastname: Slack
authors.forename: S
authors.initials: S
authors.lastname: Cade
authors.forename: D
authors.initials: D
authors.lastname: Schapira
authors.forename: R J
authors.initials: RJ
authors.lastname: Thwaites
authors.forename: A
authors.initials: A
authors.lastname: Crowley-Luke
authors.forename: J
authors.initials: J
authors.lastname: Southern
authors.forename: R
authors.initials: R
authors.lastname: Borrow
authors.forename: E
authors.initials: E
authors.lastname: Miller
mesh_terms: D000917:Antibody Formation / Q000276:immunology*; D015331:Cohort Studies; D015721:Diphtheria-Tetanus-Pertussis Vaccine; D018073:Haemophilus Vaccines / Q000276:immunology*; D006801:Humans; D007074:Immunoglobulin G / Q000378:metabolism; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature / Q000276:immunology*; D022401:Meningococcal Vaccines / Q000276:immunology*; D011054:Poliovirus Vaccine, Inactivated / Q000276:immunology*; D011446:Prospective Studies; D017778:Vaccines, Combined / Q000276:immunology*
chemical_list: C500334:DT5aP-Hib-IPV vaccine; D015721:Diphtheria-Tetanus-Pertussis Vaccine; D018073:Haemophilus Vaccines; D007074:Immunoglobulin G; D022401:Meningococcal Vaccines; D011054:Poliovirus Vaccine, Inactivated; D017778:Vaccines, Combined; C080881:diphtheria-tetanus-pertussis-haemophilus b conjugate vaccine; C410218:serogroup C meningococcal conjugate vaccine