Predictors of pneumococcal conjugate vaccine immunogenicity among infants and toddlers in an American Indian PnCRM7 efficacy trial.
BACKGROUND
Pneumococcal conjugate vaccines are important for the prevention of serious illness and death among infants. Factors associated with pneumococcal conjugate vaccine immunogenicity have not been explored.


METHODS
Children <24 months of age received 2, 3, or 4 doses of 7-valent pneumococcal conjugate vaccine (PnCRM7) or control vaccine depending on age at enrollment. Serum samples were tested for serotype-specific antibodies by enzyme-linked immunosorbant assay. Multiple linear regression was used to determine predictors of immunogenicity.


RESULTS
Among 315 PnCRM7-vaccinated subjects and 295 control subjects enrolled at <7 months of age, geometric mean concentrations (GMCs) of antibodies were significantly higher after dose 3 than after dose 2 for all serotypes except type 4. The proportion of subjects with antibody concentrations > or =5.0 micro g/mL was higher for all serotypes, but the proportion with concentrations > or =0.35 micro g/mL was higher only for types 6B and 23F. Three-dose and 2-dose regimens for those 7-11 and 12-23 months of age, respectively, were highly immunogenic. Increased maternal antibody concentrations were associated with reduced responses to dose 1 and 3 but not to dose 4 of PnCRM7.


CONCLUSIONS
Maternal antibody is associated with a reduced infant response to PnCRM7 but does not interfere with immune memory. In infants, a third priming dose increases the antibody GMC and the proportion achieving an antibody concentration > or =5.0 micro g/mL but has little impact on the proportion achieving a concentration > or =0.35 micro g/mL.
O'Brien
Katherine L
KL
Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA. klobrien@jhsph.edu
Moisi
Jennifer
J
Moulton
Lawrence H
LH
Madore
Dace
D
Eick
Angelia
A
Reid
Ray
R
Weatherholtz
Robert
R
Millar
Eugene
E
Hu
Diana
D
Hackell
Jill
J
Kohberger
Robert
R
Siber
George
G
Santosham
Mathuram
M
D000367:Age Factors; D000907:Antibodies, Bacterial / Q000097:blood*; D001942:Breast Feeding; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D000069443:Heptavalent Pneumococcal Conjugate Vaccine; D006801:Humans; D007112:Immunity, Maternally-Acquired; D007115:Immunization Schedule; D007117:Immunization, Secondary; D007198:Indians, North American; D007223:Infant; D016014:Linear Models; D008297:Male; D022401:Meningococcal Vaccines / Q000008:administration & dosage / Q000276:immunology*; D011008:Pneumococcal Infections / Q000517:prevention & control*; D022242:Pneumococcal Vaccines / Q000008:administration & dosage / Q000276:immunology*; D013296:Streptococcus pneumoniae / Q000276:immunology; D014481:United States
D000907:Antibodies, Bacterial; D000069443:Heptavalent Pneumococcal Conjugate Vaccine; D022401:Meningococcal Vaccines; D022242:Pneumococcal Vaccines