Immunogenicity of a fourth dose of Haemophilus influenzae type b (Hib) conjugate vaccine and antibody persistence in young children from the United Kingdom who were primed with acellular or whole-cell pertussis component-containing Hib combinations in infancy.
In response to the rising incidence of Haemophilus influenzae type b (Hib) disease in the United Kingdom, a national campaign to give a booster dose of single-antigen Hib conjugate vaccine to children aged 6 months to 4 years was undertaken in 2003. Children (n = 386) eligible for Hib vaccine in the campaign were recruited. Hib antibody concentrations were measured before boost and at 1 month, 6 months, 1 year, and 2 years after boost and were analyzed according to children's ages at booster dose and whether a Hib combination vaccine containing acellular pertussis (aP) or whole-cell pertussis (wP) components was given in infancy. The geometric mean antibody concentrations (GMCs) before the booster declined as the time since primary immunization increased (P < 0.001), and GMCs were threefold higher in recipients of wP-Hib than aP-Hib combination vaccines (P < 0.001). GMCs 1 month after the booster increased with age (P < 0.001) as follows: 6 to 11 months; 30 microg/ml (95% confidence interval [CI], 22 to 40); 12 to 17 months, 68 microg/ml (95% CI, 38 to 124); and 2 to 4 years, 182 microg/ml (151 to 220), with no difference according to the type of priming vaccine received. Antibody levels declined after the booster, but 2 years later, GMCs were more than 1.0 microg/ml for all age groups. By extrapolating data for the decline in antibody levels, we found the GMCs 4 years after boosting were predicted to be 0.6, 1.4, and 2.6 microg/ml for those boosted at 6 to 11 months, 12 to 17 months, and 2 to 4 years, respectively, with levels of at least 0.15 microg/ml in about 90% of individuals. A booster dose of Hib vaccine given after the first year of life should provide long-lasting protection.
Southern
Jo
J
Immunisation Department, Centre for Infections, Health Protection Agency, London NW9 5EQ, United Kingdom. jo.southern@hpa.org.uk
McVernon
Jodie
J
Gelb
David
D
Andrews
Nick
N
Morris
Rhonwen
R
Crowley-Luke
Annette
A
Goldblatt
David
D
Miller
Elizabeth
E
D000907:Antibodies, Bacterial / Q000097:blood*; D002675:Child, Preschool; D004306:Dose-Response Relationship, Immunologic; D018073:Haemophilus Vaccines / Q000008:administration & dosage / Q000276:immunology*; D006193:Haemophilus influenzae / Q000276:immunology*; D006801:Humans; D007117:Immunization, Secondary / Q000379:methods*; D007223:Infant; D008583:Meningitis, Haemophilus / Q000276:immunology / Q000517:prevention & control*; D010567:Pertussis Vaccine / Q000008:administration & dosage / Q000276:immunology*; D006113:United Kingdom; D022282:Vaccines, Acellular / Q000008:administration & dosage / Q000276:immunology; D014613:Vaccines, Attenuated / Q000008:administration & dosage / Q000276:immunology; D018074:Vaccines, Conjugate / Q000008:administration & dosage / Q000276:immunology
D000907:Antibodies, Bacterial; D018073:Haemophilus Vaccines; D010567:Pertussis Vaccine; D022282:Vaccines, Acellular; D014613:Vaccines, Attenuated; D018074:Vaccines, Conjugate
Curr Med Res Opin. 2001;17(3):197-209
11900313
Pediatr Infect Dis J. 2000 Jul;19(7):589-91
10917213
Lancet. 2003 May 3;361(9368):1521-3
12737866
J Infect Dis. 2003 Aug 15;188(4):481-5
12898433
Lancet. 2004 Jul 24-30;364(9431):365-7
15276396
Epidemiol Infect. 2004 Aug;132(4):765-7
15310180
BMJ. 2004 Sep 18;329(7467):655-8
15374916
J Infect Dis. 1983 Jun;147(6):1100
6602191
Eur J Immunol. 1986 Oct;16(10):1297-301
3490389
J Immunol Methods. 1990 Dec 31;135(1-2):121-8
2273252
Lancet. 1994 Aug 6;344(8919):362-6
7914306
J Infect Dis. 1995 Jan;171(1):93-8
7798687
BMJ. 1994 Nov 26;309(6966):1412-4
7819853
Immunity. 1998 Mar;8(3):363-72
9529153
BMJ. 1998 May 23;316(7144):1570-1
9596595
J Infect Dis. 1999 Aug;180(2):538-41
10395878
J Infect Dis. 2005 Aug 1;192(3):387-93
15995951
Emerg Infect Dis. 2006 Jun;12(6):937-41
16707049
Arch Dis Child. 2007 Jan;92(1):11-6
16670121
Vaccine. 2007 Jan 22;25(6):1055-63
17049692
Lancet. 1999 Dec 11;354(9195):2063-8
10636384
Science. 2002 Dec 13;298(5601):2199-202
12481138