title: Interchangeability of meningococcal group C conjugate vaccines with different carrier proteins in the United Kingdom infant immunisation schedule.
abstract: An open, non-randomised study was undertaken in England during 2011-12 to evaluate vaccine antibody responses in infants after completion of the routine primary infant immunisation schedule, which included two doses of meningococcal group C (MenC) conjugate (MCC) vaccine at 3 and 4 months. Any of the three licensed MCC vaccines could be used for either dose, depending on local availability. Healthy term infants registered at participating general practices (GPs) in Hertfordshire and Gloucestershire, UK, were recruited prospectively to provide a single blood sample four weeks after primary immunisation, which was administered by the GP surgery. Vaccination history was obtained at blood sampling. MenC serum bactericidal antibody (SBA) and IgG antibodies against Haemophilus influenzae b (Hib), pertussis toxin (PT), diphtheria toxoid (DT), tetanus toxoid (TT) and thirteen pneumococcal serotypes were analysed according to MCC vaccines received. MenC SBA responses differed significantly (P<0.001) according to MCC vaccine schedule as follows: MenC SBA geometric mean titres (GMTs) were significantly lower in infants receiving a diphtheria cross-reacting material-conjugated MCC (MCC-CRM) vaccine followed by TT-conjugated MCC (MCC-TT) vaccine (82.0; 95% CI, 39-173; n=14) compared to those receiving two MCC-CRM (418; 95% CI, 325-537; n=82), two MCC-TT (277; 95% CI, 223-344; n=79) or MCC-TT followed by MCC-CRM (553; 95% CI, 322-949; n=18). The same group also had the lowest Hib geometric mean concentrations (0.60 μg/mL, 0.27-1.34) compared to 1.85 μg/mL (1.23-2.78), 2.86 μg/mL (2.02-4.05) and 4.26 μg/mL (1.94-9.36), respectively. Our results indicate that MCC vaccines with different carrier proteins are not interchangeable. When several MCC vaccines are available, children requiring more than one dose should receive MCC vaccines with the same carrier protein or, alternatively, receive MCC-TT first wherever possible.
authors.affiliation: Immunisation, Hepatitis and Blood Safety Department, Public Health England, London, United Kingdom. Electronic address: shamez.ladhani@phe.gov.uk.
authors.forename: Shamez N
authors.initials: SN
authors.lastname: Ladhani
authors.affiliation: Statistics, Modelling and Economics and Immunisation, Public Health England, London, United Kingdom.
authors.forename: Nick J
authors.initials: NJ
authors.lastname: Andrews
authors.affiliation: Immunisation, Hepatitis and Blood Safety Department, Public Health England, London, United Kingdom.
authors.forename: Pauline
authors.initials: P
authors.lastname: Waight
authors.affiliation: Immunoassay Laboratory, Public Health England, Porton Down, United Kingdom.
authors.forename: Bassam
authors.initials: B
authors.lastname: Hallis
authors.affiliation: Immunoassay Laboratory, Public Health England, Porton Down, United Kingdom.
authors.forename: Mary
authors.initials: M
authors.lastname: Matheson
authors.affiliation: Immunoassay Laboratory, Public Health England, Porton Down, United Kingdom.
authors.forename: Anna
authors.initials: A
authors.lastname: England
authors.affiliation: Vaccine Evaluation Unit, Public Health England, Manchester Royal Infirmary, Manchester, United Kingdom.
authors.forename: Helen
authors.initials: H
authors.lastname: Findlow
authors.affiliation: Vaccine Evaluation Unit, Public Health England, Manchester Royal Infirmary, Manchester, United Kingdom.
authors.forename: Xilian
authors.initials: X
authors.lastname: Bai
authors.affiliation: Vaccine Evaluation Unit, Public Health England, Manchester Royal Infirmary, Manchester, United Kingdom.
authors.forename: Ray
authors.initials: R
authors.lastname: Borrow
authors.affiliation: Immunobiology Unit, Institute of Child Health, University College, London, United Kingdom.
authors.forename: Polly
authors.initials: P
authors.lastname: Burbidge
authors.affiliation: Immunobiology Unit, Institute of Child Health, University College, London, United Kingdom.
authors.forename: Emma
authors.initials: E
authors.lastname: Pearce
authors.affiliation: Immunobiology Unit, Institute of Child Health, University College, London, United Kingdom.
authors.forename: David
authors.initials: D
authors.lastname: Goldblatt
authors.affiliation: Immunisation, Hepatitis and Blood Safety Department, Public Health England, London, United Kingdom.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Miller
mesh_terms: D000907:Antibodies, Bacterial / Q000097:blood*; D001770:Blood Bactericidal Activity; D002352:Carrier Proteins / Q000008:administration & dosage / Q000737:chemistry / Q000276:immunology*; D006001:Glycoconjugates / Q000008:administration & dosage / Q000737:chemistry / Q000276:immunology*; D006801:Humans; D007223:Infant; D022401:Meningococcal Vaccines / Q000008:administration & dosage / Q000737:chemistry / Q000276:immunology*; D016896:Treatment Outcome; D006113:United Kingdom
chemical_list: D000907:Antibodies, Bacterial; D002352:Carrier Proteins; D006001:Glycoconjugates; D022401:Meningococcal Vaccines; C410218:serogroup C meningococcal conjugate vaccine
keywords: Carrier proteins; Conjugate vaccines; Interchangeability; Interference; Meningococcal capsular group C