Reduced antibody response to revaccination with meningococcal serogroup A polysaccharide vaccine in adults
Section snippets
Study population
The study population comprised students who had received a single dose of MACP vaccine as part of control measures following a University outbreak in late 1997. These students were originally enrolled as part of a study to investigate the effect of either MACP or conjugate C vaccine 6 months later on serogroup C antibody responses [10]. From this cohort, sera were available from 36 students 1 and 6 months post first MACP vaccine and 1 month after the second MACP vaccine.
As part of the original
Results
Of the 522 students at the University who had previously received MACP vaccine, 51 received a second dose of MACP (median interval since initial vaccination 29 weeks). Post first MACP and pre- and post-second MACP vaccination blood samples were obtained on 36 subjects (20 male, 16 female; median age 19 years, range 18–25). Reactogenicity data was as previously reported in Richmond et al. [10].
Serogroup A-specific SBA responses are shown in Table 1. There were no significant differences in
Discussion
This study has demonstrated a reduced serogroup A SBA antibody response to a second full dose of MACP vaccine in adults revaccinated 6 months after the initial dose. Unlike for serogroup C, immunological hyporesponsiveness following meningococcal A polysaccharide has not been widely reported. Three previous studies have documented the serological response to repeated doses of serogroup A meningococcal polysaccharide in the first 6 years of life [13], [14], [15]. The first two studies [13], [14]
Acknowledgements
The laboratory work was supported by Aventis Pasteur. The field work for this study was supported by the UK Department of Health (Grant VCA7/9/3). The authors would like to thank Drs Rosemary McCann and Jenny Hill (Salford and Trafford Health Authority) for their assistance in facilitating the collection of clinical samples.
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Cited by (59)
No long-term evidence of hyporesponsiveness after use of pneumococcal conjugate vaccine in children previously immunized with pneumococcal polysaccharide vaccine
2016, Journal of Allergy and Clinical ImmunologyCitation Excerpt :We also reviewed hospital records for all children in the original study and found no difference in hospitalizations related to pneumococcal disease, although this study was not sufficiently powered for this analysis. Vaccine-induced hyporesponsiveness was first reported for meningococcal polysaccharide-based vaccines, with prior immunization resulting in reduced antibody titers for both children and adults.17,18 For pneumococcal polysaccharide vaccines, studies to detect hyporesponsiveness in adults receiving repeated doses of 23vPPV have produced variable results19-22 while making results difficult to interpret because of issues of possible bias from the nonrandomized study design of a number of these 23vPPV trials.
Complement Deficiencies
2016, Pediatric Allergy: Principles and Practice: Third EditionImpaired serotype-specific immune function following pneumococcal vaccination in infants with prior carriage
2014, VaccineCitation Excerpt :While most of the data on hyporesponsiveness in the context of prior or current pneumococcal colonization have been reported for PCV immunization, this has not been fully described for PPS, most likely due to the fact that pneumococcal polysaccharides do not induce strong immunity in children less than 2 years of age and so are not routinely given to this population [25]. Despite this, hyporesponsiveness was first described following the use of polysaccharide-based vaccines for meningococcus, with immunization using group C quadrivalent vaccine resulting in reduced antibody titres in children and adults [26,27], with similar findings also reported in adults given the quadrivalent MPV vaccine [28]. Hyporesponsiveness has also been demonstrated in infants immunized with older generation PPS vaccines that contained fewer valencies as well as older adults given repeated doses of PPS [29,30].