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Burman C, Knuf M, Sáfadi MAP, Findlow J. Antibody persistence and revaccination recommendations of MenACWY-TT: a review of clinical studies assessing antibody persistence up to 10 years after vaccination. Expert Rev Vaccines 2024; 23:614-635. [PMID: 38697798 DOI: 10.1080/14760584.2024.2348609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 04/24/2024] [Indexed: 05/05/2024]
Abstract
INTRODUCTION Invasive meningococcal disease (IMD) is potentially fatal and associated with severe sequelae among survivors. It is preventable by several vaccines, including meningococcal vaccines targeting the most common disease-causing serogroups (A, B, C, W, Y). The meningococcal ACWY tetanus toxoid conjugate vaccine (MenACWY-TT [Nimenrix]) is indicated from 6 weeks of age in the European Union and >50 additional countries. AREAS COVERED Using PubMed, Google Scholar, ClinicalTrials.gov and ad hoc searches for publications to June 2023, we review evidence of antibody persistence for up to 10 years after primary vaccination and up to 6 years after MenACWY-TT revaccination. We also review global MenACWY revaccination recommendations and real-world impact of vaccination policies, focusing on how these data can be considered alongside antibody persistence data to inform future IMD prevention strategies. EXPERT OPINION Based on clear evidence that immunogenicity data (demonstrated antibody titers above established correlates of protection) are correlated with real-world effectiveness, long-term persistence of antibodies after MenACWY-TT vaccination suggests continuing protection against IMD. Optimal timing of primary and subsequent vaccinations is critical to maximize direct and indirect protection. Recommending bodies should carefully consider factors such as age at vaccination and long-term immune responses associated with the specific vaccine being used.
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Affiliation(s)
- Cynthia Burman
- Vaccines, Antivirals and Evidence Generation, Pfizer Inc, Collegeville, PA, USA
| | - Markus Knuf
- Children's Hospital, Worms Clinic, Worms, Germany
- Pediatric Infectious Diseases, University Medicine Mainz, Mainz, Germany
| | - Marco Aurelio P Sáfadi
- Department of Pediatrics, Santa Casa de São Paulo School of Medical Sciences, São Paulo, Brazil
| | - Jamie Findlow
- Vaccines, Antivirals and Evidence Generation, Pfizer Ltd, Surrey, UK
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Luo W, Arkwright PD, Borrow R. Antibody persistence following meningococcal ACWY conjugate vaccine licensed in the European Union by age group and vaccine. Expert Rev Vaccines 2020; 19:745-754. [PMID: 32897762 DOI: 10.1080/14760584.2020.1800460] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Meningococcal disease caused by Neisseria meningitidis is a major cause of meningitis and septicemia with high rates of morbidity and mortality worldwide. MenACWY-TT and MenACWY-CRM197 are meningococcal conjugate vaccines approved for use in children and adults in the UK. The aim of this review was to evaluate and compare antibody responses and persistence in different age groups after MenACWY-TT and MenACWY-CRM197. AREAS COVERED Randomized trials showed that MenACWY-TT is immunogenic at all ages. MenACWY-CRM197 is immunogenic for infants and adults, but there is a lack of data for children aged 1 to 2 years. Studies on MenACWY-TT indicated that serum bactericidal antibody (SBA) utilizing baby rabbit complement (rSBA) titers were significantly higher and more stable than SBA using human complement (hSBA) titers, compared with hSBA titers, which were lower and declined more rapidly by 1 year following post-primary MenACWY-TT and MenACWY-CRM197 vaccination, especially for MenA. EXPERT OPINION MenACWY-TT and MenACWY-CRM197 are both well tolerated and induce similar antibody persistence and immunogenicity against all four serogroups for individuals more than one year old. rSBA assay is a more robust assay than the hSBA assay when vaccinating with MenACWY-TT, while rSBA and hSBA assays had similar antibody persistence when vaccinating with MenACWY-CRM197.
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Affiliation(s)
- Weichang Luo
- Royal Manchester Children's Hospital, University of Manchester , Manchester, UK
| | - Peter D Arkwright
- Royal Manchester Children's Hospital, Lydia Becker Institute of Immunology and Inflammation, University of Manchester , Manchester, UK
| | - Ray Borrow
- Vaccine Evaluation Unit, Public Health England, Manchester Royal Infirmary , Manchester, UK
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Quiambao B, Peyrani P, Li P, Cutler MW, Van Der Wielen M, Perez JL, Webber C. Efficacy and safety of a booster dose of the meningococcal A, C, W, Y-tetanus toxoid conjugate vaccine administered 10 years after primary vaccination and long-term persistence of tetanus toxoid conjugate or polysaccharide vaccine. Hum Vaccin Immunother 2020; 16:1272-1279. [PMID: 32401600 PMCID: PMC7482828 DOI: 10.1080/21645515.2020.1744363] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 02/26/2020] [Accepted: 03/13/2020] [Indexed: 10/25/2022] Open
Abstract
A previous phase 3, randomized, multicenter study showed the immunogenicity of a primary vaccination of subjects aged 11 to 17 years with the quadrivalent meningococcal vaccine conjugated to tetanus toxoid (MenACWY-TT) or the quadrivalent meningococcal polysaccharide vaccine (MenACWY-PS). This extension study evaluated the safety and immunogenicity of a MenACWY-TT booster 10 years after receiving a primary dose of either MenACWY-TT or MenACWY-PS. The primary immunogenicity endpoint was booster response, evaluated using serum bactericidal antibody assays with rabbit complement (rSBA), 1 month postbooster. Safety endpoints included the percentage of subjects experiencing local and general adverse events (AEs) ≤4 days after MenACWY-TT booster. Of 229 subjects enrolled, 169 and 58 in the MenACWY-TT and MenACWY-PS groups, respectively, completed the booster phase. The 1 month postbooster response for each serogroup ranged from 81.5% to 95.7% for MenACWY-TT and 66.7% to 94.1% for MenACWY-PS. Similar percentages of MenACWY-TT and MenACWY-PS recipients had a booster response to serogroups A, W, and Y, whereas more MenACWY-TT recipients than MenACWY-PS recipients had a booster response to serogroup C. For the MenACWY-TT and MenACWY-PS groups, respectively, the MenACWY-TT booster elicited rSBA titers ≥1:8 in 100% and ≥98.0% of subjects across all serogroups; 100% and ≥96.1% of all subjects had titers ≥1:128. No new safety signals were observed during the booster phase. In conclusion, a MenACWY-TT booster dose after receiving either a primary dose of MenACWY-TT or MenACWY-PS elicited robust immune responses and was well tolerated. Functional antibody responses last up to 10 years after primary MenACWY-TT vaccination.
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Affiliation(s)
- Beatriz Quiambao
- Clinical Research Division, Research Institute for Tropical Medicine, Alabang, Muntinlupa City, Philippines
| | - Paula Peyrani
- Pfizer Vaccine Clinical Research and Development, Pfizer Inc, Collegeville, PA, USA
| | - Ping Li
- Pfizer Vaccine Clinical Research and Development, Pfizer Inc, Collegeville, PA, USA
| | - Mark W. Cutler
- Pfizer Vaccine Research and Development, Pfizer Inc, Pearl River, NY, USA
| | | | - John L. Perez
- Pfizer Vaccine Clinical Research and Development, Pfizer Inc, Collegeville, PA, USA
| | - Chris Webber
- Pfizer Vaccine Clinical Research and Development, Pfizer Inc, Hurley, UK
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Findlow J, Knuf M. Immunogenicity and safety of meningococcal group A, C, W and Y tetanus toxoid conjugate vaccine: review of clinical and real-world evidence. Future Microbiol 2019; 14:563-580. [PMID: 31091978 DOI: 10.2217/fmb-2018-0343] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Protection by meningococcal group A, C, W and Y (MenACWY) vaccines against four meningococcal disease-causing serogroups is increasingly important because of changing epidemiologic patterns of meningococcal disease, including recent meningococcal serogroup W outbreaks/disease clusters. The MenACWY vaccine conjugated to tetanus toxoid (MenACWY-TT) has been extensively evaluated across the age spectrum (age ≥6 weeks) in randomized Phase II and III and in postmarketing studies. Results support the robust immunogenicity of MenACWY-TT across ages and coadministration with other vaccines. The safety profile is similar regardless of age, primary versus booster vaccination, or concomitant administration; local (swelling, pain, redness) and systemic (fever, fatigue, headache, drowsiness, loss of appetite, irritability) reactogenicity events are most common. These data support use of MenACWY-TT to protect against MenACWY disease.
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Affiliation(s)
- Jamie Findlow
- Vaccines, Medical & Scientific Affairs, International Developed Markets, Pfizer Ltd, Surrey, UK
| | - Markus Knuf
- Childrens Hospital, Dr. Horst Schmidt Clinic, Wiesbaden, Germany & Pediatric Infectious Diseases, University Medicine, Mainz, Germany
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Quiambao BP, Bavdekar A, Dubey AP, Jain H, Kolhe D, Bianco V, Miller JM, Van der Wielen M. Antibody persistence up to 5 y after vaccination with a quadrivalent meningococcal ACWY-tetanus toxoid conjugate vaccine in adolescents. Hum Vaccin Immunother 2017; 13:636-644. [PMID: 28152332 PMCID: PMC5360140 DOI: 10.1080/21645515.2016.1248009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Long-term protection against meningococcal disease relies on antibody persistence after vaccination. We report antibody persistence up to 5 y after vaccination in adolescents who received a single dose of either meningococcal serogroups A, C, W, Y tetanus toxoid conjugate vaccine (MenACWY-TT, Pfizer) or MenACWY polysaccharide vaccine (MenPS, GSK Vaccines) at the age of 11-17 y in the randomized controlled primary study NCT00464815. In this phase III, open, controlled, multi-center persistence follow-up study conducted in India and the Philippines (NCT00974363), antibody persistence was evaluated by a serum bactericidal antibody assay using rabbit complement (rSBA) yearly, up to year 5 after vaccination. Serious adverse events (SAEs) related to study participation were recorded. Five years after a single dose of MenACWY-TT, the percentage of participants (N = 236) with rSBA titers ≥1:8 was 97.5% for serogroup A, 88.6% for serogroup C, 86.0% for serogroup W and 96.6% for serogroup Y. The percentages in the MenPS group (N = 86) were 93.0%, 87.1%, 34.9% and 66.3%, respectively. Exploratory analysis indicated a higher percentage of subjects with rSBA titers ≥1:8 for serogroups W and Y, and higher rSBA geometric mean antibody titers for serogroups A, W and Y in the MenACWY-TT group than the MenPS group at each time point (years 3, 4 and 5). No differences between groups were observed for serogroup C. No SAEs related to study participation were reported. In conclusion, the results of this follow-up study indicate that antibodies persisted up to 5 y after a single dose of MenACWY-TT in adolescents.
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Affiliation(s)
- Beatriz P Quiambao
- a Clinical Research Division , Research Institute for Tropical Medicine , Alabang, Muntinlupa City , Philippines
| | - Ashish Bavdekar
- b K.E.M Hospital, Sardar Moodliar Road , Pune , Maharashtra , India
| | - Anand Prakash Dubey
- c Department of Pediatrics , Maulana Azad Medical College (MAMC), and Associated Lok Nayak Hospital , New Delhi , India
| | | | - Devayani Kolhe
- e GSK Vaccines, Bangalore, India; Wavre, Belgium; and King of Prussia , PA , USA
| | - Véronique Bianco
- e GSK Vaccines, Bangalore, India; Wavre, Belgium; and King of Prussia , PA , USA
| | - Jacqueline M Miller
- e GSK Vaccines, Bangalore, India; Wavre, Belgium; and King of Prussia , PA , USA
| | - Marie Van der Wielen
- e GSK Vaccines, Bangalore, India; Wavre, Belgium; and King of Prussia , PA , USA
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