1
|
Presa J, Serra L, Weil-Olivier C, York L. Preventing invasive meningococcal disease in early infancy. Hum Vaccin Immunother 2022; 18:1979846. [PMID: 35482946 PMCID: PMC9196819 DOI: 10.1080/21645515.2021.1979846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
This review considers the pathogenesis, diagnosis, and epidemiology of invasive meningococcal disease in infants, to examine and critique meningococcal disease prevention in this population through vaccination. High rates of meningococcal disease and poor outcomes, particularly for very young infants, highlight the importance of meningococcal vaccination in early infancy. Although effective and safe meningococcal vaccines are available for use from 6 weeks of age, they are not recommended globally. Emerging real-world data from the increased incorporation of these vaccines within immunization programs inform recommendations regarding effectiveness, appropriate vaccination schedule, possible long-term safety effects, and persistence of antibody responses. Importantly, to protect infants from IMD, national vaccination recommendations should be consistent with available data regarding vaccine safety, effectiveness, and disease risk.
Collapse
Affiliation(s)
- Jessica Presa
- Vaccine Medical, Development, Scientific, and Clinical Affairs, Pfizer Inc, Collegeville, PA, USA
| | - Lidia Serra
- Global Vaccines Medical Development and Scientific, and Clinical Affairs, Pfizer Inc, Collegeville, PA, USA
| | | | - Laura York
- York Biologics Consulting LLC, Wayne, PA, USA
| |
Collapse
|
2
|
Marshall GS, Fergie J, Presa J, Peyrani P. Rationale for the Development of a Pentavalent Meningococcal Vaccine: A US-Focused Review. Infect Dis Ther 2022; 11:937-951. [PMID: 35357651 PMCID: PMC8969818 DOI: 10.1007/s40121-022-00609-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 02/14/2022] [Indexed: 12/04/2022] Open
Abstract
While invasive meningococcal disease (IMD) is uncommon, it can result in serious sequelae and even death. In 2018 in the United States, the incidence of IMD per 100,000 people was 0.03 among adolescents 11−15 years of age, 0.10 among persons 16−23 years of age, and 0.83 among infants < 1 year of age. Serogroup B accounted for 86%, 62%, and 66% of cases, respectively, in those age groups. Currently, routine meningococcal vaccination covering serogroups ACWY (MenACWY) is recommended in the United States for all adolescents at 11−12 years of age, with a booster dose at 16 years of age, whereas a meningococcal serogroup B (MenB) vaccine series is recommended for persons 16−23 years of age under the shared clinical decision-making paradigm. The MenACWY vaccination program in adolescents has been successful in reducing disease burden, but does not prevent disease caused by serogroup B, which accounts for more than half of IMD cases. There are currently no approved vaccines that cover all of the most common disease-causing meningococcal serogroups, which are A, B, C, W, and Y. A pentavalent MenABCWY vaccine that is constituted from 2 licensed meningococcal vaccines—MenB-FHbp and MenACWY-TT—is being investigated in healthy persons ≥ 10–25 years of age. The addition of a MenABCWY vaccine is the next natural step in the incremental meningococcal immunization program in the United States to improve protection against the most common serogroup causing IMD, with no increase in the number of immunizations needed. With high uptake, routine use of MenABCWY could reduce IMD cases and associated mortality, the rate of long-term physical and psychosocial sequelae in survivors, and costs associated with controlling outbreaks, particularly on college campuses. A MenABCWY vaccine would also reduce the number of injections required for adolescents, potentially improving compliance.
Collapse
Affiliation(s)
- Gary S. Marshall
- Division of Pediatric Infectious Diseases, Norton Children’s and University of Louisville School of Medicine, 571 S. Floyd St, Suite 321, Louisville, KY 40202 USA
| | - Jaime Fergie
- Driscoll Children’s Hospital, Corpus Christi, TX USA
| | - Jessica Presa
- Vaccines Medical Development & Scientific/Clinical Affairs, Pfizer Inc, Collegeville, PA USA
| | - Paula Peyrani
- Vaccines Medical Development & Scientific/Clinical Affairs, Pfizer Inc, Collegeville, PA USA
| |
Collapse
|
3
|
Koliou M, Kasapi D, Mazeri S, Maikanti P, Demetriou A, Skordi C, Agathocleous M, Tzanakaki G, Constantinou E. Epidemiology of invasive meningococcal disease in Cyprus 2004 to 2018. ACTA ACUST UNITED AC 2020; 25. [PMID: 32734853 PMCID: PMC7393851 DOI: 10.2807/1560-7917.es.2020.25.30.1900534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background Despite progress in the management of invasive meningococcal disease (IMD) it causes significant mortality and sequelae. Aim This study aims to describe the epidemiology and clinical characteristics of IMD in Cyprus and discuss the current immunisation programmes. Methods This is a retrospective study of all cases of IMD notified to the Ministry of Health between 2004 and 2018. Demographic, epidemiological, clinical and microbiological data were collected when a new case was notified. Risk factors associated with mortality were investigated using univariable logistic regression. Results 54 cases of IMD were recorded, an overall incidence of 0.4 cases per 100,000 population. The incidence rate was highest among infants (7.2/100,000) and adolescents (1.4/100,000). Case fatality rate was 10.4%. Serogroup B accounted for 24 of 40 cases caused by known serogroup. Serogroups W and Y comprised nine cases and were responsible for most fatal cases. Serogroup C was the cause in only four cases. There was an increase in the odds of death with increasing age, while the presence of meningitis in the clinical picture was found to be associated with lower odds of death. Conclusion Despite the low incidence of IMD in Cyprus, it remains an important cause of morbidity and mortality. Serogroup B is the most frequent serogroup, while incidence of serogroups W and Y is rising. Monitoring new cases and yearly evaluation of the immunisation programmes by the National Immunization Technical Advisory Group (NITAG) is essential for successful control of the disease.
Collapse
Affiliation(s)
- Maria Koliou
- Unit for Surveillance and control of Communicable diseases, Medical and Public Health Services, Ministry of Health, Nicosia, Cyprus.,Medical School, University of Cyprus, Nicosia, Cyprus
| | | | - Stella Mazeri
- The Roslin Institute, Division of Genetics and Genomics, Easter Bush Veterinary Centre, Roslin, United Kingdom.,The Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Edinburgh, United Kingdom
| | | | - Anna Demetriou
- Health Monitoring Unit, Ministry of Health, Nicosia, Cyprus
| | | | | | - Georgina Tzanakaki
- National Meningitis Reference Laboratory, Department of Public Health Policy, School of Public Health, University of West Attica, Athens, Greece
| | | |
Collapse
|
4
|
Boccalini S, Bechini A, Sartor G, Paolini D, Innocenti M, Bonanni P, Panatto D, Lai PL, Zangrillo F, Marchini F, Lecini E, Iovine M, Amicizia D, Landa P. [Health Technology Assessment of meningococcal B vaccine (Trumenba ®) in adolescent in Italy]. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2019; 60:E1-E94. [PMID: 32047867 PMCID: PMC7007189 DOI: 10.15167/2421-4248/jpmh2019.60.3s2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- S Boccalini
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - A Bechini
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - G Sartor
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - D Paolini
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - M Innocenti
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - P Bonanni
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - D Panatto
- Dipartimento di Scienze della Salute, Università degli Studi di Genova
| | - P L Lai
- Dipartimento di Scienze della Salute, Università degli Studi di Genova
| | - F Zangrillo
- Dipartimento di Scienze della Salute, Università degli Studi di Genova
| | - F Marchini
- Dipartimento di Scienze della Salute, Università degli Studi di Genova
| | - E Lecini
- Dipartimento di Scienze della Salute, Università degli Studi di Genova
| | - M Iovine
- Dipartimento di Scienze della Salute, Università degli Studi di Genova
| | - D Amicizia
- Dipartimento di Scienze della Salute, Università degli Studi di Genova
| | - P Landa
- Dipartimento di Economia, Università degli Studi di Genova
| |
Collapse
|
5
|
Rouabhia M, Mighri N, Mao J, Park HJ, Mighri F, Ajji A, Zhang Z. Surface treatment with amino acids of porous collagen based scaffolds to improve cell adhesion and proliferation. CAN J CHEM ENG 2018. [DOI: 10.1002/cjce.23205] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Mahmoud Rouabhia
- Groupe de Recherche en Écologie Buccale; Faculté de Médecine Dentaire; Université Laval; 2420 rue de la Terrasse Québec QC G1V 0A6 Canada
| | - Nabila Mighri
- Groupe de Recherche en Écologie Buccale; Faculté de Médecine Dentaire; Université Laval; 2420 rue de la Terrasse Québec QC G1V 0A6 Canada
- Axe Médecine régénératrice; Centre de Recherche du CHU de Québec; Département de Chirurgie; Faculté de Médecine; Université Laval; Québec QC G1L 3L5 Canada
| | - Jifu Mao
- Axe Médecine régénératrice; Centre de Recherche du CHU de Québec; Département de Chirurgie; Faculté de Médecine; Université Laval; Québec QC G1L 3L5 Canada
| | - Hyun Jin Park
- Groupe de Recherche en Écologie Buccale; Faculté de Médecine Dentaire; Université Laval; 2420 rue de la Terrasse Québec QC G1V 0A6 Canada
- Axe Médecine régénératrice; Centre de Recherche du CHU de Québec; Département de Chirurgie; Faculté de Médecine; Université Laval; Québec QC G1L 3L5 Canada
| | - Frej Mighri
- Department of Chemical Engineering; Université Laval; 1065 avenue de la Médecine Québec QC G1V 0A6 Canada
| | - Abdallah Ajji
- Department of Chemical Engineering; École Polytechnique de Montréal; Montréal QC H3C 3A7 Canada
| | - Ze Zhang
- Axe Médecine régénératrice; Centre de Recherche du CHU de Québec; Département de Chirurgie; Faculté de Médecine; Université Laval; Québec QC G1L 3L5 Canada
| |
Collapse
|
6
|
Balmer P, York LJ. Optimal use of meningococcal serogroup B vaccines: moving beyond outbreak control. Ther Adv Vaccines Immunother 2018; 6:49-60. [PMID: 30182092 DOI: 10.1177/2515135518781757] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 04/26/2018] [Indexed: 11/16/2022] Open
Abstract
Neisseria meningitidis is a major cause of meningitis and septicemia globally. Vaccines directed against N. meningitidis serogroup B (MenB) have been used to control sporadic and sustained disease in industrialized and non-industrialized countries. Early outer membrane vesicle (OMV) vaccines effectively reduced MenB disease in countries such as Norway, New Zealand, and France; however, these vaccines were highly specific for their targeted outbreak strain, did not elicit a durable immune response, and were ineffective for widespread use due to the diversity of MenB-disease-causing isolates. Recently developed recombinant protein-based MenB vaccines that target conserved surface proteins have the potential to induce a broader immune response against the diversity of disease-causing strains. Given the deleterious consequences and sporadic nature of MenB disease, the use of optimal vaccination strategies is crucial for prevention. Reactive vaccination strategies used in the past have significant limitations, including delayed implementation, substantial use of resources, and time constraints. The broad coverage potential of recombinant protein-based MenB vaccines suggests that routine use could result in a reduced burden of disease. Despite this, routine use of MenB vaccines is currently limited in practice.
Collapse
Affiliation(s)
- Paul Balmer
- Senior Medical Director, Pfizer Vaccines Medical Development and Scientific/Clinical Affairs, Pfizer Inc., 500 Arcola Road, Collegeville, PA, USA
| | - Laura J York
- Vice President, Global Meningococcal Vaccines, Pfizer Vaccines Medical Development and Scientific/Clinical Affairs, Pfizer Inc., 500 Arcola Road, Collegeville, PA, USA
| |
Collapse
|
7
|
Deciphering the Burden of Meningococcal Disease: Conventional and Under-recognized Elements. J Adolesc Health 2016; 59:S12-20. [PMID: 27449145 DOI: 10.1016/j.jadohealth.2016.03.041] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Revised: 03/21/2016] [Accepted: 03/21/2016] [Indexed: 11/21/2022]
Abstract
Invasive meningococcal disease remains a substantial global public health burden despite being vaccine-preventable worldwide. More than one million cases are reported annually, with average fatality rates ranging from 10% to 40% depending on clinical presentation and geographic location. Survivors may suffer debilitating sequelae that reduce the quality of life for the patient and family members responsible for their care. Major financial burdens are associated with acute treatment and follow-up care, and outbreak management often places extensive financial strains on public health resources. Although the clinical and financial aspects of meningococcal disease burden are straightforward to quantify, other burdens such as lifelong cognitive deficits, psychological stress, adaptive measures for reintegration into society, familial impact, and legal costs are systematically overlooked. These and other facets of disease burden are therefore not systematically considered in cost-effectiveness analyses that public health authorities take into consideration when making decisions regarding vaccination programs. Changing the approach for measuring meningococcal disease burden is necessary to accurately understand the societal consequences of this devastating illness. In this article, the conventional and under-recognized burdens of meningococcal disease are presented and discussed.
Collapse
|
8
|
Hede SV. Diagnosis and Treatment of Childhood Meningitis Caused by Streptococcus bovis Group. Curr Infect Dis Rep 2016; 18:11. [PMID: 26879740 DOI: 10.1007/s11908-016-0519-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Streptococcus bovis is a rare, but important cause of bacterial meningitis in children. Since its discovery in the early 1970s, the pathogen has undergone multiple taxonomic changes producing four distinct subspecies today, the most prevalent of which is S. gallolyticus subsp pasteurianus in infants and children. While initially reported as sporadic case reports, there is a growing body of literature documenting invasive disease primarily in neonates and infants clinically indistinguishable from group B streptococcus. In this review, I discuss the taxonomic evolution of S. bovis meningitis and its subsequent clinical diagnosis, manifestations and treatment in children.
Collapse
|
9
|
Stefanelli P, Fazio C, Neri A, Boros S, Renna G, Pompa MG. Changing epidemiology of Infant Meningococcal Disease after the introduction of meningococcal serogroup C vaccine in Italy, 2006-2014. Vaccine 2015; 33:3678-81. [PMID: 26087297 DOI: 10.1016/j.vaccine.2015.06.032] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Revised: 05/06/2015] [Accepted: 06/04/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND In Italy, the incidence of Invasive Meningococcal Disease (IMD) was around 0.28 per 100,000 over the last years. Since the risk IMD is usually high among infants aged less than 1 year, we decided to evaluate the trend of IMD cases reported between 2006 and 2014 in this age group. In particular, the study aim was to describe the main characteristics of IMD cases in infants following the introduction of MCC vaccine (2005) and to estimate the number of cases which are potentially preventable through early vaccination. METHODS The National Surveillance System of Bacterial Meningitis was established in 1994 and in 2007 was extended to all invasive bacterial diseases. Clinical data and isolates and/or clinical samples are collected from hospitalized patients throughout the country. IMD cases are reported by clinicians to the local health authorities, and samples are sent to the Reference Laboratory at the Istituto Superiore di Sanità for further characterization and storage at -80°C. In particular, serogroup identification is obtained by agglutination with commercial antisera or by multiplex PCR. RESULTS The annual incidence for infants <1 year old remained rather stable of 3.6 per 100,000, with several upward and downward oscillations and a peak in 2010. The incidence of IMD among infants was more than 10 times higher than the overall rate of IMD observed in Italy. Finally, serogroup B was more frequently detected among infants aged <1 year, accounting for 65% of the total (p<0.01). CONCLUSIONS During the study period, IMD incidence reported among infants aged less than one year old was 10 times higher than the overall rate, and serogroup B was the most commonly detected over time. The long-term impact of meningococcal C conjugate vaccine and the effect of the introduction of meningococcal B vaccination among infants need to be evaluated.
Collapse
Affiliation(s)
- P Stefanelli
- Department of Infectious, Parasitic & Immuno-mediated Diseases, Istituto Superiore di Sanità, Rome, Italy.
| | - C Fazio
- Department of Infectious, Parasitic & Immuno-mediated Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - A Neri
- Department of Infectious, Parasitic & Immuno-mediated Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - S Boros
- Department of Infectious, Parasitic & Immuno-mediated Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - G Renna
- Department of Infectious, Parasitic & Immuno-mediated Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - M G Pompa
- Ministry of Health, Directorate General for Prevention, Rome, Italy
| | | |
Collapse
|
10
|
Rodriguez P, Alvarez I, Torres MT, Diaz J, Bertoglia MP, Carcamo M, Seoane M, Araya P, Russo M, Santolaya ME. Meningococcal carriage prevalence in university students, 1824 years of age in Santiago, Chile. Vaccine 2014; 32:5677-80. [PMID: 25148776 DOI: 10.1016/j.vaccine.2014.08.015] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Revised: 07/29/2014] [Accepted: 08/08/2014] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Neisseria meningitidis invasive disease is a major public health problem. Pharyngeal carriage is considered a prerequisite for invasive infection. Prevalence reaches 10% in general population and up to 30% in the 20-24 years age group. The aim of this study was to asses pharyngeal carriage prevalence in healthy subjects aged 18-24 years, and as secondary endpoints evaluate known risk factors, to identify serogroups and sequence in the isolated strains. METHODS Cross-sectional study in 500 healthy subjects; students from Universidad de Chile aged 18-24 years, Santiago, Chile, October 2012. Each subject underwent a risk factor survey prior to throat culture sampling. Samples were processed in one central Microbiology Laboratory of Hospital Luis Calvo Mackenna and serogrouping and sequencing was performed at Instituto de Salud Pública de Chile. RESULTS We obtained throat samples from 500 healthy subjects, 20 (4%) positive for N. meningitidis. Of positive strains 20% were serogroup B, 15% W and the rest non groupable. The median age was 20 years, 50% were men. Of the risk factors evaluated, 24% were current smokers, 16% shared a room, 72% had kissed someone during the last month, 64% had gone to pub and 76% had consumed alcohol in the same period of time. DISCUSSION Literatures meningococcal carriage prevalence reaches up to 30% in people aged 18-24 years. Prevalence in our study was 4%. Different interpretations could be given; one could be the absence of overcrowding in our students because of the lack of dorms in our scholar system and also the characteristics of our enrolled group. CONCLUSIONS Our results suggest the necessity to extend the study to other age groups and to other cities, to better understand the Chilean reality, as well as others regions of America, considering that these results cannot be extrapolated to another countries.
Collapse
Affiliation(s)
- P Rodriguez
- Pediatrics Infectious Diseases Fellowship, Faculty of Medicine, Universidad de Chile, Santiago, Chile; Division of Infectious Diseases, Pediatrics Department, Hospital Luis Calvo Mackenna, Faculty of Medicine, Universidad de Chile, Santiago, Chile.
| | - I Alvarez
- Microbiology Laboratory, Hospital Luis Calvo Mackenna, Santiago, Chile
| | - M T Torres
- Microbiology Laboratory, Hospital Luis Calvo Mackenna, Santiago, Chile
| | - J Diaz
- Scientific Affairs, Instituto de Salud Pública de Chile, Santiago, Chile
| | - M P Bertoglia
- Biomedical Department, Bacteriology Section, Instituto de Salud Pública de Chile, Santiago, Chile
| | - M Carcamo
- Scientific Affairs, Instituto de Salud Pública de Chile, Santiago, Chile
| | - M Seoane
- Biomedical Department, Bacteriology Section, Instituto de Salud Pública de Chile, Santiago, Chile
| | - P Araya
- Biomedical Department, Bacteriology Section, Instituto de Salud Pública de Chile, Santiago, Chile
| | - M Russo
- Faculty of Medicine, Universidad Diego Portales, Santiago, Chile
| | - M E Santolaya
- Division of Infectious Diseases, Pediatrics Department, Hospital Luis Calvo Mackenna, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| |
Collapse
|
11
|
One or two doses of quadrivalent meningococcal serogroups A, C, W-135 and Y tetanus toxoid conjugate vaccine is immunogenic in 9- to 12-month-old children. Pediatr Infect Dis J 2013; 32:760-7. [PMID: 23348814 DOI: 10.1097/inf.0b013e31828693c5] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The incidence of invasive meningococcal disease is highest in infants. A quadrivalent meningococcal serogroups A, C, W-135 and Y tetanus toxoid conjugate vaccine (MenACWY-TT) was evaluated in children 9-12 months of age. METHODS We randomized infants (1:1) to receive 1 dose of MenACWY-TT at 12 months of age (ACWY-1 group) or 2 doses at 9 and 12 months (ACWY-2). We measured immunogenicity after each dose and 1 year after completing vaccination using human serum bactericidal antibody (hSBA) assays according to prespecified criteria of ≥ 1:8. Local and general symptoms were solicited for 8 days after vaccination. Adverse events were recorded for 6 months after the last dose. RESULTS We enrolled and vaccinated 349 subjects, of whom 248 reenrolled at Year 1 for evaluation of antibody persistence. Percentages of subjects with postvaccination hSBA ≥ 1:8 in the ACWY-1 group were 79.5%, 94.6%, 50.8% and 56.1% and in the 2-dose group (ACWY-2) were 88.4%, 100%, 99.3% and 99.3% postdose 2 for serogroups A, C, W-135 and Y, respectively. At Year 1, 80.0-99.1% in each group had hSBA ≥ 1:8, except for serogroup A, for which 20.6% (ACWY-1) and 25.9% (ACWY-2) retained hSBA ≥1:8. Both schedules were well-tolerated, with no observed increase in reactogenicity after the second dose. CONCLUSIONS MenACWY-TT was immunogenic when administered as a single dose at 12 months of age, or as 2 doses at 9 and 12 months, and had a clinically acceptable safety profile. Good antibody persistence was observed through 12 months postvaccination after both treatment schedules for serogroups C, W-135, Y.
Collapse
|