Effect on meningococcal serogroup W immunogenicity when Tdap was administered prior, concurrent or subsequent to the quadrivalent (ACWY) meningococcal CRM197-conjugate vaccine in adult Hajj pilgrims: A randomised controlled trial

Mohamed Tashani, Al Mamoon Badahdah*, Mohammad Alfelali, Osamah Barasheed, Amani S. Alqahtani, Leon Heron, Melanie Wong, Jennifer Louth, Harunor Rashid, Raymond Borrow, Robert Booy

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)

Abstract

Immune responses to the capsular polysaccharide administered in the polysaccharide-protein conjugate vaccines can be either improved or suppressed by the pre-existence of immunity to the carrier protein. Receiving multiple vaccinations is essential for travellers such as Hajj pilgrims, and the use of conjugated vaccines is recommended. We studied the immune response to meningococcal serogroup W upon prior, concurrent and sequential administration of a quadrivalent meningococcal conjugate vaccine (MCV4) conjugated to CRM197 (coadministered with 13 valent pneumococcal vaccine conjugate CRM197 [PCV13]), and tetanus-diphtheria-acellular pertussis (Tdap) vaccine in Australian adults before attending the Hajj pilgrimage in 2014. Participants were randomly assigned, by computer-generated numbers, to three study arms by 1:1:1 ratio. Group A received Tdap followed by MCV4-CRM197 (+PCV13) 3–4 weeks later. Group B received all three vaccines in a single visit. Group C received MCV4-CRM197 (+PCV13) followed by Tdap 3–4 weeks later. Blood samples obtained prior to and 3–4 weeks after immunisation with MCV4-CRM197 were tested for meningococcal serogroup W-specific serum bactericidal antibody responses using baby rabbit complement (rSBA). One hundred and seven participants aged between 18 and 64 (median 40) years completed the study. No significant difference in meningococcal serogroup W rSBA geometric mean titre (GMT) was observed between the study arms post vaccination with MCV-CRM197 but Group A tended to have a slightly lower GMT (A = 404, B = 984 and C = 1235, p = 0.15). No statistical difference was noticed between the groups in proportions of subjects achieving a ≥4-fold rise in rSBA titres or achieving rSBA titre ≥8 post vaccination. In conclusion, receipt of MCV4-CRM197 vaccine prior, concurrent or subsequent to Tdap has similar immunologic response, and hence concurrent administration is both immunogenic and practical. However, further investigation into whether carrier induced suppression is a public health issue is suggested. Clinical trial registration: ANZCTR no. ACTRN12613000536763.

Original languageEnglish
Pages (from-to)3562-3567
Number of pages6
JournalVaccine
Volume37
Issue number27
DOIs
Publication statusPublished - 12 Jun 2019

Bibliographical note

Funding Information:
Dr Leon Heron and Professor Robert Booy have received funding from Baxter, CSL/Seqirus, GSK, Merck, Novartis, Pfizer, Roche, Romark and Sanofi Pasteur for the conduct of sponsored research, travel to present at conferences or consultancy work; all funding received is directed to research accounts at The Children’s Hospital at Westmead. Dr Harunor Rashid received fees from Pfizer, Novartis and Sanofi Pasteur for consulting or serving on an advisory board. Prof Ray Borrow and Dr Jennifer Louth conduct contract research on behalf of Public Health England for GSK, Pfizer and Sanofi Pasteur. The other authors have declared no conflict of interest in relation to this work.

Funding Information:
Richard Pryce-Williams, PHE Manchester, UK for laboratory work. Mohamed Tashani would like to acknowledge the Islamic Development Bank (IsDB) for providing financial support.

Funding Information:
Richard Pryce-Williams, PHE Manchester, UK for laboratory work. Mohamed Tashani would like to acknowledge the Islamic Development Bank (IsDB) for providing financial support.

Publisher Copyright:
© 2019 Elsevier Ltd

Keywords

  • Carrier protein
  • Diphtheria, tetanus, acellular pertussis vaccine
  • Meningococcal conjugate vaccine
  • Serum bactericidal antibody
  • Vaccine interaction

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