Interchangeability of meningococcal group C conjugate vaccines with different carrier proteins in the United Kingdom infant immunisation schedule

Shamez Ladhani*, Nicholas Andrews, Pauline Waight, Bassam Hallis, Mary Matheson, Anna England, Helen Findlow, Xilian Bai, Raymond Borrow, Polly Burbidge, Emma Pearce, David Goldblatt, Elizbeth Miller

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

14 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)648-655
Number of pages8
JournalVaccine
Volume33
Issue number5
DOIs
Publication statusPublished - 29 Jan 2015

Bibliographical note

Funding Information:
Conflicts of interest statement : Dr Ladhani has conducted clinical trials and received financial assistance to attend scientific conferences from vaccine manufacturers on behalf of St. George's University of London, but receives no personal remuneration. Professor Borrow, Dr Findlow and Dr Bai perform contract research for vaccine manufacturers on behalf of Public Health England, but receive no personal remuneration. Dr H. Findlow has received financial assistance from a vaccine manufacturer to attend a scientific conference. Professor Goldblatt has provided consultancy services for vaccine manufacturers and his institution has received grants from vaccine manufacturers for contract research. All other authors: no conflict. Funding : We thank the Research and Development Directorate of the United Kingdom Department of Health for funding the fieldwork of the study (grant number 039/0031 ). The funding body did not have any role in the design or conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication. The views expressed in the publication are those of the authors and not necessarily those of the Department of Health.

Publisher Copyright:
© 2014 Elsevier Ltd.

Keywords

  • Carrier proteins
  • Conjugate vaccines
  • Interchangeability
  • Interference
  • Meningococcal capsular group C

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