Richmond P, Kaczmarski E, Borrow R, Findlow J, Clark S, McCann R, Hill J, Barker M, Miller E
Immunisation Division, Communicable Disease Surveillance Centre, Public Health Laboratory Service, Immunobiology Unit, Institute of Child Health, London, United Kingdom.
J Infect Dis. 2000 Feb;181(2):761-4. doi: 10.1086/315284.
Widespread use of meningococcal AC polysaccharide (MACP) vaccines has raised concerns about induction of hyporesponsiveness to C polysaccharide. Whether meningococcal C conjugate (MCC) vaccine overcomes any immunologic refractoriness following MACP vaccination in adults was investigated. University students vaccinated 6 months previously with MACP vaccine were randomized to receive MACP or MCC vaccine, and antibody responses were compared with those of previously unvaccinated students receiving MACP or MCC vaccine. In students primed with MACP vaccine, MCC vaccine induced significantly higher IgG and serum bactericidal antibody levels than did a second dose of MACP vaccine. Responses to a second dose of MACP vaccine were significantly lower than to the first dose. Previous receipt of MACP vaccine reduced serum bactericidal antibody but not IgG responses to MCC vaccine compared with those in previously unvaccinated students. This confirms that MACP vaccine induces immunologic hyporesponsiveness to C polysaccharide in adults, but this can be overcome with MCC vaccine. Repeated vaccination with MACP vaccine may be ineffective, and MCC vaccines should provide better long-term protection.
脑膜炎球菌AC多糖（MACP）疫苗的广泛使用引发了人们对诱导对C多糖低反应性的担忧。本研究调查了成人接种MACP疫苗后，脑膜炎球菌C结合疫苗（MCC）是否能克服任何免疫不应答情况。6个月前接种过MACP疫苗的大学生被随机分为两组，分别接受MACP疫苗或MCC疫苗，并将其抗体反应与未接种过疫苗的学生接受MACP疫苗或MCC疫苗后的反应进行比较。在接种过MACP疫苗的学生中，MCC疫苗诱导产生的IgG和血清杀菌抗体水平显著高于第二剂MACP疫苗。对第二剂MACP疫苗的反应显著低于第一剂。与未接种过疫苗的学生相比，之前接种过MACP疫苗会降低血清杀菌抗体，但不会降低对MCC疫苗的IgG反应。这证实了MACP疫苗会在成人中诱导对C多糖的免疫低反应性，但MCC疫苗可以克服这一问题。重复接种MACP疫苗可能无效，而MCC疫苗应能提供更好的长期保护。
