2至10岁儿童中四价(A、C、Y、W-135)脑膜炎球菌多糖-白喉结合疫苗与四价多糖疫苗安全性和免疫原性的对比试验
Comparative trial of the safety and immunogenicity of quadrivalent (A, C, Y, W-135) meningococcal polysaccharide-diphtheria conjugate vaccine versus quadrivalent polysaccharide vaccine in two- to ten-year-old children.
作者信息
Pichichero Michael, Casey Janet, Blatter Mark, Rothstein Edward, Ryall Robert, Bybel Mike, Gilmet Gregory, Papa Thomas
机构信息
Department of Microbiology and Immunology, University of Rochester, Rochester, NY 14642, USA.
出版信息
Pediatr Infect Dis J. 2005 Jan;24(1):57-62. doi: 10.1097/01.inf.0000148928.10057.86.
BACKGROUND
A quadrivalent meningococcal diphtheria conjugate vaccine (MCV-4) has been developed to provide T-cell dependent immune responses against 4 major disease-causing serogroups (A, C, Y, W-135).
METHODS
In a comparative, randomized, modified double blind, controlled study in healthy 2- to 10-year-old U.S. children, safety and immunogenicity profiles of MCV-4 (n = 696) were compared with those of a licensed quadrivalent polysaccharide vaccine, Menomune A/C/Y/W-135 (PSV-4, n = 702). Vaccine-related adverse reactions were assessed for 28-day and 6-month follow-up periods. Serum bactericidal activity (SBA) was assayed in prevaccination, day 28 and 6-month postvaccination sera samples.
RESULTS
Both vaccines were well-tolerated, with no vaccine-related serious adverse events and similar rates of mostly mild local and systemic reactions. Functional antibody (SBA) seroconversion percentages were significantly higher for all 4 serogroups in the MCV-4 group. The SBA geometric mean titers against serogroups A, C, Y and W-135 with MCV-4 were 1700, 354, 637 and 750, respectively, compared with PSV-4 (893, 231, 408 and 426) 28 days postvaccination (P < 0.001 for all comparisons). This significant difference persisted through 6 months.
CONCLUSIONS
In 2- to 10-year-old children MCV-4 had a safety profile similar to that of PSV-4 and elicited significantly higher and more persistent serum bactericidal antibody responses against meningococcal serogroups A, C, Y and W-135 than did the licensed polysaccharide vaccine.
背景
已研发出一种四价脑膜炎球菌结合白喉疫苗(MCV-4),以提供针对4种主要致病血清群(A、C、Y、W-135)的T细胞依赖性免疫反应。
方法
在一项针对美国2至10岁健康儿童的比较、随机、改良双盲对照研究中,将MCV-4(n = 696)的安全性和免疫原性特征与一种已获许可的四价多糖疫苗Menomune A/C/Y/W-135(PSV-4,n = 702)进行比较。在28天和6个月的随访期内评估与疫苗相关的不良反应。在接种疫苗前、接种后第28天和6个月的血清样本中检测血清杀菌活性(SBA)。
结果
两种疫苗耐受性良好,均未出现与疫苗相关的严重不良事件,且大多数轻度局部和全身反应的发生率相似。MCV-4组中所有4种血清群的功能性抗体(SBA)血清转化率均显著更高。接种疫苗后28天,MCV-4针对血清群A、C、Y和W-135的SBA几何平均滴度分别为1700、354、637和750,而PSV-4分别为893、231、408和426(所有比较P < 0.001)。这种显著差异持续至6个月。
结论
在2至10岁儿童中,MCV-4的安全性与PSV-4相似,并且与已获许可的多糖疫苗相比,其针对脑膜炎球菌血清群A、C、Y和W-135引发的血清杀菌抗体反应显著更高且更持久。