Southern J, Crowley-Luke A, Borrow R, Andrews N, Miller E
Immunisation Department, Centre for Infections, Health Protection Agency, 61 Colindale Avenue, London NW9 5EQ, UK.
Vaccine. 2006 Jan 12;24(2):215-9. doi: 10.1016/j.vaccine.2005.07.060. Epub 2005 Aug 8.
Reduction of the number of injections necessary to confer protection in the infant schedule would reduce discomfort, improve cost-effectiveness and create space for the addition of new vaccinations in the future. This study assessed the immunogenicity of one, two or three doses of meningococcal C conjugate vaccine conjugated to tetanus toxoid (MCC-TT) [Neis-VacC] given concomitantly with a combined diphtheria/tetanus/acellular pertussis/Haemophilus influenzae type b -TT conjugate (DTaP-Hib-TT) [Infanrix-Hib] vaccine at 2, 3 and 4 months of age. A total of 106 healthy UK infants were enrolled and randomised into two groups, one in which blood was taken after the first and third dose and the other after the second and third dose. The meningococcal serogroup C serum bactericidal antibody (SBA) geometric mean titre (GMT) rose significantly from post-first dose (491, 95% CI 275, 877) to post-second dose (1052, 95% CI 774, 1433) (p=0.03), with no significant change after the third dose (1024, 95% CI 768, 1366). An SBA titre of >or=8 was achieved by 92% after the first dose and 100% after the second and third doses. The Hib IgG geometric mean concentration (GMC) rose significantly after each dose: post-first (0.14 microg/ml 95% CI 0.10, 0.18), post-second (0.54 microg/ml, 95% CI 0.33, 0.90), post-third (2.04 microg/ml, 95% CI 1.52, 2.74). The Hib GMC after the third dose was higher than reported previously when this DTaP/Hib was given either on its own or concomitantly with a MCC-CRM conjugate vaccine according to the UK 2, 3 and 4 month schedule. This suggests some enhancement of the response to a Hib-TT vaccine by concomitant administration of MCC-TT. These results suggest that a reduced number of doses of MCC-TT would be adequate in infancy if given concomitantly with an acellular pertussis-containing vaccine.
减少婴儿免疫程序中提供保护所需的注射次数，将减轻不适、提高成本效益，并为未来添加新疫苗创造空间。本研究评估了在2、3和4月龄时，一剂、两剂或三剂与破伤风类毒素结合的C群脑膜炎球菌结合疫苗（MCC-TT）[Neis-VacC]与白喉/破伤风/无细胞百日咳/b型流感嗜血杆菌-TT结合疫苗（DTaP-Hib-TT）[Infanrix-Hib]联合接种的免疫原性。共有106名健康的英国婴儿入组并随机分为两组，一组在第一剂和第三剂后采血，另一组在第二剂和第三剂后采血。C群脑膜炎球菌血清杀菌抗体（SBA）几何平均滴度（GMT）从第一剂后（491，95%可信区间275，877）显著升至第二剂后（1052，95%可信区间774，1433）（p=0.03），第三剂后无显著变化（1024，95%可信区间768，1366）。第一剂后92%的婴儿达到SBA滴度≥8，第二剂和第三剂后为100%。每次接种后，Hib IgG几何平均浓度（GMC）均显著升高：第一剂后（0.14μg/ml，95%可信区间0.10，0.18），第二剂后（0.54μg/ml，95%可信区间0.33，0.90），第三剂后（2.04μg/ml，95%可信区间1.52，2.74）。根据英国2、3和4月龄免疫程序，第三剂后的Hib GMC高于此前单独接种该DTaP/Hib或与MCC-CRM结合疫苗联合接种时的报告值。这表明同时接种MCC-TT可增强对Hib-TT疫苗的反应。这些结果表明，如果与含无细胞百日咳疫苗同时接种，婴儿期减少MCC-TT的剂量就足够了。
