Vaccine Evaluation Unit, Health Protection Agency, Manchester Medical Microbiology Partnership, Manchester Royal Infirmary, Manchester, United Kingdom.
Pediatr Infect Dis J. 2012 Jun;31(6):616-22. doi: 10.1097/INF.0b013e31824f34e6.
From 1999, in the United Kingdom, meningococcal C conjugate (MCC) vaccines from 3 manufacturers were introduced to the infant immunization schedule at 2, 3 and 4 months of age. In 2006, the schedule was refined to a 2-dose primary schedule at 3 and 4 months of age, with a combined MCC/Haemophilus influenzae type b (MCC/Hib-TT) booster at 12 months of age. Recent data have demonstrated that 2 of the 3 MCC vaccines showed potential for use as a single priming dose in infancy.
A randomized trial was undertaken with 2 MCC vaccines; one using tetanus toxoid carrier protein (MCC-TT) and one using CRM197 carrier protein (MCC-CRM197). Infants were immunized with MCC at 3 months of age followed by an MCC/Hib-TT booster at 12 months of age.
The serum bactericidal antibody geometric mean titers 1 month after a single dose of MCC-TT or MCC-CRM 197 were 223.3 (95% confidence interval [CI]: 162.9-306.1) and 95.8 (95% CI: 66.4-138.2) with 100% and 95.5% of infants having serum bactericidal antibody titers ≥ 8, respectively. Before boosting, antibody titers had declined, and 1 month after the MCC/Hib-TT booster, serum bactericidal antibody geometric mean titers rose to 2251.0 (95% CI: 1535.3-3300.3) and 355.9 (95% CI: 235.4-538.1) for children primed with MCC-TT and MCC-CRM 197, respectively.
In conclusion, a single priming dose of either MCC-TT or MCC-CRM197 administered at 3 months of age can be used together with the Hib/MCC-TT booster in the second year of life.
自 1999 年以来，英国将三种制造商生产的脑膜炎球菌 C 结合疫苗（MCC）引入婴幼儿免疫计划，于 2、3 和 4 个月大时接种。2006 年，计划调整为在 3 和 4 个月大时进行两剂基础免疫，在 12 个月大时接种一剂 MCC/流感嗜血杆菌 b 型（MCC/Hib-TT）加强针。最近的数据表明，三种 MCC 疫苗中的两种可能作为婴幼儿单剂基础免疫使用。
进行了一项随机试验，使用了两种 MCC 疫苗；一种使用破伤风类毒素载体蛋白（MCC-TT），另一种使用 CRM197 载体蛋白（MCC-CRM197）。婴儿于 3 个月大时接种 MCC，然后于 12 个月大时接种 MCC/Hib-TT 加强针。
接种 MCC-TT 或 MCC-CRM197 单剂后 1 个月，血清杀菌抗体几何平均滴度分别为 223.3（95%置信区间 [CI]：162.9-306.1）和 95.8（95% CI：66.4-138.2），分别有 100%和 95.5%的婴儿血清杀菌抗体滴度≥8。加强针前，抗体滴度下降，在接种 MCC/Hib-TT 加强针后 1 个月，用 MCC-TT 和 MCC-CRM197 进行基础免疫的儿童血清杀菌抗体几何平均滴度分别升高至 2251.0（95% CI：1535.3-3300.3）和 355.9（95% CI：235.4-538.1）。
总之，在 3 个月大时接种单剂 MCC-TT 或 MCC-CRM197，可与第二年的 Hib/MCC-TT 加强针联合使用。
