Melo Flor Irene Rodriguez, Morales José Juan Renteria, De Los Santos Abiel Homero Mascareñas, Rivas Enrique, Vigne Claire, Noriega Fernando
From the *BIOCEM Unidad de Investigación Biomedica del Hospital Centro de Especialidades Médicas del Sureste, Mérida Yucatán, México; †Centro de Investigación Clínica del Pacífico, Acapulco, Guerreo, Mexico; ‡Servicios Médicos de la Universidad Autónoma de Nuevo León y Centro de Investigación y Desarrollo en Ciencias de la Salud de la Universidad Autónoma de Nuevo León, Mexico; §Clinical Sciences, Sanofi Pasteur, Col. Coyoacán, Mexico City, Mexico; ¶Clinical Program, Sanofi Pasteur, Marcy l'Etoile, France; and ‖Clinical Sciences, Sanofi Pasteur, Swiftwater, Pennsylvania.
Pediatr Infect Dis J. 2017 Jun;36(6):602-608. doi: 10.1097/INF.0000000000001542.
The live, attenuated, tetravalent dengue vaccine (CYD-TDV) is licensed in a number of dengue endemic countries for individuals ≥9 years of age. Before the integration of any vaccine into childhood vaccination schedules, a lack of immune interference and acceptable safety when coadministered with other recommended vaccines should be demonstrated.
This randomized, multi-center phase III trial was conducted in Mexico. Healthy toddlers (n = 732) received a booster dose of a licensed pentavalent combination vaccine [diphtheria, tetanus, acellular pertussis, inactivated polio vaccine and Haemophilus influenzae type b (DTaP-IPV//Hib)] either concomitantly or sequentially, with the second dose of CYD-TDV administered as a 3-dose schedule. Antibody titers against diphtheria toxoid, tetanus toxoid and pertussis antigens were measured by enzyme-linked immunosorbent assay. Antibodies against poliovirus and dengue serotypes were measured using a plaque reduction neutralization test. Noninferiority was demonstrated for each of the DTaP-IPV//Hib antigens if the lower limit of the 2-sided 95% confidence interval of the difference in seroconversion rates between the 2 groups (CYD-TDV and placebo) was ≥10%. Safety of both vaccines was assessed.
Noninferiority in immune response was demonstrated for all DTaP-IPV//Hib antigens. After 3 doses of CYD-TDV, no difference was observed in the immune response for CYD-TDV between groups. There were no safety concerns during the study.
Coadministration of the DTaP-IPV//Hib booster vaccine with CYD-TDV has no observed impact on the immunogenicity or safety profile of the DTaP-IPV//Hib booster vaccine. No difference was observed on the CYD-TDV profile when administered concomitantly or sequentially with the DTaP-IPV//Hib booster vaccine.
减毒活四价登革热疫苗(CYD - TDV)已在一些登革热流行国家获得许可,用于9岁及以上人群。在将任何疫苗纳入儿童免疫规划之前,应证明其与其他推荐疫苗同时接种时不存在免疫干扰且安全性可接受。
这项随机、多中心III期试验在墨西哥进行。732名健康幼儿接受一剂已获许可的五价联合疫苗[白喉、破伤风、无细胞百日咳、灭活脊髓灰质炎疫苗和b型流感嗜血杆菌(DTaP - IPV//Hib)]的加强剂量,该疫苗与CYD - TDV的第二剂按3剂程序同时或先后接种。通过酶联免疫吸附测定法测量针对白喉类毒素、破伤风类毒素和百日咳抗原的抗体滴度。使用蚀斑减少中和试验测量针对脊髓灰质炎病毒和登革热血清型的抗体。如果两组(CYD - TDV组和安慰剂组)血清转化率差异的双侧95%置信区间下限≥10%,则证明每种DTaP - IPV//Hib抗原具有非劣效性。评估了两种疫苗的安全性。
所有DTaP - IPV//Hib抗原均证明免疫反应具有非劣效性。接种3剂CYD - TDV后,各组间CYD - TDV的免疫反应未观察到差异。研究期间无安全性问题。
DTaP - IPV//Hib加强疫苗与CYD - TDV同时接种对DTaP - IPV//Hib加强疫苗的免疫原性或安全性无观察到的影响。CYD - TDV与DTaP - IPV//Hib加强疫苗同时或先后接种时,其情况未观察到差异。