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婴儿4CMenB疫苗减量接种程序及儿童补种程序:一项随机开放标签3b期试验的免疫原性和安全性结果

Reduced schedules of 4CMenB vaccine in infants and catch-up series in children: Immunogenicity and safety results from a randomised open-label phase 3b trial.

作者信息

Martinón-Torres Federico, Safadi Marco Aurelio P, Martinez Alfonso Carmona, Marquez Pilar Infante, Torres Juan Carlos Tejedor, Weckx Lily Yin, Moreira Edson Duarte, Mensi Ilhem, Calabresi Marco, Toneatto Daniela

机构信息

Translational Pediatrics and Infectious Diseases, Department of Pediatrics, Hospital Clinico Universitario de Santiago de Compostela, A Choupana, s/n, 15706 Santiago de Compostela, Spain.

Santa Casa de São Paulo School of Medical Sciences, Rua Doutor Cesário Motta Júnior, 61 - Vila Buarque, 01221-020 São Paulo, Brazil.

出版信息

Vaccine. 2017 Jun 16;35(28):3548-3557. doi: 10.1016/j.vaccine.2017.05.023. Epub 2017 May 19.

Abstract

BACKGROUND

This study evaluated the immunogenicity and safety of a licensed meningococcal serogroup B vaccine (4CMenB) administered alone according to reduced schedules in infants or catch-up series in children.

METHODS

In this open-label, multicentre, phase 3b study (NCT01339923), infants randomised 1:1:1 received 4CMenB: 2+1 doses at 3½-5-11months or 6-8-11months of age, 3+1 doses at ages 2½-3½-5-11months. Children aged 2-10years received 2 catch-up doses administered 2months apart. Immune responses were measured by hSBA assays against 4 strains specific for vaccine components fHbp, NadA, PorA and NHBA. Sufficiency of immune responses was defined in groups with 2+1 doses schedules as a lower limit ≥70% for the 97.5% confidence interval of the percentage of infants with hSBA titres ≥4, 1month post-dose 2 for fHbp, NadA, PorA. Adverse events were collected for 7days post-vaccination; serious adverse events (SAEs) throughout the study.

RESULTS

754 infants and 404 children were enrolled. Post-primary vaccination, 98-100% of infants across all groups developed hSBA titres ≥4 for fHbp, NadA, PorA, and 48-77% for NHBA. Sufficiency of immune responses in infants receiving 2+1 schedules was demonstrated for fHbp, NadA, PorA after 2 doses of 4CMenB, as pre-specified criteria were met. Following receipt of 2 catch-up doses, 95-99% of children developed hSBA titres ≥4 for 4CMenB components. Similar safety profiles were observed across groups. A total of 45 SAEs were reported, 3 of which were related to vaccination.

CONCLUSION

Reduced infant schedules and catch-up series in children were immunogenic and safe, having the potential to widen 4CMenB vaccine coverage.

FUNDING

GlaxoSmithKline Biologicals SA.

摘要

背景

本研究评估了一种已获许可的B群脑膜炎球菌疫苗(4CMenB)按照简化程序单独接种于婴儿或在儿童中进行补种系列接种时的免疫原性和安全性。

方法

在这项开放标签、多中心3b期研究(NCT01339923)中,随机分为1:1:1的婴儿接受4CMenB:在3个半月至5个月和11个月龄或6至8个月和11个月龄时接种2 + 1剂,在2个半月至3个半月、5个月和11个月龄时接种3 + 1剂。2至10岁的儿童接受2剂补种,间隔2个月接种。通过针对疫苗成分fHbp、NadA、PorA和NHBA的4种菌株的hSBA检测来测量免疫反应。在采用2 + 1剂接种程序的组中,免疫反应充足性的定义为在第2剂接种后1个月,hSBA滴度≥4的婴儿百分比的97.5%置信区间下限≥70%,针对fHbp、NadA、PorA。接种疫苗后7天收集不良事件;在整个研究期间收集严重不良事件(SAE)。

结果

共纳入754名婴儿和404名儿童。初次接种疫苗后,所有组中98 - 100%的婴儿针对fHbp、NadA、PorA产生的hSBA滴度≥4,针对NHBA产生的hSBA滴度为48 - 77%。在接种2剂4CMenB后,对于接受2 + 1接种程序的婴儿,fHbp、NadA、PorA的免疫反应充足性得到证实,因为符合预先设定的标准。在接种2剂补种疫苗后,95 - 99%的儿童针对4CMenB成分产生的hSBA滴度≥4。各组观察到相似的安全性概况。共报告45起严重不良事件,其中3起与疫苗接种有关。

结论

婴儿简化接种程序和儿童补种系列具有免疫原性且安全,有可能扩大4CMenB疫苗的覆盖范围。

资助

葛兰素史克生物制品公司。

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