van Ravenhorst Mariëtte B, van der Klis Fiona R M, van Rooijen Debbie M, Sanders Elisabeth A M, Berbers Guy A M
Centre for Infectious Disease Control (Cib), National Institute of Public Health and the Environment (RIVM), Bilthoven, The Netherlands; Department of Pediatric Immunology and Infectious Diseases, Wilhelmina Children's Hospital, University Medical Center, Utrecht, The Netherlands.
Centre for Infectious Disease Control (Cib), National Institute of Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
Vaccine. 2017 Aug 24;35(36):4753-4760. doi: 10.1016/j.vaccine.2017.06.007. Epub 2017 Jun 21.
Recently the incidence of meningococcal serogroup Y (MenY) and in particular serogroup W (MenW) invasive disease has risen in several European countries, including the Netherlands. Adolescents are a target group for primary prevention through vaccination to protect against disease and reduce carriage and induce herd protection in the population. The present study assessed MenA, MenW and MenY antibody levels in adolescents up to one year following primary vaccination with quadrivalent MenACWY-PS conjugated to tetanus toxoid (MenACWY-TT).
In this phase IV, open-label study, healthy 10-, 12- and 15-year-olds received the MenACWY-TT vaccine. Blood samples were collected before, 1month and 1year after the vaccination. Functional antibody levels against MenA, MenW and MenY were measured with serum bactericidal assay using baby rabbit complement (rSBA). MenA-, MenW-, and MenY-PS specific IgG, IgG1 and IgG2 levels were measured using fluorescent-bead-based multiplex immunoassay.
The quadrivalent MenACWY-TT vaccine elicited robust antibody responses against MenA, MenW and MenY, and the majority (94%) of the participants maintained rSBA titers ≥128 one year after the vaccination against all three serogroups. After one year, higher MenW rSBA GMTs were observed in the 12- and 15-year-olds compared to the 10-year-olds, while rSBA GMTs against MenA and MenY were similar between age groups. Furthermore, those participant who showed SBA titer ≥8 at baseline, also had higher antibody levels one year after vaccination as compared to participants with rSBA titer <8 at baseline.
The MenACWY-TT vaccine induces robust protective primary immune responses up to one year after vaccination. Our results suggest that persistence of individual protection increases with the age at which a primary quadrivalent MenACWY-TT vaccination is administered. Our results indicate that 12 or 15years seems a more optimal age for a primary quadrivalent MenACWY-TT vaccination to protect against the rapid increase of MenW disease.
最近，包括荷兰在内的几个欧洲国家中，脑膜炎球菌Y群（MenY）尤其是W群（MenW）侵袭性疾病的发病率有所上升。青少年是通过接种疫苗进行一级预防的目标群体，以预防疾病、减少带菌情况并在人群中产生群体保护作用。本研究评估了用破伤风类毒素结合的四价MenACWY-PS（MenACWY-TT）进行初次疫苗接种后一年内青少年体内的A群、W群和Y群脑膜炎球菌抗体水平。
在这项IV期开放标签研究中，健康的10岁、12岁和15岁青少年接种了MenACWY-TT疫苗。在接种前、接种后1个月和1年采集血样。使用兔仔补体通过血清杀菌试验（rSBA）测量针对A群、W群和Y群脑膜炎球菌的功能性抗体水平。使用基于荧光珠的多重免疫测定法测量A群、W群和Y群多糖特异性IgG、IgG1和IgG2水平。
四价MenACWY-TT疫苗引发了针对A群、W群和Y群脑膜炎球菌的强烈抗体反应，并且大多数（94%）参与者在接种疫苗一年后针对所有三个血清群的rSBA滴度维持在≥128。一年后，与10岁青少年相比，12岁和15岁青少年的W群rSBA几何平均滴度（GMT）更高，而不同年龄组之间针对A群和Y群脑膜炎球菌的rSBA GMT相似。此外，与基线rSBA滴度<8的参与者相比，那些在基线时rSBA滴度≥8的参与者在接种疫苗一年后的抗体水平也更高。
MenACWY-TT疫苗在接种后一年内可诱导强烈的保护性初次免疫反应。我们的结果表明，初次接种四价MenACWY-TT疫苗时的年龄越大，个体保护的持续时间越长。我们的结果表明，12岁或15岁似乎是进行四价MenACWY-TT初次疫苗接种以预防MenW疾病快速增长的更理想年龄。
