Agence de Médecine Préventive, Paris, France.
Centre Muraz, Bobo-Dioulasso, Burkina Faso.
J Pediatric Infect Dis Soc. 2019 Nov 6;8(5):422-432. doi: 10.1093/jpids/piy075.
Many African countries have introduced pneumococcal conjugate vaccine (PCV) into their routine immunization program to reduce the burden of morbidity and death that results from Streptococcus pneumoniae infection, yet immunogenicity and reactogenicity data from the region are limited for the 2 available PCV products.
We conducted a randomized trial of 13-valent PCV (PCV13) in Bobo-Dioulasso, Burkina Faso. Infants received 3 doses of PCV at 6, 10, and 14 weeks of age or at 6 weeks, 14 weeks, and 9 months of age; toddlers received 2 doses 2 months apart or 1 dose beginning at 12 to 15 months of age; and children received 1 dose between 2 and 4 years of age. We measured each participant's serotype-specific serum immunoglobulin G concentration and opsonophagocytic activity before and after vaccination. For each age group, we compared immune responses between study arms and between the standard schedule in our study and the PCV13-licensing trials.
In total, 280 infants, 302 toddlers, and 81 children were assigned randomly and underwent vaccination; 268, 235, and 77 of them completed follow-up, respectively. PCV13 resulted in low reactogenicity in all the study arms. The vaccine elicited a strong primary immune response in infants after 2 or more doses and in children aged 1 to 4 years after 1 dose. Infants who received a booster dose exhibited a robust memory response. Immunogenicity was higher than or comparable to that observed in the PCV13-licensing trials for a majority of serotypes in all 3 age groups.
PCV13 has a satisfactory immunogenicity and reactogenicity profile in this population. Our findings will help support decision making by countries regarding their infant and catch-up vaccination schedules.
许多非洲国家已将肺炎球菌结合疫苗(PCV)纳入常规免疫规划,以降低肺炎链球菌感染导致的发病和死亡负担,但该地区关于两种可用 PCV 产品的免疫原性和反应原性数据有限。
我们在布基纳法索博博-迪乌拉索开展了 13 价肺炎球菌结合疫苗(PCV13)的随机试验。婴儿在 6、10 和 14 周龄或 6 周龄、14 周龄和 9 月龄时接受 3 剂 PCV;幼儿在 2 个月时接受 2 剂或在 12 至 15 月龄时接受 1 剂;儿童在 2 至 4 岁时接受 1 剂。我们在接种前后测量了每位参与者的血清型特异性血清免疫球蛋白 G 浓度和调理吞噬活性。对于每个年龄组,我们比较了研究臂之间以及我们研究中的标准方案与 PCV13 许可试验之间的免疫反应。
共有 280 名婴儿、302 名幼儿和 81 名儿童被随机分配并接受了疫苗接种;分别有 268、235 和 77 名完成了随访。所有研究臂中,PCV13 的反应原性都较低。2 剂或更多剂的 PCV13 可在婴儿中引起强烈的初次免疫反应,1 剂的 PCV13 可在 1 至 4 岁儿童中引起强烈的初次免疫反应。接受加强剂量的婴儿表现出强大的记忆反应。在所有 3 个年龄组中,大多数血清型的免疫原性都高于或与 PCV13 许可试验中观察到的相当。
PCV13 在该人群中的免疫原性和反应原性良好。我们的研究结果将有助于支持各国在婴儿和补种疫苗接种时间表方面做出决策。