Influence of initial vaccination with 13-valent pneumococcal conjugate vaccine or 23-valent pneumococcal polysaccharide vaccine on anti-pneumococcal responses following subsequent pneumococcal vaccination in adults 50 years and older |
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Authors: | Lisa A. Jackson Alejandra Gurtman Martin van Cleeff Robert W. Frenck John Treanor Kathrin U. Jansen Daniel A. Scott Emilio A. Emini William C. Gruber Beate Schmoele-Thoma |
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Affiliation: | 1. The Group Health Research Institute, Group Health, Seattle, Washington, United States;2. Pfizer Inc, Pearl River, New York, United States;3. Triangle Medical Research Associates, Cary, North Carolina, United States;4. Department of Pediatrics, Cincinnati Children''s Hospital Medical Center, Cincinnati, Ohio, United States;5. University of Rochester Medical Center, Rochester, New York, United States;6. Pfizer GmbH, Berlin, Germany |
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Abstract: | BackgroundUnlike free polysaccharide vaccines, pneumococcal polysaccharide conjugate vaccines (PCVs) induce a T cell-dependent immune response and have the potential to provide an extended duration of protection with repeated vaccinations.MethodsThis was an extension of a previous study in pneumococcal vaccine-naïve adults aged 50–64 years in which adults 60–64 years of age were given 13-valent PCV (PCV13) or 23-valent pneumococcal polysaccharide vaccine (PPSV23) and adults aged 50–59 were given PCV13. In this follow up study conducted about 4 years later, the 60–64 year olds initially given PCV13 received PCV13 or PPSV23, and those initially given PPSV23 received another PPSV23. All adults aged 50–59 years were re-vaccinated with PCV13. Anti-pneumococcal opsonophagocytic activity (OPA) titers were measured before and 1 month after vaccination.ResultsA second PCV13 given about 4 years after a first vaccination induced OPA titers that were significantly higher than those following the initial vaccination for 7 of 13 serotypes in the older group, and 6 of 13 serotypes in the younger group, and responses to the remaining serotypes were largely non-inferior. In contrast, OPA titers following revaccination with PPSV23 were statistically significantly lower for 9 of the 13 serotypes, and non-inferior for the remaining serotypes, when compared to the responses to the first PPSV23. OPA titers in the older adults who received PPSV23 after initial PCV13 were significantly higher than those following a first PPSV23 for 10 of the 13 serotypes.ConclusionIn adults 50 to 64 years of age, initial vaccination with PCV13 establishes an immune state that results in recall anti-pneumococcal responses upon subsequent vaccination with either conjugated or free polysaccharide vaccine. In contrast, initial vaccination with PPSV23 results in an immune state in which subsequent PPSV23 administration yields generally lower responses compared with the initial responses. |
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Keywords: | ACIP, United States Advisory Committee on Immunization Practices AE, adverse event CI, confidence interval CRM197, cross-reactive material 197 GMR, geometric mean ratio GMT, geometric mean titer OPA, opsonophagocytic activity PCV, pneumococcal polysaccharide conjugate vaccine PCV13, 13-valent pneumococcal conjugate vaccine PPSV23, 23-valent polysaccharide vaccine RCDC, reverse cumulative distribution curve SAE, serious adverse event |
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