ORIGINAL ARTICLE

DT5aP-Hib-IPV and MCC vaccines: preterm infants’ response to accelerated immunisation

M H Slack¹, S Cade¹, D Schapira², R J Thwaites¹, A Crowley-Luke³, J Southern⁴, R Borrow⁵, E Miller⁴

¹ Department of Paediatrics, St Mary’s Hospital, Portsmouth, UK
² Department of Paediatrics, Royal Hampshire County Hospital, Winchester, UK
³ HPA Porton Down, Salisbury, UK
⁴ Immunisation Division, HPA Communicable Disease Surveillance Centre, 61 Colindale Avenue, London, UK
⁵ Vaccine Evaluation Department, Manchester Royal Infirmary, Manchester, UK

Correspondence to:
Correspondence to:
Dr M Slack
Department of Paediatrics, St Mary’s Hospital, Portsmouth PO3 6AD, UK; marts{at}doctors.org.uk

Aims: To describe the immune response of preterm infants to combined diphtheria/tetanus/5 component acellular pertussis-Haemophilus influenzae type b inactivated polio vaccine (DT5aP-Hib-IPV) and meningococcal serogroup C conjugate vaccine (MCC) under accelerated schedule. To compare results with term infants immunised with DT5aP-Hib-IPV and with historical data from preterm infants immunised with a DT3 component aP-Hib vaccine.

Methods: Prospective observational study in preterm infants born at <32 weeks gestation with comparison to contemporary cohort of term infants. DT5aP-Hib-IPV and MCC vaccines were given at 2, 3, and 4 months.

Results: Fifty preterm infants (mean gestational age 28.5 weeks) completed the study. After three doses of vaccines Hib polysaccharide IgG geometric mean concentration (GMC) was 1.21 µg/ml with 80% 0.15 µg/ml; MCC serum bactericidal assay geometric mean titre (GMT) was 1245 with 100% 8. All infants achieved protective titres to diphtheria, tetanus, and the three poliovirus types with 80% achieving protective rises in IgG against the five pertussis antigens.

Conclusion: Preterm infants immunised with DT5aP-Hib-IPV and MCC vaccines show IgG responses to Hib and MCC greater than seen historically in both term and preterm infants with a DT3aP-Hib vaccine, and for pertussis antigens and poliovirus type 1 responses similar to that seen in term infants immunised with DT5aP-Hib-IPV. Responses to poliovirus types 2 and 3 are reduced, but all infants achieved protective titres.

Abbreviations: aP, acellular pertussis; DT5aP-Hib-IPV, diphtheria/tetanus/5 component acellular pertussis-Haemophilus influenzae type b inactivated polio vaccine; DTwP, diphtheria/tetanus/whole cell pertussis; GMC, geometric mean concentration; GMT, geometric mean titre; IPV, inactivated polio vaccine; MCC, meningococcal serogroup C conjugate vaccine; OPV, oral polio vaccine; PRP, polyribosylphosphate

Keywords: Haemophilus influenzae type b; infant; premature; vaccine; acellular pertussis; meningococcal serogroup C

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This article has been cited by other articles:

• Bonhoeffer, J, Siegrist, C-A, Heath, P T (2006). Immunisation of premature infants. Arch. Dis. Child. 91: 929-935 [Abstract] [Full Text]