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DT5aP-Hib-IPV and MCC vaccines: preterm infants’ response to accelerated immunisation
  1. M H Slack1,
  2. S Cade1,
  3. D Schapira2,
  4. R J Thwaites1,
  5. A Crowley-Luke3,
  6. J Southern4,
  7. R Borrow5,
  8. E Miller4
  1. 1Department of Paediatrics, St Mary’s Hospital, Portsmouth, UK
  2. 2Department of Paediatrics, Royal Hampshire County Hospital, Winchester, UK
  3. 3HPA Porton Down, Salisbury, UK
  4. 4Immunisation Division, HPA Communicable Disease Surveillance Centre, 61 Colindale Avenue, London, UK
  5. 5Vaccine Evaluation Department, Manchester Royal Infirmary, Manchester, UK
  1. Correspondence to:
    Dr M Slack
    Department of Paediatrics, St Mary’s Hospital, Portsmouth PO3 6AD, UK; martsdoctors.org.uk

Abstract

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.

  • 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
  • Haemophilus influenzae type b
  • infant
  • premature
  • vaccine
  • acellular pertussis
  • meningococcal serogroup C

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Footnotes

  • Funding: The study was funded in part by an unrestricted grant from AventisPasteur MSD

  • Competing interests: Dr Slack and Ms Southern attended the 2003 Annual Meeting of the European Society of Paediatric Infectious Diseases as guests of AventisPasteur MSD