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Review
. 2014 Jan;33 Suppl 2(Suppl 2 Optimum Dosing of Pneumococcal Conjugate Vaccine For Infants 0 A Landscape Analysis of Evidence Supportin g Different Schedules):S130-9.
doi: 10.1097/INF.0000000000000081.

The differential impact of coadministered vaccines, geographic region, vaccine product and other covariates on pneumococcal conjugate vaccine immunogenicity

Daniel E Park  1 , T Scott Johnson, Bareng Aletta S Nonyane, Subhash Chandir, Laura Conklin, Katherine E Fleming-Dutra, Jennifer D Loo, David Goldblatt, Cynthia G Whitney, Katherine L O'Brien, Maria Deloria Knoll
Affiliations
Free PMC article
Review

The differential impact of coadministered vaccines, geographic region, vaccine product and other covariates on pneumococcal conjugate vaccine immunogenicity

Daniel E Park et al. Pediatr Infect Dis J. 2014 Jan.
Free PMC article

Abstract

Background: Antipneumococcal capsular polysaccharide antibody concentrations are used as predictors of vaccine efficacy against vaccine serotype (ST) pneumococcal disease among infants. While pneumococcal conjugate vaccines (PCV) are recommended globally, factors associated with optimal PCV immune response are not well described. We aimed to systematically assess local setting factors, beyond dosing schedule, which may affect PCV antibody levels.

Methods: We conducted a literature review of PCV immunogenicity, abstracting data from published reports, unpublished sources, and conference abstracts from 1994 to 2010 (and ad hoc 2011 reports). Studies included in this analysis evaluated ≥ 2 primary doses of PCV before 6 months of age in non-high-risk populations, used 7-valent or higher PCV products (excluding Aventis-Pasteur and Merck products) and provided information on geometric mean concentration (GMC) for STs 1, 5, 6B, 14, 19F or 23F. Using random effects meta-regression, we assessed the impact of geographic region, coadministered vaccines and PCV product on postprimary GMC, adjusting for dosing schedule and ELISA laboratory method.

Results: Of 12,980 citations reviewed, we identified 103 vaccine study arms for this analysis. Children in studies from Asia, Africa and Latin America had significantly higher GMC responses compared with those in studies from Europe and North America. Coadministration with acellular pertussis DTP compared with whole-cell DTP had no effect on PCV immunogenicity except for ST14, where GMCs were higher when coadministered with acellular pertussis DTP. Vaccine product, number of PCV doses, dosing interval, age at first dose and ELISA laboratory method also affected the GMC.

Conclusions: PCV immunogenicity is associated with geographic region and vaccine product; however, the associations and magnitude varied by ST. Consideration of these factors is essential when comparing PCV immunogenicity results between groups and should be included in the evidence base when selecting optimal PCV vaccine schedules in specific settings.

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Conflict of interest statement

The findings and conclusions in this article are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention. Support for this project was provided by Program for Appropriate Technology in Health (PATH) through funding from the Global Alliance for Vaccines and Immunisation (GAVI). The views expressed by the authors do not necessarily reflect the views of GAVI and/or PATH. D.G.’s laboratory performs contract and or collaborative research for/with Pfizer, GlaxoSmithKline, Merck, Novartis and Sanofi Pasteur. D.G. has received travel or honorarium support for participation in external expert committees for Merck, Sanofi Pasteur, Pfizer and GlaxoSmithKline. K.O.B. has received grant support from Pfizer, GlaxoSmithKline and has received travel or honorarium support for participation in external expert committees for Merck, Aventis-Pasteur and GlaxoSmithKline. M.D.K. has received support from Novartis for participation on a Data and Safety Monitoring Board, meeting travel reimbursement from Pfizer and grant support from Merck. The authors have no other funding or conflicts of interest to declare.

Figures

FIGURE 1.
FIGURE 1.
Average pre- and post-PCV pneumococcal IgG GMC in children by ST and region.
FIGURE 2.
FIGURE 2.
Effect of DTaP versus DTwP coadministration on postprimary PCV GMC for selected vaccine STs.
See this image and copyright information in PMC

References

    1. Jódar L, Butler J, Carlone G, et al. Serological criteria for evaluation and licensure of new pneumococcal conjugate vaccine formulations for use in infants. Vaccine. 2003;21:3265–3272. - PubMed
    1. WHO. Recommendations for the production and control of pneumococcal conjugate vaccines. WHO Tech Report Series. 2005;927
    1. Siber GR, Chang I, Baker S, et al. Estimating the protective concentration of anti-pneumococcal capsular polysaccharide antibodies. Vaccine. 2007;25:3816–3826. - PubMed
    1. Dagan R, Givon-Lavi N, Fraser D, et al. Serum serotype-specific pneumococcal anticapsular immunoglobulin g concentrations after immunization with a 9-valent conjugate pneumococcal vaccine correlate with nasopharyngeal acquisition of pneumococcus. J Infect Dis. 2005;192:367–376. - PubMed
    1. Millar EV, O’Brien KL, Bronsdon MA, et al. Anticapsular serum antibody concentration and protection against pneumococcal colonization among children vaccinated with 7-valent pneumococcal conjugate vaccine. Clin Infect Dis. 2007;44:1173–1179. - PubMed

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