Persistence of the immune response after 4CMenB vaccination, and the response to an additional booster dose in infants, children, adolescents, and young adults

Abstract

The multicomponent meningococcal serogroup B vaccine, 4CMenB, has demonstrated effectiveness in preventing invasive MenB disease in infants and in controlling MenB outbreaks. The need for/timing of additional booster doses is not yet established. We reviewed eight studies that evaluated antibody persistence and booster following primary 4CMenB vaccination of infants, children, adolescents, and young adults. Putative seroprotective hSBA titers for ≥1 vaccine antigen were maintained by 76-100% of children 24-36 months after priming during infancy and in 84-100% after priming in the second year of life. hSBA levels were higher in vaccinees at 4 and 7.5 years following priming during adolescence than in vaccine-naïve individuals of a similar age. Antibodies persisted at higher levels to NHBA and NadA than to PorA or fHbp. Booster vaccination induced robust anamnestic responses, demonstrating effective priming by 4CMenB across age-groups. These data can inform decision-making to optimize vaccination strategies.

Keywords: 4CMenB; Neisseria meningitidis; antibody persistence; immunogenicity; meningococcal serogroup B.

Figure 1.

Focus on the patient section.

Figure 2.

hSBA GMTs one month following priming and booster at 35–47 months of age: (a) 3 + 1 schedule (2.5, 3.5, 5 and 11 months of age), (b) 2 + 1 schedule (3.5, 5 and 11 months of age) (Study 5). Footnotes: Sample size: A 127–140 in the booster cohort; B 111–131 in the booster cohort; CI = confidence interval, hSBA = serum bactericidal assay using human complement source, GMT = geometric mean antibody titer, fHbp = factor H binding protein, NadA = Neisseria adhesin A, PorA = porin A, NHBA = Neisserial Heparin Binding Antigen.

Figure 3.

hSBA GMTs one month following priming and booster 7.5 years after two dose priming of adolescents at 11–17 years of age* (Study 6). Footnotes: * Two-dose schedule: 0–1, 0–2, or 0–6 months. Data from baseline through 6 months is from the 0–1 month schedule group; Persistence data from 18–23 months onwards is from pooled 0–1, 0–2, and 0–6 month schedules; Sample size = 93–127 in the pooled schedule booster cohort; CI = confidence interval, hSBA = serum bactericidal assay using human complement source, GMT = geometric mean antibody titer, fHbp = factor H binding protein, NadA = Neisseria adhesin A, PorA = porin A, NHBA = Neisserial Heparin Binding Antigen.