Modeling antibody persistence after MenACYW-TT vaccination and comparative analysis with other quadrivalent meningococcal vaccines

Abstract

Evaluating the persistence of antibody titers produced by quadrivalent meningococcal vaccines is crucial for determining the optimal timing for primary and booster doses. Using 3 - 7-year persistence data after a single priming dose of MenACYW-TT to fit a statistical model of antibody decay over time (10 years), this analysis modeled long-term antibody persistence for this vaccine in toddlers (12-23 months), adolescents/young adults (13-26 years), and older adults (≥ 56 years), comparing it with other vaccines (MCV4-TT, MenACWY-CRM, MPSV4). The statistical model is based on a Bayesian approach and it accounts for vaccine- and age group-specific antibody decline, missing data, assay errors, and antibody boosting from breakthrough infections. At 10 years post-vaccination, it predicted comparable or higher seroprotective immunopersistence for MenACYW-TT (titers ≥ 1:8 with hSBA) versus (1) MCV4-TT in toddlers (77% [95% CI 70-84] vs. 17% [6-31] for serogroup C, 67% [59-74] vs. 36% [20-53] for serogroup W); (2) MenACWY-CRM in adolescents/young adults (63% [55-71] vs. 40% [32-48] for serogroup C, 67% [59-74] vs. 57% [47-67] for serogroup W); and (3) MPSV4 in older adults (31% [23-39] vs. 22% [14-29] for serogroup C, 38% [31-46] vs. 20% [14-27] for serogroup W). In conclusion, our analysis indicated similar or higher immune persistence at 10 years for MenACYW-TT compared with other quadrivalent meningococcal vaccines, particularly for serogroups C and W.

Keywords: Invasive meningococcal disease; Long-term immunopersistence; MenACYW-TT; Modelling; Quadrivalent meningococcal vaccines; Serogroups A, C, W, Y; Seroprotection.

Fig. 1

Observed (a) GMTs and (b) seroprotection rates based on hSBA ≥ 1:8, by age group and vaccine. Day 0 = 30 days after the primary vaccination. Persistence data for each age group are pooled data presented Table 1. Observations for each study and each vaccine were grouped by the number of years post-vaccination at which they have been collected (0, 3, 4 and 5 years for adolescents/young adults, 0, 3, 5 and 7 years for older adults, and 3 and 5 years for toddlers).

Fig. 2

Observed and predicted GMTs according to age group and time. Day 0 = 30 days after the primary vaccination. Dots and vertical lines correspond, respectively, to observed GMT and 95% confidence interval of this observed value. Lines and corresponding shaded areas correspond, respectively, to the average estimated GMT and corresponding 95% confidence interval.

Fig. 3

Observed and predicted serogroup-specific seroprotection rate (titer based on hSBA ≥ 1:8) up to 10 years. Day 0 = 30 days after the primary vaccination. Dots and vertical lines correspond, respectively, to observed seroprotection rate and 95% confidence interval of this observed value. Lines and corresponding shaded areas correspond, respectively, to the average estimated seroprotection rate and corresponding 95% confidence interval.

Fig. 4

Predicted (a) GMTs and predicted (b) seroprotection rate (titer based on hSBA ≥ 1:8) at year 10. *Indicates significant differences between the predicted values for MenACYW-TT versus the comparator vaccine. Bars correspond to average predicted seroprotection rates and vertical lines to the 95% confidence interval associated with these predicted values.