Evaluation of haemophilus influenzae type b vaccine for routine immunization in Nepali infants.

BACKGROUND: Haemophilus influenzae type b (Hib) carriage and disease studies in Nepali children suggest a significant burden of infection. Hib conjugate vaccines (HibCV) do not have uniform immunogenicity between populations. We determined the immunogenicity of HibCV in Nepali infants, before its i...

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Main Authors: Metz, J, Hanieh, S, Pradhan, R, Joshi, A, Shakya, D, Shrestha, L, Shrestha, A, Upadhyay, B, Kelly, S, John, T, Maharjan, B, Yu, L, Omar, O, Borrow, R, Findlow, J, Kelly, D, Thorson, S, Adhikari, N, Murdoch, DR, Pollard, A
Format: Journal article
Language:English
Published: 2012
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author Metz, J
Hanieh, S
Pradhan, R
Joshi, A
Shakya, D
Shrestha, L
Shrestha, A
Upadhyay, B
Kelly, S
John, T
Maharjan, B
Yu, L
Omar, O
Borrow, R
Findlow, J
Kelly, D
Thorson, S
Adhikari, N
Murdoch, DR
Pollard, A
author_facet Metz, J
Hanieh, S
Pradhan, R
Joshi, A
Shakya, D
Shrestha, L
Shrestha, A
Upadhyay, B
Kelly, S
John, T
Maharjan, B
Yu, L
Omar, O
Borrow, R
Findlow, J
Kelly, D
Thorson, S
Adhikari, N
Murdoch, DR
Pollard, A
author_sort Metz, J
collection OXFORD
description BACKGROUND: Haemophilus influenzae type b (Hib) carriage and disease studies in Nepali children suggest a significant burden of infection. Hib conjugate vaccines (HibCV) do not have uniform immunogenicity between populations. We determined the immunogenicity of HibCV in Nepali infants, before its introduction into the routine immunization schedule. METHODS: Ninety infants recruited at Patan Hospital, Kathmandu, received 3 doses of the HibCV with routine immunizations (diphtheria, tetanus, whole cell pertussis-hepatitis B vaccine + oral polio vaccine) at 6, 10 and 14 weeks of age, and a HibCV booster at 52 weeks. Anti-polyribosylribitol phosphate (PRP) concentrations were measured at 18, 52 and 56 weeks, and the antibody persistence at 52 weeks was compared with antibody values in unimmunized controls (n = 30). RESULTS: After 3 doses of primary immunizations, at 18 weeks of age (n = 74), all infants had anti-PRP concentrations above the accepted thresholds for short- and long-term protection (0.15 and 1.0 µg/mL, respectively). At 1 year of age, before administration of the booster of HibCV, the anti-PRP geometric mean antibody concentration was 2.76 µg/mL (confidence interval: 1.88-4.07) in sera from the immunized children compared with 0.11 µg/mL (95% confidence interval: 0.08-0.17) in the nonimmunized control group (n = 30). Twenty-seven percent (20/74) of participants, however, had anti-PRP concentrations <1.0 µg/mL. Four weeks after the booster dose of HibCV, 98.5% of infants had anti-PRP concentrations above 1.0 µg/mL. CONCLUSION: Immunization with HibCV given as part of the Expanded Program on Immunization schedule in Nepal elicits robust antibody responses. Though the antibody wanes during the first year of life, most 1-year-old infants remain protected and respond robustly to a booster dose of the vaccine.
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spelling oxford-uuid:55fc92bc-98fb-4909-a02a-710f2f37eeb42022-03-26T16:47:35ZEvaluation of haemophilus influenzae type b vaccine for routine immunization in Nepali infants.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:55fc92bc-98fb-4909-a02a-710f2f37eeb4EnglishSymplectic Elements at Oxford2012Metz, JHanieh, SPradhan, RJoshi, AShakya, DShrestha, LShrestha, AUpadhyay, BKelly, SJohn, TMaharjan, BYu, LOmar, OBorrow, RFindlow, JKelly, DThorson, SAdhikari, NMurdoch, DRPollard, A BACKGROUND: Haemophilus influenzae type b (Hib) carriage and disease studies in Nepali children suggest a significant burden of infection. Hib conjugate vaccines (HibCV) do not have uniform immunogenicity between populations. We determined the immunogenicity of HibCV in Nepali infants, before its introduction into the routine immunization schedule. METHODS: Ninety infants recruited at Patan Hospital, Kathmandu, received 3 doses of the HibCV with routine immunizations (diphtheria, tetanus, whole cell pertussis-hepatitis B vaccine + oral polio vaccine) at 6, 10 and 14 weeks of age, and a HibCV booster at 52 weeks. Anti-polyribosylribitol phosphate (PRP) concentrations were measured at 18, 52 and 56 weeks, and the antibody persistence at 52 weeks was compared with antibody values in unimmunized controls (n = 30). RESULTS: After 3 doses of primary immunizations, at 18 weeks of age (n = 74), all infants had anti-PRP concentrations above the accepted thresholds for short- and long-term protection (0.15 and 1.0 µg/mL, respectively). At 1 year of age, before administration of the booster of HibCV, the anti-PRP geometric mean antibody concentration was 2.76 µg/mL (confidence interval: 1.88-4.07) in sera from the immunized children compared with 0.11 µg/mL (95% confidence interval: 0.08-0.17) in the nonimmunized control group (n = 30). Twenty-seven percent (20/74) of participants, however, had anti-PRP concentrations <1.0 µg/mL. Four weeks after the booster dose of HibCV, 98.5% of infants had anti-PRP concentrations above 1.0 µg/mL. CONCLUSION: Immunization with HibCV given as part of the Expanded Program on Immunization schedule in Nepal elicits robust antibody responses. Though the antibody wanes during the first year of life, most 1-year-old infants remain protected and respond robustly to a booster dose of the vaccine.
spellingShingle Metz, J
Hanieh, S
Pradhan, R
Joshi, A
Shakya, D
Shrestha, L
Shrestha, A
Upadhyay, B
Kelly, S
John, T
Maharjan, B
Yu, L
Omar, O
Borrow, R
Findlow, J
Kelly, D
Thorson, S
Adhikari, N
Murdoch, DR
Pollard, A
Evaluation of haemophilus influenzae type b vaccine for routine immunization in Nepali infants.
title Evaluation of haemophilus influenzae type b vaccine for routine immunization in Nepali infants.
title_full Evaluation of haemophilus influenzae type b vaccine for routine immunization in Nepali infants.
title_fullStr Evaluation of haemophilus influenzae type b vaccine for routine immunization in Nepali infants.
title_full_unstemmed Evaluation of haemophilus influenzae type b vaccine for routine immunization in Nepali infants.
title_short Evaluation of haemophilus influenzae type b vaccine for routine immunization in Nepali infants.
title_sort evaluation of haemophilus influenzae type b vaccine for routine immunization in nepali infants
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