Schedules for pneumococcal vaccination of preterm infants: an RCT
BACKGROUND AND OBJECTIVE: Premature infants have a higher risk of invasive pneumococcal disease and are more likely to have lower vaccine responses compared with term infants. Increasingly, immunization schedules are including a reduced, 2-dose, pneumococcal conjugate vaccine priming schedule. Our g...
| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Journal article |
| Language: | English |
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American Academy of Pediatrics
2016
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| _version_ | 1826287488298123264 |
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| author | Kent, A Ladhani, S Andrews, N Scorrer, T Pollard, A Clarke, P Hughes, S Heal, C Menson, E Chang, J Satodia, P Collinson, A Faust, S Goldblatt, D Miller, E Heath, P PUNS Study Group |
| author_facet | Kent, A Ladhani, S Andrews, N Scorrer, T Pollard, A Clarke, P Hughes, S Heal, C Menson, E Chang, J Satodia, P Collinson, A Faust, S Goldblatt, D Miller, E Heath, P PUNS Study Group |
| author_sort | Kent, A |
| collection | OXFORD |
| description | BACKGROUND AND OBJECTIVE: Premature infants have a higher risk of invasive pneumococcal disease and are more likely to have lower vaccine responses compared with term infants. Increasingly, immunization schedules are including a reduced, 2-dose, pneumococcal conjugate vaccine priming schedule. Our goal was to assess the immunogenicity of 3 commonly used 13-valent pneumococcal conjugate vaccine (PCV13) priming schedules in premature infants and their response to a 12-month booster dose. METHODS: Premature infants (<35 weeks' gestation) were randomized to receive PCV13 at 2 and 4 months (reduced schedule); 2, 3, and 4 months (accelerated schedule); or 2, 4, and 6 months (extended schedule). All infants received a 12-month PCV13 booster. Serotype-specific pneumococcal immunoglobulin G (IgG) for PCV13 serotypes was measured by using enzyme-linked immunosorbent assay 1 month after the primary and booster vaccinations. RESULTS: A total of 210 infants (median birth gestation, 29(+6) weeks; range, 23(+2)-34(+6) weeks) were included. After the primary vaccination, 75% (95% confidence interval [CI], 62-85), 88% (95% CI, 76-95), and 97% (95% CI, 87-99) of participants had protective antibody concentrations for at least one-half the PCV13 serotypes for the reduced, accelerated, and extended schedules, respectively. After the booster vaccination, participants receiving the extended schedule had significantly lower (P < .05) geometric mean concentrations compared with reduced (for 9 of 13 serotypes) and accelerated (for 4 of 13 serotypes) schedules, but nearly all participations, regardless of schedule or serotype, had seroprotective IgG concentrations. CONCLUSIONS: A reduced priming schedule of PCV13 resulted in higher post-booster IgG concentrations but lower post-primary concentrations. The optimum vaccine schedule for preterm infants will therefore depend on when they are most at risk for invasive pneumococcal disease. |
| first_indexed | 2024-03-07T01:59:25Z |
| format | Journal article |
| id | oxford-uuid:9cd6942b-b0f8-4562-95ce-f13f5d6011e0 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T01:59:25Z |
| publishDate | 2016 |
| publisher | American Academy of Pediatrics |
| record_format | dspace |
| spelling | oxford-uuid:9cd6942b-b0f8-4562-95ce-f13f5d6011e02022-03-27T00:38:57ZSchedules for pneumococcal vaccination of preterm infants: an RCTJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:9cd6942b-b0f8-4562-95ce-f13f5d6011e0EnglishSymplectic Elements at OxfordAmerican Academy of Pediatrics2016Kent, ALadhani, SAndrews, NScorrer, TPollard, AClarke, PHughes, SHeal, CMenson, EChang, JSatodia, PCollinson, AFaust, SGoldblatt, DMiller, EHeath, PPUNS Study GroupBACKGROUND AND OBJECTIVE: Premature infants have a higher risk of invasive pneumococcal disease and are more likely to have lower vaccine responses compared with term infants. Increasingly, immunization schedules are including a reduced, 2-dose, pneumococcal conjugate vaccine priming schedule. Our goal was to assess the immunogenicity of 3 commonly used 13-valent pneumococcal conjugate vaccine (PCV13) priming schedules in premature infants and their response to a 12-month booster dose. METHODS: Premature infants (<35 weeks' gestation) were randomized to receive PCV13 at 2 and 4 months (reduced schedule); 2, 3, and 4 months (accelerated schedule); or 2, 4, and 6 months (extended schedule). All infants received a 12-month PCV13 booster. Serotype-specific pneumococcal immunoglobulin G (IgG) for PCV13 serotypes was measured by using enzyme-linked immunosorbent assay 1 month after the primary and booster vaccinations. RESULTS: A total of 210 infants (median birth gestation, 29(+6) weeks; range, 23(+2)-34(+6) weeks) were included. After the primary vaccination, 75% (95% confidence interval [CI], 62-85), 88% (95% CI, 76-95), and 97% (95% CI, 87-99) of participants had protective antibody concentrations for at least one-half the PCV13 serotypes for the reduced, accelerated, and extended schedules, respectively. After the booster vaccination, participants receiving the extended schedule had significantly lower (P < .05) geometric mean concentrations compared with reduced (for 9 of 13 serotypes) and accelerated (for 4 of 13 serotypes) schedules, but nearly all participations, regardless of schedule or serotype, had seroprotective IgG concentrations. CONCLUSIONS: A reduced priming schedule of PCV13 resulted in higher post-booster IgG concentrations but lower post-primary concentrations. The optimum vaccine schedule for preterm infants will therefore depend on when they are most at risk for invasive pneumococcal disease. |
| spellingShingle | Kent, A Ladhani, S Andrews, N Scorrer, T Pollard, A Clarke, P Hughes, S Heal, C Menson, E Chang, J Satodia, P Collinson, A Faust, S Goldblatt, D Miller, E Heath, P PUNS Study Group Schedules for pneumococcal vaccination of preterm infants: an RCT |
| title | Schedules for pneumococcal vaccination of preterm infants: an RCT |
| title_full | Schedules for pneumococcal vaccination of preterm infants: an RCT |
| title_fullStr | Schedules for pneumococcal vaccination of preterm infants: an RCT |
| title_full_unstemmed | Schedules for pneumococcal vaccination of preterm infants: an RCT |
| title_short | Schedules for pneumococcal vaccination of preterm infants: an RCT |
| title_sort | schedules for pneumococcal vaccination of preterm infants an rct |
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