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Antibody persistence and booster response following MenACWY-CRM vaccination in children as assessed by two different
Nicola P Klein1, Stan L Block2, Brandon Essink3
1Kaiser Permanente Vaccine Study Center, 1 Kaiser Plaza, 16th Floor, Oakland, CA 94612, United States.
Insights
The quadrivalent meningococcal conjugate vaccine (MenACWY-CRM) provides moderate antibody persistence for up to 4 years. A booster dose at 60 months induces a robust immune response and is well-tolerated in children.
Area of Science:
- Immunology
- Vaccinology
- Pediatric Infectious Diseases
Background:
- The quadrivalent meningococcal conjugate vaccine (MenACWY-CRM) is immunogenic and well-tolerated in infants and toddlers.
- Previous studies established the safety and immunogenicity of MenACWY-CRM in young children.
Purpose of the Study:
- To evaluate antibody persistence up to 4 years after infant vaccination with MenACWY-CRM.
- To assess the immune response and safety of a booster dose of MenACWY-CRM at 60 months of age.
Main Methods:
- Phase 3b, open-label, multicenter extension trial (NCT01148017).
- Assessed antibody persistence using human serum bactericidal assay (hSBA) and rabbit serum bactericidal assay (rSBA).
- Administered a booster dose of MenACWY-CRM to children at 60 months of age and evaluated safety and immune response.
Main Results:
- Antibody persistence was higher in children who received 4 infant doses (ACWY-4 group) compared to those who received fewer doses (ACWY-2 group).
- Post-booster, over 96% of primed and 73% of naïve children had protective hSBA titers against all serogroups.
- The booster dose was well-tolerated, with no safety concerns identified.
Conclusions:
- Infant vaccination with MenACWY-CRM results in moderate antibody persistence for up to 4 years.
- A booster dose at 60 months induces a robust and well-tolerated immune response in children, regardless of the priming schedule.
Background:
The quadrivalent meningococcal conjugate vaccine MenACWY-CRM has been shown to be immunogenic and well-tolerated in infants and toddlers. We evaluated antibody persistence for up to 4 years after vaccination with MenACWY-CRM in the first years of life and response to a booster dose administered at 60 months of age.
Methods:
This was phase 3b, open-label, multicenter extension trial (NCT01148017). We assessed by hSBA and rSBA the persistence of antibody responses to serogroups ACWY in 203 healthy 60-month-olds receiving 4 doses of MenACWY-CRM during infancy (ACWY-4 group), or 2 doses at 12/13 and 15 months or 1 dose at 18 months of age (ACWY-2 group). We administered a MenACWY-CRM dose to 224 primed and 45 naïve 60-month-olds and evaluated safety and antibody response 1 month later.
Results:
Antibody persistence measured by both assays was higher in primed than naïve 60-month-olds. The percentages of primed children with hSBA titers ≥8 was low for serogroup A (6-25%) and moderate for serogroups C (27-43%), Y (69-74%) and W (56-69%). For all serogroups, hSBA antibody geometric mean titers (GMTs) tended to be higher in the ACWY-2 than the ACWY-4 group. Post-booster/single dose, ≥96% of primed and ≥73% of naïve children had hSBA titers ≥8 against each serogroup, and hSBA GMTs were higher in primed children. The booster dose was well-tolerated and no safety concern was identified. We further assessed persistence using rSBA across different age groups and detected no overall correlation between rSBA and hSBA titers.
Conclusions:
Primary vaccination of infants/toddlers with MenACWY-CRM resulted in moderate antibody persistence against serogroups C, W and Y for up to 4 years after the last priming dose. Regardless of priming schedule, a MenACWY-CRM booster dose at 60 months of age induced a robust immune response against all serogroups and was well-tolerated in all children.
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