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Published on: December 10, 2013
Immune Response to the 13-Valent Pneumococcal Conjugate Vaccine Is Reduced in Infants Immunized During the
Ron Dagan1, Bart A van der Beek1
1Faculty of Health Sciences, The Shraga Segal Department of Microbiology, Immunology, and Genetics, Ben Gurion University, Beer Sheva, Israel.
Insights
Infant pneumococcal conjugate vaccine (PCV) responses may be blunted when given during respiratory viral seasons, especially with higher valency vaccines like PCV13. PCV7 responses were unaffected, indicating increased susceptibility to immune blunting with PCV13.
Area of Science:
- Immunology
- Vaccinology
- Pediatrics
Background:
- Infant vaccination schedules often coincide with peak respiratory viral seasons.
- The impact of concurrent viral infections on vaccine immunogenicity is a critical consideration for public health.
Purpose of the Study:
- To investigate whether infant pneumococcal conjugate vaccine (PCV) administration during the respiratory viral season (RVS) blunts immune responses.
- To compare the immunogenicity of 13-valent (PCV13) versus 7-valent (PCV7) pneumococcal conjugate vaccines when administered during RVS versus non-RVS.
Main Methods:
- Post-hoc analysis of a randomized trial comparing PCV13 and PCV7 in infants.
- Defined RVS (December-April) and non-RVS (June-October) based on local epidemiology.
- Compared serotype-specific immunoglobulin-G geometric mean concentrations (SSIgG-GMC) at 7 and 13 months between seasons.
Main Results:
- PCV13 recipients during RVS showed significantly lower SSIgG-GMCs for most serotypes at 7 months compared to non-RVS.
- This blunting effect was partially corrected after the booster dose for PCV13.
- PCV7 recipients did not exhibit seasonal differences in immune response.
Conclusions:
- Infant PCV13 vaccination during the RVS leads to a blunted immune response, particularly for the initial dose.
- Higher carrier-load vaccines like PCV13 may be more susceptible to respiratory viral-mediated immune interference.
- PCV7 responses were not affected, suggesting a differential impact based on vaccine valency.
Background:
We hypothesized that response to infant pneumococcal conjugate vaccines (PCVs) administered during peak respiratory viral seasons (RVSs) could be blunted, particularly to higher carrier-load PCVs.
Methods:
We conducted a post hoc analysis of a large, double-blind, randomized study comparing 13-valent vs 7-valent PCVs (PCV13, PCV7) administered to infants (at 2, 4, 6, and 12 months). We defined RVS, based on local epidemiology as December through April and non-RVS as June through October. Infants receiving the first dose at 7-9 weeks during the defined seasons were eligible. Serotype-specific immunoglobulin-G geometric mean concentrations (SSIgG-GMCs; µg/mL) were compared between the 2 seasons at age 7 and 13 months.
Results:
179 and 225 infants received PCV13 in RVS and non-RVS. The corresponding numbers for PCV7 were 188 and 217. At 7 months, PCV13 recipients during RVS had significantly lower SSIgG-GMCs compared with non-RVS for 10/13 serotypes (GMC ratios: 0.76-0.86). This difference remained significant in 2/13 serotypes after a booster dose. Unlike PCV13 recipients, PCV7 recipients showed no seasonal difference. Results were similar for both vaccine results among children who had received the first dose only or both the first and second dose during the defined seasons. Similarly, no difference was observed if the booster was given in RVS or non-RVS.
Conclusions:
Administration of the first PCV13 dose to young infants during RVS resulted in a significant blunting of the immune response, partially corrected by booster administration. PCV7 recipients were unaffected, suggesting an increased susceptibility to respiratory viral immune blunting with higher carrier-load PCVs.
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