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Response to Haemophilus influenzae type b conjugate vaccine in chronically ill premature infants
L K Washburn1, T M O'Shea, D C Gillis
1Department of Pediatrics, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, North Carolina 27157.
Insights
Premature infants with chronic lung disease showed lower antibody responses to Haemophilus influenzae vaccine compared to term infants. This suggests potential challenges in achieving protective immunity in this vulnerable population.
Area of Science:
- Pediatrics
- Immunology
- Neonatology
Background:
- Premature infants, particularly those with chronic lung disease, represent a vulnerable population.
- Assessing vaccine immunogenicity in premature infants is crucial for establishing effective immunization strategies.
Purpose of the Study:
- To evaluate the immunogenicity of a polyribosylribitol phosphate-outer membrane protein conjugate Haemophilus vaccine in premature infants with chronic lung disease.
- To compare the antibody responses in premature infants to those of term infants.
Main Methods:
- Twenty-two premature infants (median gestational age 28 weeks) with chronic lung disease were administered the Haemophilus vaccine at 2 and 4 months of chronologic age.
- Antibody levels to polyribosylribitol phosphate (PRP) were measured after each vaccine dose.
Main Results:
- After the first dose, 27% of infants achieved PRP antibody levels > 1 microgram/ml (geometric mean titer [GMT] 0.43 microgram/ml).
- After the second dose, 55% achieved levels > 1 microgram/ml (GMT 0.73 microgram/ml).
- These antibody levels and proportions were significantly lower than those observed in term infants.
Conclusions:
- Premature infants with chronic lung disease exhibit a diminished antibody response to the conjugate Haemophilus vaccine.
- Lower immunogenicity may necessitate modified or additional vaccination strategies for this population to ensure adequate protection against Haemophilus influenzae infections.
Abstract:
Twenty-two premature infants with chronic lung disease (median gestational age 28 weeks) received polyribosylribitol phosphate-outer membrane protein conjugate Haemophilus vaccine at 2 and 4 months of chronologic age. The proportions with antibodies to polyribosylribitol phosphate at levels > 1 microgram/ml after doses 1 and 2 were 27% and 55%; geometric mean titers were 0.43 and 0.73 microgram/ml, significantly lower than values for term infants.