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Responses to a Conjugate Pneumococcal Vaccine in Preterm Infants Immunized at 2, 3, and 4 Months of Age

Lookup NU author(s): Dr Alan Fenton, Dr Jennifer Toomey, Angela Grainger, Professor Andrew GenneryORCiD

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Abstract

Preterm infants are at an increased risk of invasive pneumococcal disease infection and, additionally, have a diminished response to Haemophilus influenzae type b (Hib) conjugate vaccines. There are little data examining the response of preterm infants to a seven-valent pneumococcal conjugate vaccine (PCV7). We examined the responses of preterm infants immunized at 2, 3, and 4 months of age to PCV7. A total of 133 preterm and 54 term infants were immunized with PCV7 and the Neisseria meningitidis group C (MCC), diphtheria, tetanus, pertussis, polio, and Hib vaccines. Pneumococcal serotype-specific IgG was measured by enzyme-linked immunosorbent assay (ELISA) pre- and postimmunization and at 12 months or following a booster of PCV7. Term and preterm responses were compared using linear and logistic regression analyses. Term infants had higher preimmunization geometric mean concentrations (GMCs) for all serotypes. Preterm infants had lower postimmunization GMCs for serotype 23F. Gestational age affected postimmunization GMCs for serotypes 4, 6B, and 23F. Preterm infants were as likely to have levels of >= 0.35 mu g/ml as term infants for all serotypes except 23F. The proportions of infants with titers of >= 0.35 mu g/ml for all 7 serotypes were comparable between groups. A total of 28 of 29 term infants who received a booster had levels of >= 0.35 mu g/ml for all serotypes. One infant had undetectable levels for serotype 6B. Of the 32 preterm infants boosted, 9 had levels of <0.35 mu g/ml for 1 serotype, and 1 had levels of <0.35 mu g/ml for 2 serotypes. In nonboosted infants, GMCs for all serotypes except 6B had fallen by 12 months of age. These results support the need for a booster dose in the second year of life.

Publication metadata

Author(s): Moss SJ, Fenton AC, Toomey JA, Grainger AJ, Smith J, Gennery AR

Publication type: Article

Publication status: Published

Journal: Clinical and Vaccine Immunology

Year: 2010

Volume: 17

Issue: 11

Pages: 1810-1816

Print publication date: 01/11/2010

ISSN (print): 1556-6811

ISSN (electronic): 1556-679X

Publisher: American Society for Microbiology

URL: http://dx.doi.org/10.1128/CVI.00214-10

DOI: 10.1128/CVI.00214-10

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