Glycoconjugate vaccines and immune interference: A review

The Pediatric Infectious Disease Unit, The Faculty of Health Sciences, Ben Gurion University of the Negev and Soroka University Medical Center, Beer-Sheva, Israel.
Vaccine (Impact Factor: 3.49). 08/2010; 28(34):5513-23. DOI: 10.1016/j.vaccine.2010.06.026
Source: PubMed

ABSTRACT Bacterial polysaccharide-protein conjugate vaccines (Haemophilus influenzae type b [Hib], pneumococcal and meningococcal conjugates) have revolutionized pediatric vaccination strategies. The widely used carrier proteins are tetanus toxoid (TT), diphtheria toxoid (DT) and diphtheria toxoid variant CRM197 protein, DT conjugates being in general less immunogenic. Multivalent conjugates using TT were found to be at risk for reduced polysaccharide responses, whilst multivalent CRM197 conjugates are at lower risk for this, but may be at higher risk of inducing bystander interference, particularly affecting Hib and hepatitis B immune responses. Novel carriers avoiding these issues could enable the further development of pediatric schedules and combinations.

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    • "In addition, several randomised controlled trials (RCTs) have reported greater Hib antibody interference with increasing amount of CRM administered [3] [4] [5]. In the UK, the 7-valent pneumococcal conjugate vaccine (PCV7; Prevenar ® ; Pfizer Ltd., Kent, UK) was replaced with a newly licensed 13-valent conjugate vaccine (PCV13; Prevenar13 ® ; Pfizer Ltd., Kent, UK), from April 2010. "
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    ABSTRACT: An open, non-randomised study was undertaken in England during 2011-12 to evaluate vaccine antibody responses in infants after completion of the routine primary infant immunisation schedule, which included two doses of meningococcal group C (MenC) conjugate (MCC) vaccine at 3 and 4 months. Any of the three licensed MCC vaccines could be used for either dose, depending on local availability. Healthy term infants registered at participating general practices (GPs) in Hertfordshire and Gloucestershire, UK, were recruited prospectively to provide a single blood sample four weeks after primary immunisation, which was administered by the GP surgery. Vaccination history was obtained at blood sampling. MenC serum bactericidal antibody (SBA) and IgG antibodies against Haemophilus influenzae b (Hib), pertussis toxin (PT), diphtheria toxoid (DT), tetanus toxoid (TT) and thirteen pneumococcal serotypes were analysed according to MCC vaccines received. MenC SBA responses differed significantly (P<0.001) according to MCC vaccine schedule as follows: MenC SBA geometric mean titres (GMTs) were significantly lower in infants receiving a diphtheria cross-reacting material-conjugated MCC (MCC-CRM) vaccine followed by TT-conjugated MCC (MCC-TT) vaccine (82.0; 95% CI, 39-173; n=14) compared to those receiving two MCC-CRM (418; 95% CI, 325-537; n=82), two MCC-TT (277; 95% CI, 223-344; n=79) or MCC-TT followed by MCC-CRM (553; 95% CI, 322-949; n=18). The same group also had the lowest Hib geometric mean concentrations (0.60μg/mL, 0.27-1.34) compared to 1.85μg/mL (1.23-2.78), 2.86μg/mL (2.02-4.05) and 4.26μg/mL (1.94-9.36), respectively. Our results indicate that MCC vaccines with different carrier proteins are not interchangeable. When several MCC vaccines are available, children requiring more than one dose should receive MCC vaccines with the same carrier protein or, alternatively, receive MCC-TT first wherever possible. Copyright © 2014. Published by Elsevier Ltd.
    Vaccine 12/2014; 33(5). DOI:10.1016/j.vaccine.2014.12.018 · 3.49 Impact Factor
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    • "Other new conjugate vaccines, a 10-valent and a 13-valent, are now also available with improvement in the efficacy due to the inclusion of higher numbers of capsular polysaccharides. Besides the high cost of these vaccines, other problems have been considered subject of concern: (i) among more than 92 different serotypes, 23 serotypes are considered the most worldwide prevalent ones and, since the serotype prevalence varies among regions, it is very hard to obtain one vaccine with high worldwide coverage, (ii) since most of the conjugate vaccines use tetanus toxoid , diphtheria toxoid or CRM197 as carrier, a multivalent conjugate as polyvalent pneumococcal vaccine might have a risk of immune interference [5] [6], and (iii) 10 years after the widespread use of PCV7, emergence of non vaccine serotypes have been noticed [7] [8]. "
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    Vaccine 09/2011; 29(47):8689-95. DOI:10.1016/j.vaccine.2011.08.109 · 3.49 Impact Factor
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    Energy Conversion Engineering Conference, 1996. IECEC 96. Proceedings of the 31st Intersociety; 09/1996
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