Antipolyribosyl ribitol phosphate response of premature infants to primary and booster vaccination with a combined diphtheria-tetanus-acellular pertussis-hepatitis B-inactivated polio virus/Haemophilus influenzae type b vaccine.

Abstract

BACKGROUND:

Prematurity may be a risk factor for Haemophilus influenzae type b vaccine failure. This article evaluates the Haemophilus influenzae type b immunogenicity of a hexavalent diphtheria-tetanus-acellular pertussis-hepatitis B-inactivated poliovirus/Haemophilus influenzae type b vaccine in preterm infants (< 37 weeks' gestation).

METHODS:

This was an open-label, parallel group study. Preterm (N = 94) and term infants (N = 92) received 3 doses of a diphtheria-tetanus-acellular pertussis-hepatitis B-inactivated poliovirus/Haemophilus influenzae type b vaccine at 2, 4, and 6 months with a booster dose at 18 to 20 months. Antipolyribosyl ribitol phosphate antibody concentrations were determined in serum samples taken before and 1 month after primary and booster vaccination.

RESULTS:

Postprimary seroprotection rates (antipolyribosyl ribitol phosphate > or = 0.15 microg/mL) were lower in preterm than in term infants (92.5% vs 97.8%), with antipolyribosyl ribitol phosphate geometric mean concentrations of 2.241 vs 4.247 microg/mL. A progressive reduction in immune response to the Haemophilus influenzae type b antigen was observed with decreasing length of gestation and decreasing birth weight when cutoff > or = 1 microg/mL was considered. Prebooster seroprotection rates and antipolyribosyl ribitol phosphate geometric mean concentrations were low in both groups (antipolyribosyl ribitol phosphate > or = 1.0 microg/mL in 10.7% of preterm and 28.4% of term infants). A vigorous response to booster vaccination was seen in both groups, with no differences in postbooster seroprotection rates or antipolyribosyl ribitol phosphate geometric mean concentrations between the 2 groups (antipolyribosyl ribitol phosphate > or = 1.0 microg/mL in 100% of preterm and 98.5% of term infants).

CONCLUSIONS:

Primary vaccination with a hexavalent diphtheria-tetanus-acellular pertussis-hepatitis B-inactivated poliovirus/Haemophilus influenzae type b vaccine at 2, 4, and 6 months with a booster dose at 18 to 20 months elicits a satisfactory antipolyribosyl ribitol phosphate response in preterm infants compared with term controls. Immunologic response decreased with decreased gestational age and birth weight.

• Authors: Felix Omeñaca, José Garcia-Sicilia, Pilar García-Corbeira, Reyes Boceta, Victorio Torres
• Journal: Pediatrics (Pediatrics) Vol. 119 Issue 1 Pg. e179-85 (Jan 2007) ISSN: 1098-4275 [Electronic] United States
• PMID: 17145903 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• DTPa-HBV-IPV combined vaccine
• Diphtheria-Tetanus-Pertussis Vaccine
• Haemophilus Vaccines
• Haemophilus influenzae type b polysaccharide vaccine
• Hepatitis B Vaccines
• Poliovirus Vaccine, Inactivated
• Polysaccharides
• Polysaccharides, Bacterial
• Vaccines, Combined
• polyribitol phosphate

Topics

• Antibody Formation
• Bacterial Capsules
• Birth Weight
• Diphtheria-Tetanus-Pertussis Vaccine
• Gestational Age
• Haemophilus Vaccines (immunology)
• Hepatitis B Vaccines
• Humans
• Immunization Schedule
• Immunization, Secondary
• Infant
• Infant, Newborn
• Infant, Premature (immunology)
• Poliovirus Vaccine, Inactivated
• Polysaccharides (immunology)
• Polysaccharides, Bacterial (immunology)
• Vaccines, Combined (immunology)