Heptavalent pneumococcal conjugate vaccine immunogenicity in very-low-birth-weight, premature infants.

Abstract

BACKGROUND:

The heptavalent pneumococcal CRM197 conjugate vaccine (PCV-7) has been incompletely studied in very-low-birth-weight (< or =1500 g) infants.

OBJECTIVE:

To assess PCV-7 immunogenicity in very-low-birth-weight, premature infants. We hypothesized that the frequency of postvaccine antibody concentrations > or =0.15 microg/mL would vary directly with birth weight.

METHODS:

This was a multicenter observational study. Infants 401 to 1500 g birth weight and <32 0/7 weeks gestation, stratified by birth weight, were enrolled from 9 National Institute of Child Health and Human Development Neonatal Research Network centers. Infants received PCV-7 at 2, 4, and 6 months after birth and had blood drawn 4 to 6 weeks following the third dose. Antibodies against the 7 vaccine serotypes were measured by enzyme-linked immunosorbent assay.

RESULTS:

Of 369 enrolled infants, 244 completed their primary vaccine series by 8 months and had serum obtained. Subjects were 27.8 +/- 2.2 (mean +/- standard deviation) weeks gestation and 1008 +/- 282 g birth weight. Twenty-six percent had bronchopulmonary dysplasia and 16% had received postnatal glucocorticoids. Infants 1001 to 1500 g birth weight were more likely than those 401 to 1000 g to achieve antibody concentrations > or =0.15 microg/mL against the least 2 immunogenic serotypes (6B: 96% vs. 85%, P = 0.003 and 23F: 97% vs. 88%, P = 0.009). In multiple logistic regression analysis, lower birth weight, postnatal glucocorticoid use, lower weight at blood draw, and Caucasian race were each independently associated with antibody concentrations <0.35 microg/mL against serotypes 6B and/or 23F.

CONCLUSIONS:

When compared with larger premature infants, infants weighing < or =1000 g at birth have similar antibody responses to most, but not all, PCV-7 vaccine serotypes.

• Authors: Carl T D'Angio, Roy J Heyne, T Michael O'Shea, Robert L Schelonka, Seetha Shankaran, Shahnaz Duara, Ronald N Goldberg, Barbara J Stoll, Krisa P Van Meurs, Betty R Vohr, Abhik Das, Lei Li, Robert L Burton, Betty Hastings, Dale L Phelps, Pablo J Sanchez, Waldemar A Carlo, David K Stevenson, Rosemary D Higgins, NICHD Neonatal Research Network
• Journal: The Pediatric infectious disease journal (Pediatr Infect Dis J) Vol. 29 Issue 7 Pg. 600-6 (Jul 2010) ISSN: 1532-0987 [Electronic] United States
• PMID: 20234331 (Publication Type: Journal Article, Multicenter Study, Research Support, N.I.H., Extramural)

Chemical References

• Antibodies, Bacterial
• Heptavalent Pneumococcal Conjugate Vaccine
• Pneumococcal Vaccines

Topics

• Antibodies, Bacterial (blood)
• Enzyme-Linked Immunosorbent Assay (methods)
• Heptavalent Pneumococcal Conjugate Vaccine
• Humans
• Infant, Newborn
• Infant, Premature
• Infant, Very Low Birth Weight
• Pneumococcal Vaccines (administration & dosage, immunology)
• United States