Can Haemophilus influenzae type b-tetanus toxoid conjugate vaccine be combined with diphtheria toxoid-pertussis vaccine-tetanus toxoid?

Abstract

OBJECTIVE:

To assess the side effects and immune responses after three serial doses of PRP-T vaccine (a Haemophilus influenzae type b [Hib]-tetanus toxoid conjugate vaccine) given concurrently or mixed with adsorbed DPT vaccine (diphtheria toxoid-pertussis vaccine-tetanus toxoid).

DESIGN:

Multicentre randomized controlled trial.

SETTING:

Four public health units in western Canada.

PARTICIPANTS:

Healthy infants 8 to 15 weeks old at entry who were able to receive routine primary vaccinations. Of 444 infants enrolled, 433 (98%) completed the study.

INTERVENTIONS:

All infants received PRP-T and DPT vaccines at 2, 4 and 6 months of age: half received them mixed in one injection and the others as separate, bilateral injections.

MAIN OUTCOME MEASURES:

Side-effects 24 and 48 hours after each dose and serologic responses to each vaccine component.

RESULTS:

Follow-up was obtained after all 1312 vaccinations. Fever was infrequent in the two treatment groups. Local adverse effects of the PRP-T vaccine were infrequent and mild (e.g., redness was noted in 5.9% of cases and the area of redness was more than 2.5 cm in diameter in 0.8%). The incidence rate of local effects of the DPT-containing vaccines was the same in the two groups except for tenderness, which was more frequent in the group given the mixed vaccine (26.6% v. 17.9%, p < 0.001). Serologic data were available for 97% of the subjects. After the three doses 98.1% of the subjects had a PRP antibody level of 0.15 micrograms/mL or more, and 87.9% had a level of 1.0 micrograms/mL or more, both levels compatible with protection against Hib. Responses to PRP-T were comparable between the treatment groups as were responses to the diphtheria and tetanus toxoids. Pertussis agglutinin titres were reduced after administration of one of two PRP-T lots mixed with DPT vaccine, but responses to four other pertussis antigens were not impaired.

CONCLUSION:

PRP-T vaccine is well tolerated and immunogenic. Combined PRP-T and DPT vaccines performed satisfactorily and may be the preferred method of administration.

• Authors: D Scheifele, L Barreto, W Meekison, R Guasparini, B Friesen
• Journal: CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne (CMAJ) Vol. 149 Issue 8 Pg. 1105-12 (Oct 15 1993) ISSN: 0820-3946 [Print] Canada
• PMID: 8221449 (Publication Type: Clinical Trial, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Antibodies, Bacterial
• Diphtheria-Tetanus-Pertussis Vaccine
• Haemophilus Vaccines
• Haemophilus influenza type b polysaccharide vaccine-tetanus toxin conjugate
• Tetanus Toxoid

Topics

• Antibodies, Bacterial (blood)
• Diphtheria-Tetanus-Pertussis Vaccine (administration & dosage, adverse effects, immunology)
• Drug Incompatibility
• Enzyme-Linked Immunosorbent Assay
• Female
• Haemophilus Vaccines (administration & dosage, adverse effects, immunology)
• Humans
• Infant
• Male
• Tetanus Toxoid (administration & dosage, adverse effects, immunology)