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- Title
A Randomized Study Comparing Combined Pneumococcal Conjugate and Polysaccharide Vaccination Schedules in Adults.
- Authors
Lazarus, Rajeka; Clutterbuck, Elizabeth; Yu, Ly-Mee; Bowman, Jaclyn; Bateman, Elizabeth A.; Diggle, Linda; Angus, Brian; Peto, Tim E.; Beverley, Peter C.; Mant, David; Pollard, Andrew J.
- Abstract
Combined schedules of pneumococcal conjugate and polysaccharide vaccines do not provide enhanced immunogenicity for the seven serotypes tested in comparison to a single dose of pneumococcal conjugate vaccine in adults.Background. The widely used 23-valent plain polysaccharide vaccine (23vP) has limited effectiveness, produces short-lived immune responses, and induces attenuated antibody production after subsequent challenge with pneumococcal vaccines. Our goal was to examine whether priming with the 7-valent pneumococcal conjugate vaccine (PCV7) could enhance the immunogenicity of 23vP for the PCV7 serotypes and to investigate whether 23vP induced hyporesponsiveness could be overcome using PCV7.Methods. We conducted an open-label randomized study that compared 3 vaccine schedules, each of which consisted of 2 doses of PCV7 and 1 dose of 23vP (23vP-PCV7-PCV7, PCV7-23vP-PCV7, PCV7-PCV7-23vP) administered over a 1-year period in a cohort of 348 adults 50–70 years of age. All vaccines were administered intramuscularly and were given 6 months apart. Blood samples were obtained prior to and 1 month after each vaccination.Results. 23vP administered after priming with 2 doses of PCV7 produced significantly higher antibody concentrations for 3 of the 7 PCV7 serotypes, compared with vaccination with a single dose of 23vP; however, the same immunogenicity could be achieved with a single dose of PCV7. Prior vaccination with 23vP attenuated the antibody response to subsequent PCV7, which was not restored by additional doses of PCV7.Conclusion. In adults, vaccination schedules combining PCV7 and 23vP do not provide improved immunogenicity over the use of a single dose of 23vP for most of the serotypes contained in PCV7.
- Subjects
STREPTOCOCCUS pneumoniae; POLYSACCHARIDES; VACCINATION of adults; RANDOMIZED controlled trials; COMPARATIVE studies; SEROTYPES; IMMUNE response
- Publication
Clinical Infectious Diseases, 2011, Vol 52, Issue 6, p736
- ISSN
1058-4838
- Publication type
Article
- DOI
10.1093/cid/cir003