Infant Immunization with Pneumococcal CRM197 Vaccines: Effect of Saccharide Size on Immunogenicity and Interactions with Simultaneously Administered Vaccines

• Published in: The Journal of infectious diseases 1997-08, Vol.176 (2), p.445-455
• Main Authors: Daum, Robert S., Hogerman, Deborah, Rennels, Margaret B., Bewley, Kathleen, Malinoski, Frank, Rothstein, Edward, Reisinger, Keith, Block, Stan, Keyserling, Harry, Steinhoff, Mark
• Format: Article
• Language: English
• Subjects: Antibodies; Antibodies, Bacterial - blood; Bacterial Capsules - immunology; Bacterial Proteins - immunology; Bacterial Vaccines - adverse effects; Bacterial Vaccines - immunology; Bacteriology; Biological and medical sciences; Conjugate vaccines; Diphtheria-Tetanus-Pertussis Vaccine - immunology; Dosage; Fundamental and applied biological sciences. Psychology; Geometric mean; Haemophilus Vaccines - immunology; Humans; Immunization; Infant; Infants; Major Articles; Microbiology; Oligosaccharides; Oligosaccharides - immunology; Pediatrics; Pneumococcal Infections - prevention & control; Polysaccharides; Polysaccharides, Bacterial - immunology; Streptococcus pneumoniae - immunology; Vaccination; Vaccines, antisera, therapeutical immunoglobulins and monoclonal antibodies; Vaccines, Conjugate - adverse effects; Vaccines, Conjugate - immunology
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1086/514063

Six pentavalent pneumococcal conjugate vaccines (Pn-CRM197) were evaluated among 400 infants. The vaccines differed in saccharide chain length (oligosaccharide [OS] or polysaccharide [PS]) and saccharide quantity (0.5, 2, or 5 µg). Subjects were randomized into groups 1–6 (Pn-CRM197 recipients) or 7 (controls) for immunization at 2, 4, and 6 months of age. Pn-CRM197 were well tolerated and elicited mean antibody concentrations that exceeded those in controls for all 5 capsular serotypes. PS formulations were generally more immunogenic than their OS counterparts. For PS vaccines, a dose-response was documented (5 µg > 2 µg > 0.5 µg), but the differences between the 5- and 2-µg formulations were insignificant. The mean anti-PRP antibody concentration was significantly higher among Pn-CRM197 recipients. It is concluded that PS vaccines are more immunogenic than OS vaccines. The improved immunogenicity from Haemophilus type b oligosaccharide conjugate (HbOC) vaccine when given with Pn-CRM197 suggests that a decreased dose of HbOC vaccine may be sufficient to elicit protection.