Reduced antibody response to revaccination with meningococcal serogroup A polysaccharide vaccine in adults

Widespread use of meningococcal A and C polysaccharide (MACP) vaccines has raised concerns about induction of hyporesponsiveness to these polysaccharides. Immunological hyporesponsiveness to C polysaccharide has been clearly documented in infants, children and adults but only limited data from Gambi...

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Bibliographic Details
Published in:Vaccine 2000-12, Vol.19 (9), p.1129-1132
Main Authors: Borrow, Ray, Joseph, Helen, Andrews, Nick, Acuna, Marisa, Longworth, Emma, Martin, Sarah, Peake, Nicholas, Rahim, Rukhsana, Richmond, Peter, Kaczmarski, Edward, Miller, Elizabeth
Format: Article
Language:English
Subjects:
Adolescent
Adult
Antibodies, Bacterial - biosynthesis
Biological and medical sciences
Epidemiology. Vaccinations
Female
General aspects
Humans
Hyporesponsiveness
Immunoglobulin G - biosynthesis
Infectious diseases
Male
Medical sciences
Meningococcal serogroup A
Meningococcal Vaccines - immunology
Neisseria meningitidis
Neisseria meningitidis - immunology
polysaccharides
Polysaccharides, Bacterial - immunology
Serotyping
Vaccination
Vaccine
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Summary:Widespread use of meningococcal A and C polysaccharide (MACP) vaccines has raised concerns about induction of hyporesponsiveness to these polysaccharides. Immunological hyporesponsiveness to C polysaccharide has been clearly documented in infants, children and adults but only limited data from Gambian children are available for A polysaccharide. We investigated whether a second dose of MACP, given 6 months after an initial dose affected the immunological response as measured by the serum bactericidal assay (SBA) and enzyme-linked immunosorbent assay (ELISA), to serogroup A meningococci in young adults (university students, n=36). Serogroup A SBA responses 1 month following the second dose of MACP (geometric mean titre (GMT) 103.6, 95% CI 45.6–235.1) were approximately one third of the levels observed 1 month post first dose (GMT 281.9, 95% CI 134.9–581.4). The serogroup A-specific IgG levels post second dose (GMC 21.2, 95% CI 15.3–29.4) were also significantly lower at an average of three-quarters the level post first dose (GMC 28.7, 95% CI 20.8–39.7). This confirms that revaccination with MACP vaccine, 6 months following the initial dose, results in a reduced immunological response to A polysaccharide in adults. Repeated vaccination with MACP vaccine may be ineffective and development and use of meningococcal serogroup A conjugate vaccines should be encouraged.
ISSN:0264-410X
1873-2518
DOI:10.1016/S0264-410X(00)00317-0