1
|
Safety of Multiple Vaccinations and Durability of Vaccine-Induced Antibodies in an Italian Military Cohort 5 Years after Immunization. Biomedicines 2021; 10:biomedicines10010006. [PMID: 35052686 PMCID: PMC8773007 DOI: 10.3390/biomedicines10010006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/17/2021] [Accepted: 12/16/2021] [Indexed: 01/24/2023] Open
Abstract
We previously examined the safety and immunogenicity of multiple vaccines administered to a military cohort, divided into two groups, the first composed of students at military schools, thus operating inside the national borders for at least 3 years, and the other formed of soldiers periodically engaged in a 9-month-long mission abroad (Lebanon). In the current study, we analyzed 112 individuals of this cohort, 50 pertaining to the first group and 62 to the second group, in order to examine the possible late appearance of side effects and to calculate the half-life of the induced antibodies. Moreover, the possible involvement of B-cell polyclonal activation as a pathogenetic mechanism for long term antibody persistence has even been explored. No late side effects, as far as autoimmunity and/or lymphoproliferation appearance, have been noticed. The long duration of the vaccine induced anti-HAV antibodies has been confirmed, whereas the antibodies induced by tetravalent meningococcal polysaccharide vaccine have been found to persist above the threshold for putative protection for a longer time, and anti-tetanus, diphtheria, and polio 1 and 3 for a shorter time than previously estimated. No signs of polyclonal B-cell activation have been found, as a possible mechanism to understand the long antibody persistence.
Collapse
|
2
|
Tashani M, Badahdah AM, Alfelali M, Barasheed O, Alqahtani AS, Heron L, Wong M, Louth J, Rashid H, Borrow R, Booy R. Effect on meningococcal serogroup W immunogenicity when Tdap was administered prior, concurrent or subsequent to the quadrivalent (ACWY) meningococcal CRM 197-conjugate vaccine in adult Hajj pilgrims: A randomised controlled trial. Vaccine 2019; 37:3562-3567. [PMID: 31128875 DOI: 10.1016/j.vaccine.2019.05.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 05/07/2019] [Accepted: 05/08/2019] [Indexed: 01/07/2023]
Abstract
Immune responses to the capsular polysaccharide administered in the polysaccharide-protein conjugate vaccines can be either improved or suppressed by the pre-existence of immunity to the carrier protein. Receiving multiple vaccinations is essential for travellers such as Hajj pilgrims, and the use of conjugated vaccines is recommended. We studied the immune response to meningococcal serogroup W upon prior, concurrent and sequential administration of a quadrivalent meningococcal conjugate vaccine (MCV4) conjugated to CRM197 (coadministered with 13 valent pneumococcal vaccine conjugate CRM197 [PCV13]), and tetanus-diphtheria-acellular pertussis (Tdap) vaccine in Australian adults before attending the Hajj pilgrimage in 2014. Participants were randomly assigned, by computer-generated numbers, to three study arms by 1:1:1 ratio. Group A received Tdap followed by MCV4-CRM197 (+PCV13) 3-4 weeks later. Group B received all three vaccines in a single visit. Group C received MCV4-CRM197 (+PCV13) followed by Tdap 3-4 weeks later. Blood samples obtained prior to and 3-4 weeks after immunisation with MCV4-CRM197 were tested for meningococcal serogroup W-specific serum bactericidal antibody responses using baby rabbit complement (rSBA). One hundred and seven participants aged between 18 and 64 (median 40) years completed the study. No significant difference in meningococcal serogroup W rSBA geometric mean titre (GMT) was observed between the study arms post vaccination with MCV-CRM197 but Group A tended to have a slightly lower GMT (A = 404, B = 984 and C = 1235, p = 0.15). No statistical difference was noticed between the groups in proportions of subjects achieving a ≥4-fold rise in rSBA titres or achieving rSBA titre ≥8 post vaccination. In conclusion, receipt of MCV4-CRM197 vaccine prior, concurrent or subsequent to Tdap has similar immunologic response, and hence concurrent administration is both immunogenic and practical. However, further investigation into whether carrier induced suppression is a public health issue is suggested. Clinical trial registration: ANZCTR no. ACTRN12613000536763.
Collapse
Affiliation(s)
- Mohamed Tashani
- The Discipline of Child and Adolescent Health, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, NSW, Australia; Faculty of Medicine, University of Tripoli, Ain Zara, Tripoli, Libya
| | - Al-Mamoon Badahdah
- The Discipline of Child and Adolescent Health, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, NSW, Australia; National Centre for Immunisation Research and Surveillance (NCIRS), The Children's Hospital at Westmead, NSW, Australia; Department of Family and Community Medicine, Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia.
| | - Mohammad Alfelali
- The Discipline of Child and Adolescent Health, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, NSW, Australia; National Centre for Immunisation Research and Surveillance (NCIRS), The Children's Hospital at Westmead, NSW, Australia; Department of Family and Community Medicine, Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Osamah Barasheed
- The Executive Administration of Research and Innovation, King Abdullah Medical City in Holy Capital (KAMC-HC), Makkah 24246, Saudi Arabia
| | | | - Leon Heron
- National Centre for Immunisation Research and Surveillance (NCIRS), The Children's Hospital at Westmead, NSW, Australia
| | - Melanie Wong
- Immunology Department, The Children's Hospital at Westmead, Westmead 2145, NSW, Australia
| | - Jennifer Louth
- Vaccine Evaluation Unit, Public Health England, Manchester Royal Infirmary, Manchester, UK
| | - Harunor Rashid
- The Discipline of Child and Adolescent Health, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, NSW, Australia; National Centre for Immunisation Research and Surveillance (NCIRS), The Children's Hospital at Westmead, NSW, Australia; Marie Bashir Institute for Infectious Diseases and Biosecurity, School of Biological Sciences and Sydney Medical School, University of Sydney, Sydney, NSW 2145, Australia
| | - Ray Borrow
- Vaccine Evaluation Unit, Public Health England, Manchester Royal Infirmary, Manchester, UK
| | - Robert Booy
- The Discipline of Child and Adolescent Health, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, NSW, Australia; National Centre for Immunisation Research and Surveillance (NCIRS), The Children's Hospital at Westmead, NSW, Australia; Marie Bashir Institute for Infectious Diseases and Biosecurity, School of Biological Sciences and Sydney Medical School, University of Sydney, Sydney, NSW 2145, Australia; WHO Collaborating Centre for Mass Gatherings and High Consequence/High Visibility Events, Flinders University, Adelaide 5001, Australia
| |
Collapse
|
3
|
Alderfer J, Srivastava A, Isturiz R, Burman C, Absalon J, Beeslaar J, Perez J. Concomitant administration of meningococcal vaccines with other vaccines in adolescents and adults: a review of available evidence. Hum Vaccin Immunother 2019; 15:2205-2216. [PMID: 30779683 PMCID: PMC6773407 DOI: 10.1080/21645515.2019.1581542] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Invasive meningococcal disease (IMD), a rapidly progressing and potentially fatal illness, disproportionately affects adolescents and young adults. While IMD is best prevented by vaccination, vaccine uptake in these groups is low. An evidence-based understanding of the safety and effectiveness of concomitant vaccination of meningococcal vaccines, including the newer MenB protein vaccines and the more established MenACWY conjugate vaccines, with other vaccines recommended for adolescents and young adults may help maximize vaccination opportunities. We identified 21 studies assessing concomitant administration of meningococcal vaccines with other vaccines in adolescents and adults. Although studies varied in methodology, concomitant administration generally did not affect immunogenicity of the meningococcal or coadministered vaccines. In some cases, reactogenicity increased following concomitant administration, but no definitive safety concerns were raised. In general, data suggest that meningococcal vaccines can be safely and effectively coadministered with other vaccines.
Collapse
Affiliation(s)
- Justine Alderfer
- Pfizer Vaccines Medical Development & Scientific and Clinical Affairs , Collegeville , PA , USA
| | - Amit Srivastava
- Pfizer Vaccines Medical Development & Scientific and Clinical Affairs , Collegeville , PA , USA
| | - Raul Isturiz
- Pfizer Vaccines Medical Development & Scientific and Clinical Affairs , Collegeville , PA , USA
| | - Cynthia Burman
- Pfizer Vaccines Medical Development & Scientific and Clinical Affairs , Collegeville , PA , USA
| | - Judith Absalon
- Pfizer Vaccine Clinical Research and Development , Pearl River , NY , USA
| | | | - John Perez
- Pfizer Vaccine Clinical Research and Development , Collegeville , PA , USA
| |
Collapse
|
4
|
Ferlito C, Biselli R, Mariotti S, von Hunolstein C, Teloni R, Ralli L, Pinto A, Pisani G, Tirelli V, Biondo MI, Salerno G, Andreasi Bassi L, Lulli P, Autore A, Scagliusi A, Tomao E, Germano V, Picchianti Diamanti A, Caporuscio S, Milanetti F, Salemi S, Nisini R, D'Amelio R. Tetanus-diphtheria vaccination in adults: the long-term persistence of antibodies is not dependent on polyclonal B-cell activation and the defective response to diphtheria toxoid re-vaccination is associated to HLADRB1∗01. Vaccine 2018; 36:6718-6725. [PMID: 30269918 DOI: 10.1016/j.vaccine.2018.09.041] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 09/18/2018] [Accepted: 09/19/2018] [Indexed: 12/14/2022]
Abstract
Cellular and humoral immune responses to tetanus-diphtheria vaccine (Td) were assessed in human leukocyte antigen (HLA)-typed Italian military personnel who received multiple concomitant vaccines. Td-specific antibodies and T-lymphocytes were measured in individuals with one (group-1) and more than one (group-2) Td boosters. A third group (group-3), who received several vaccines, but not Td, was studied to verify the hypothesis of the polyclonal B-cell activation as mechanism for antibody persistence. The antibody response to Td toxoids was higher in group-1, who showed lower baseline antibody levels, than in group-2 subjects. The antibody response to tetanus was higher than to diphtheria toxoid in both groups. No correlation between antibody and cellular response, and no interference in the response to Td by co-administration of different vaccines were observed. HLA-DRB1∗01 allele was detected at significant higher frequency in subjects unable to double the baseline anti-diphtheria antibody levels after the vaccination. Anti-tetanus and diphtheria antibodies half-lives were assessed and the long-lasting persistence above the threshold for protection (0.1 IU/ml) was estimated in over 65 and 20 years, respectively. No significant increase of anti-diphtheria antibodies was observed in consequence of polyclonal B-cell activation. This study emphasizes the duration of Td vaccination-induced seroprotection, suggesting that re-vaccination should probably be performed at intervals longer than 10 years. No reciprocal interference by concomitantly administered vaccines has been observed. HLA-DRB1∗01 allele was significantly associated with anti-diphtheria defective response. Finally, this study does not confirm that anti-diphtheria antibody levels are maintained by polyclonal B-cell activation. Clinical trial registry: The study was registered with NCT01807780.
Collapse
Affiliation(s)
- Claudia Ferlito
- Sapienza Università di Roma, Dipartimento di Medicina Clinica e Molecolare, A.O. Sant'Andrea, Roma, Italy
| | - Roberto Biselli
- Aeronautica Militare Italiana, Comando Logistico, Servizio Sanitario, Roma, Italy
| | - Sabrina Mariotti
- Istituto Superiore di Sanità, Dipartimento di Malattie Infettive, Roma, Italy
| | | | - Raffaela Teloni
- Istituto Superiore di Sanità, Dipartimento di Malattie Infettive, Roma, Italy
| | - Luisa Ralli
- Istituto Superiore di Sanità, Dipartimento di Malattie Infettive, Roma, Italy
| | - Antonella Pinto
- Istituto Superiore di Sanità, Dipartimento di Malattie Infettive, Roma, Italy
| | - Giulio Pisani
- Istituto Superiore di Sanità, Dipartimento di Malattie Infettive, Roma, Italy
| | - Valentina Tirelli
- Istituto Superiore di Sanità, Dipartimento di Malattie Infettive, Roma, Italy
| | - Michela Ileen Biondo
- Sapienza Università di Roma, Dipartimento di Medicina Clinica e Molecolare, A.O. Sant'Andrea, Roma, Italy
| | - Gerardo Salerno
- Sapienza Università di Roma, Dipartimento di Medicina Clinica e Molecolare, A.O. Sant'Andrea, Roma, Italy
| | - Livia Andreasi Bassi
- Sapienza Università di Roma, Dipartimento di Medicina Clinica e Molecolare, A.O. Sant'Andrea, Roma, Italy
| | - Patrizia Lulli
- Sapienza Università di Roma, Dipartimento di Medicina Clinica e Molecolare, A.O. Sant'Andrea, Roma, Italy
| | - Alberto Autore
- Aeronautica Militare Italiana, Comando Logistico, Centro Sperimentale di Volo, Pratica di Mare, Italy
| | - Alessandro Scagliusi
- Aeronautica Militare Italiana, Comando Logistico, Centro Sperimentale di Volo, Pratica di Mare, Italy
| | - Enrico Tomao
- Aeronautica Militare Italiana, Capo del Corpo Sanitario, Roma, Italy
| | - Valentina Germano
- Sapienza Università di Roma, Dipartimento di Medicina Clinica e Molecolare, A.O. Sant'Andrea, Roma, Italy
| | - Andrea Picchianti Diamanti
- Sapienza Università di Roma, Dipartimento di Medicina Clinica e Molecolare, A.O. Sant'Andrea, Roma, Italy
| | - Sara Caporuscio
- Sapienza Università di Roma, Dipartimento di Medicina Clinica e Molecolare, A.O. Sant'Andrea, Roma, Italy
| | - Francesca Milanetti
- Sapienza Università di Roma, Dipartimento di Medicina Clinica e Molecolare, A.O. Sant'Andrea, Roma, Italy
| | - Simonetta Salemi
- Sapienza Università di Roma, Dipartimento di Medicina Clinica e Molecolare, A.O. Sant'Andrea, Roma, Italy
| | - Roberto Nisini
- Istituto Superiore di Sanità, Dipartimento di Malattie Infettive, Roma, Italy.
| | - Raffaele D'Amelio
- Sapienza Università di Roma, Dipartimento di Medicina Clinica e Molecolare, A.O. Sant'Andrea, Roma, Italy
| |
Collapse
|
5
|
Ferlito C, Biselli R, Cattaruzza MS, Teloni R, Mariotti S, Tomao E, Salerno G, Peragallo MS, Lulli P, Caporuscio S, Autore A, Bizzarro G, Germano V, Biondo MI, Picchianti Diamanti A, Salemi S, Nisini R, D'Amelio R. Immunogenicity of meningococcal polysaccharide ACWY vaccine in primary immunized or revaccinated adults. Clin Exp Immunol 2018; 194:361-370. [PMID: 30099753 DOI: 10.1111/cei.13202] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/06/2018] [Indexed: 12/19/2022] Open
Abstract
Meningococcal polysaccharide (Men-Ps) vaccine immunogenicity following either primary immunization or revaccination in adults was evaluated. The study population consisted of subjects who have received tetravalent Men-Ps vaccine once (group 1) or at least twice, with a 2-6 dose range (group 2). Human leucocyte antigen (HLA)-typing was performed by polymerase chain reaction and specific immunoglobulin (Ig)G was measured by enzyme-linked immunosorbent assay. Nine months post-immunization, the percentages of individuals with levels of anti-Men-Ps IgG ≥ 2 µg/ml were comparable in both groups, with the exception of anti-Men-PsW135 IgG, which were significantly higher in group 2. The percentage of subjects doubling IgG levels at 9 months was significantly higher in group 1. The high baseline anti-Men-Ps antibody levels negatively influenced the response to revaccination, suggesting a feedback control of specific IgG. The calculated durability of anti-Men-Ps IgG was 2·5-4·5 years, depending on the Men-Ps, following a single vaccine dose. No interference by other vaccinations nor HLA alleles association with immune response were observed. This study confirms that Men-Ps vaccine in adults is immunogenic, even when administered repeatedly, and underlines the vaccine suitability for large-scale adult immunization programmes that the higher costs of conjugate vaccines may limit in developing countries.
Collapse
Affiliation(s)
- C Ferlito
- Sapienza Università di Roma, Dipartimento di Medicina Clinica e Molecolare, Azienda Ospedaliera Universitaria S. Andrea, Rome, Italy
| | - R Biselli
- Aeronautica Militare Italiana, Comando Logistico, Servizio Sanitario, Rome, Italy
| | - M S Cattaruzza
- Sapienza Università di Roma, Dipartimento di Sanità Pubblica e Malattie Infettive, Rome, Italy
| | - R Teloni
- Istituto Superiore di Sanità, Dipartimento Malattie Infettive, Rome, Italy
| | - S Mariotti
- Istituto Superiore di Sanità, Dipartimento Malattie Infettive, Rome, Italy
| | - E Tomao
- Aeronautica Militare Italiana, Corpo Sanitario, Rome, Italy
| | - G Salerno
- Sapienza Università di Roma, Dipartimento di Medicina Clinica e Molecolare, Azienda Ospedaliera Universitaria S. Andrea, Rome, Italy
| | - M S Peragallo
- Esercito Italiano, Centro Studi e Ricerche di Sanità e Veterinaria, Rome, Italy
| | - P Lulli
- Sapienza Università di Roma, Dipartimento di Medicina Clinica e Molecolare, Azienda Ospedaliera Universitaria S. Andrea, Rome, Italy
| | - S Caporuscio
- Sapienza Università di Roma, Dipartimento di Medicina Clinica e Molecolare, Azienda Ospedaliera Universitaria S. Andrea, Rome, Italy
| | - A Autore
- Aeronautica Militare, Comando Logistico, Centro Sperimentale di Volo, Aeroporto Pratica di Mare, Rome, Italy
| | - G Bizzarro
- Aeronautica Militare, Comando Logistico, Centro Sperimentale di Volo, Aeroporto Pratica di Mare, Rome, Italy
| | - V Germano
- Sapienza Università di Roma, Dipartimento di Medicina Clinica e Molecolare, Azienda Ospedaliera Universitaria S. Andrea, Rome, Italy
| | - M I Biondo
- Sapienza Università di Roma, Dipartimento di Medicina Clinica e Molecolare, Azienda Ospedaliera Universitaria S. Andrea, Rome, Italy
| | - A Picchianti Diamanti
- Sapienza Università di Roma, Dipartimento di Medicina Clinica e Molecolare, Azienda Ospedaliera Universitaria S. Andrea, Rome, Italy
| | - S Salemi
- Sapienza Università di Roma, Dipartimento di Medicina Clinica e Molecolare, Azienda Ospedaliera Universitaria S. Andrea, Rome, Italy
| | - R Nisini
- Istituto Superiore di Sanità, Dipartimento Malattie Infettive, Rome, Italy
| | - R D'Amelio
- Sapienza Università di Roma, Dipartimento di Medicina Clinica e Molecolare, Azienda Ospedaliera Universitaria S. Andrea, Rome, Italy
| |
Collapse
|
6
|
Immunogenicity and safety of the quadrivalent meningococcal vaccine MenACWY-TT co-administered with a combined diphtheria-tetanus-acellular pertussis vaccine versus their separate administration in adolescents and young adults: A phase III, randomized study. Vaccine 2018; 36:4750-4758. [DOI: 10.1016/j.vaccine.2018.04.034] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 04/12/2018] [Accepted: 04/13/2018] [Indexed: 12/15/2022]
|
7
|
Effect of Tdap upon antibody response to meningococcal polysaccharide when administered before, with or after the quadrivalent meningococcal TT-conjugate vaccine (coadministered with the 13-valent pneumococcal CRM197-conjugate vaccine) in adult Hajj pilgrims: A randomised controlled trial. Vaccine 2018; 36:4375-4382. [PMID: 29880243 DOI: 10.1016/j.vaccine.2018.04.033] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 04/12/2018] [Indexed: 11/23/2022]
Abstract
Hajj pilgrims are susceptible to several serious infections and are required to receive multiple vaccinations. Polysaccharide-protein conjugate vaccines contain carrier proteins such as tetanus toxoid (TT), diphtheria toxoid or a mutant of diphtheria toxoid (CRM197). These carrier proteins may interact with other conjugate or combination vaccines containing tetanus or diphtheria on concurrent or sequential administration. We examined the immune interaction of separate and concomitant administration of a tetanus/diphtheria/acellular pertussis (Tdap) vaccine with a TT-conjugated quadrivalent meningococcal vaccine (MCV4) (coadministered with 13-valent pneumococcal CRM197-conjugate vaccine [PCV13]) in adult Australian pilgrims before attending Hajj in 2015. We randomly assigned each participant to one of three vaccination schedules. Group 1 received Tdap 3-4 weeks before receiving MCV4 coadministered with PCV13. Group 2 received all three vaccines concomitantly. Group 3 received MCV4 and PCV13 3-4 weeks before Tdap. Blood samples were collected at baseline, at each vaccination visit and 3-4 weeks after vaccination and tested for response to meningococcal serogroups C, W and Y using a serum bactericidal antibody (rSBA) assay with baby rabbit complement, and to diphtheria and tetanus toxoid, measuring IgG antibodies by ELISA. Participants completed symptom diaries after each vaccination. A total of 166 participants aged 18-64 (median 42) years were recruited, of whom 160 completed the study. Compared to the other groups, Group 1 (given Tdap first) had significantly lower proportion of subjects achieving a ≥4-fold rise in rSBA for serogroup W. No difference was detected across the three groups in achieving protection threshold (rSBA ≥8 post vaccination) or SBA geometric mean titre (GMT) post vaccination. Group 3, which was given MCV4/PCV13 first, had high levels of antibody against diphtheria and tetanus than the other groups, when tested prior to receipt of Tdap; Only the anti-tetanus responses remained significantly higher after Tdap administration. No serious adverse events were reported. In conclusion, when multiple vaccination is required for Hajj pilgrims, administering Tdap concurrently with MCV4/PCV13 produces adequate immune responses, and avoids meningococcal immune interference, in the convenience of a single consultation. However, giving Tdap 3-4 weeks after MCV4/PCV13 has the advantage of an enhanced tetanus toxoid response. The trial is Trials Registry (ANZCTR): ACTRN12613000536763.
Collapse
|