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Prevalence of Serum Bactericidal Antibody to Serogroup C Neisseria meningitidis in England a Decade after Vaccine Introduction

Prevalence of Serum Bactericidal Antibody to Serogroup C Neisseria meningitidis in England a... Prevalence of Serum Bactericidal Antibody to Serogroup C Neisseria meningitidis in England a Decade after Vaccine Introduction David A. Ishola Jr. a , e , Ray Borrow b , c , Helen Findlow b , Jamie Findlow b , Caroline Trotter d and Mary E. Ramsay a a Immunisation Department, Health Protection Agency, Colindale, London, United Kingdom b Vaccine Evaluation Unit, Health Protection Agency North West, Manchester Royal Infirmary, Manchester, United Kingdom c University of Manchester, Inflammation Sciences Research Group, School of Translational Medicine, Manchester, United Kingdom d School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom e Centre for Infectious Disease Epidemiology, Department of Infection and Population Health, University College London, United Kingdom ABSTRACT Serogroup C meningococcal disease incidence and carriage declined rapidly in the United Kingdom after infant serogroup C conjugate vaccination was introduced in 1999, with catch-up vaccination for children under 18 years. Antibody levels and effectiveness waned quickly in children vaccinated at 2, 3, and 4 months of age. Therefore, in 2006, the current revised schedule of doses at 3, 4, and 12 months was introduced. This study assessed age-specific protection in 2009 compared with data from historical prevaccination and early postvaccination studies. Rabbit complement serum bactericidal antibody (SBA) was measured in anonymously banked serum samples collected in England in 2009 ( n = 1,174), taking titers of ≥8 as protective. Age-stratified proportions of SBA titers that were ≥8 and geometric mean titers were compared. SBA titers varied markedly by birth cohort and time since vaccination. Overall, 35% of samples (95% confidence interval (CI), 33 to 38%) had titers that were ≥8. Only in cohorts eligible for catch-up vaccination did the majority of individuals have protective antibody levels. Antibody levels were higher in children eligible for vaccination at primary and secondary school ages, compared to those eligible below the age of 5 years. In those eligible for completed vaccination under the current schedule, protective levels were very modest and there was no evidence of superiority to cohorts that were eligible for the previous schedule. This supports a need for older childhood or adolescent booster vaccination in those previously eligible for vaccination during the infant, toddler, or preschool periods, to maintain direct protection and potentially enhance population immunity. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Clinical and Vaccine Immunology American Society For Microbiology

Prevalence of Serum Bactericidal Antibody to Serogroup C Neisseria meningitidis in England a Decade after Vaccine Introduction

Prevalence of Serum Bactericidal Antibody to Serogroup C Neisseria meningitidis in England a Decade after Vaccine Introduction

Clinical and Vaccine Immunology , Volume 19 (8): 1126 – Aug 1, 2012

Abstract

Prevalence of Serum Bactericidal Antibody to Serogroup C Neisseria meningitidis in England a Decade after Vaccine Introduction David A. Ishola Jr. a , e , Ray Borrow b , c , Helen Findlow b , Jamie Findlow b , Caroline Trotter d and Mary E. Ramsay a a Immunisation Department, Health Protection Agency, Colindale, London, United Kingdom b Vaccine Evaluation Unit, Health Protection Agency North West, Manchester Royal Infirmary, Manchester, United Kingdom c University of Manchester, Inflammation Sciences Research Group, School of Translational Medicine, Manchester, United Kingdom d School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom e Centre for Infectious Disease Epidemiology, Department of Infection and Population Health, University College London, United Kingdom ABSTRACT Serogroup C meningococcal disease incidence and carriage declined rapidly in the United Kingdom after infant serogroup C conjugate vaccination was introduced in 1999, with catch-up vaccination for children under 18 years. Antibody levels and effectiveness waned quickly in children vaccinated at 2, 3, and 4 months of age. Therefore, in 2006, the current revised schedule of doses at 3, 4, and 12 months was introduced. This study assessed age-specific protection in 2009 compared with data from historical prevaccination and early postvaccination studies. Rabbit complement serum bactericidal antibody (SBA) was measured in anonymously banked serum samples collected in England in 2009 ( n = 1,174), taking titers of ≥8 as protective. Age-stratified proportions of SBA titers that were ≥8 and geometric mean titers were compared. SBA titers varied markedly by birth cohort and time since vaccination. Overall, 35% of samples (95% confidence interval (CI), 33 to 38%) had titers that were ≥8. Only in cohorts eligible for catch-up vaccination did the majority of individuals have protective antibody levels. Antibody levels were higher in children eligible for vaccination at primary and secondary school ages, compared to those eligible below the age of 5 years. In those eligible for completed vaccination under the current schedule, protective levels were very modest and there was no evidence of superiority to cohorts that were eligible for the previous schedule. This supports a need for older childhood or adolescent booster vaccination in those previously eligible for vaccination during the infant, toddler, or preschool periods, to maintain direct protection and potentially enhance population immunity.

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References (29)

Publisher
American Society For Microbiology
Copyright
Copyright © 2012 by the American society for Microbiology.
ISSN
1556-6811
eISSN
1556-679X
DOI
10.1128/CVI.05655-11
pmid
22647271
Publisher site
See Article on Publisher Site

Abstract

Prevalence of Serum Bactericidal Antibody to Serogroup C Neisseria meningitidis in England a Decade after Vaccine Introduction David A. Ishola Jr. a , e , Ray Borrow b , c , Helen Findlow b , Jamie Findlow b , Caroline Trotter d and Mary E. Ramsay a a Immunisation Department, Health Protection Agency, Colindale, London, United Kingdom b Vaccine Evaluation Unit, Health Protection Agency North West, Manchester Royal Infirmary, Manchester, United Kingdom c University of Manchester, Inflammation Sciences Research Group, School of Translational Medicine, Manchester, United Kingdom d School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom e Centre for Infectious Disease Epidemiology, Department of Infection and Population Health, University College London, United Kingdom ABSTRACT Serogroup C meningococcal disease incidence and carriage declined rapidly in the United Kingdom after infant serogroup C conjugate vaccination was introduced in 1999, with catch-up vaccination for children under 18 years. Antibody levels and effectiveness waned quickly in children vaccinated at 2, 3, and 4 months of age. Therefore, in 2006, the current revised schedule of doses at 3, 4, and 12 months was introduced. This study assessed age-specific protection in 2009 compared with data from historical prevaccination and early postvaccination studies. Rabbit complement serum bactericidal antibody (SBA) was measured in anonymously banked serum samples collected in England in 2009 ( n = 1,174), taking titers of ≥8 as protective. Age-stratified proportions of SBA titers that were ≥8 and geometric mean titers were compared. SBA titers varied markedly by birth cohort and time since vaccination. Overall, 35% of samples (95% confidence interval (CI), 33 to 38%) had titers that were ≥8. Only in cohorts eligible for catch-up vaccination did the majority of individuals have protective antibody levels. Antibody levels were higher in children eligible for vaccination at primary and secondary school ages, compared to those eligible below the age of 5 years. In those eligible for completed vaccination under the current schedule, protective levels were very modest and there was no evidence of superiority to cohorts that were eligible for the previous schedule. This supports a need for older childhood or adolescent booster vaccination in those previously eligible for vaccination during the infant, toddler, or preschool periods, to maintain direct protection and potentially enhance population immunity.

Journal

Clinical and Vaccine ImmunologyAmerican Society For Microbiology

Published: Aug 1, 2012

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