Induction of Immunologic Memory by Conjugated vs Plain Meningococcal C Polysaccharide Vaccine in Toddlers
|
|
- Kenneth Wade
- 5 years ago
- Views:
Transcription
1 Clinical Investigation Induction of Immunologic Memory by Conjugated vs Plain C Vaccine in Toddlers A Randomized Controlled Trial Noni E. MacDonald, MD, FRCPC; Scott A. Halperin, MD; Barbara J. Law, MD, FRCPC; Bruce Forrest, MB, MD; Lisa E. Danzig, MD; Dan M. Granoff, MD Context. polysaccharide vaccines are not used routinely in infants and toddlers, the groups at highest risk of invasive disease, because of poor immunologic responses to the Neisseria meningitidis serogroup C polysaccharide in these age groups. C conjugate vaccines offer the prospect of circumventing this problem. Objective. To assess the immunogenicity and the induction of immunologic memory in toddlers by meningococcal C conjugate vaccine. Design. A multicenter, randomized, observer-blinded controlled trial. Setting. Urban and suburban family medicine or pediatric practices. Participants. Two hundred eleven healthy toddlers aged 15 to 23 months. Intervention. Two injections at 2 months apart of meningococcal C conjugate (group 1, n = 69), plain meningococcal polysaccharide (group 2, n = 72), or hepatitis B virus vaccine (group 3, n = 70). All toddlers received a follow-up dose of plain meningococcal polysaccharide vaccine 12 months later. Main Outcome Measures. IgG meningococcal C anticapsular antibody concentrations determined by enzyme-linked immunosorbent assay and complementmediated bactericidal antibody. Results. In group 1, the magnitude of the IgG response to meningococcal C conjugate vaccine was more than 4-fold higher after dose 1 and more than 10-fold higher after dose 2 compared with meningococcal polysaccharide vaccine (group 2) (P.001). Higher titers persisted in the meningococcal C conjugate group for at least 12 months (P.001). Group 1, primed with meningococcal C conjugate, had 25-fold higher IgG responses to the meningococcal polysaccharide 1-year booster dose than the controls who had received hepatitis B virus vaccine initially and were given meningococcal polysaccharide vaccine 1 year later for the first time (P.001). In contrast, group 2, primed with meningococcal polysaccharide, had a 2-fold lower response to the 1-year booster meningococcal polysaccharide dose than the hepatitis B virus control group (P =.006). Serum bactericidal responses paralleled the enzyme-linked immunosorbent assay responses. Conclusions. Immunization of toddlers with meningococcal C conjugate vaccine induces high titers of anticapsular and bactericidal antibody. Furthermore, this vaccine induces immunologic memory to meningococcal C polysaccharide. In contrast, meningococcal polysaccharide vaccine is less immunogenic than the conjugate vaccine and also induces a hyporesponsive state that persists for at least 12 months. JAMA. 1998;280: From the University of Ottawa, Ottawa, Ontario (Dr MacDonald); Dalhousie University, Halifax, Nova Scotia (Dr Halperin); University of Manitoba, Winnipeg (Dr Law); Chiron Vaccines, Chiron Corp, Emeryville, Calif (Drs Forrest, Danzig, and Granoff); and Children s Hospital, Oakland Research Institute, Oakland, Calif (Dr Granoff). Presented in part at the 37th Interscience Conference on Antimicrobial Agents and Chemotherapy, Toronto, Ontario, September 29, Corresponding author: Noni E. MacDonald, MD, FRCPC, Children s Hospital of Eastern Ontario, 401 Smyth Rd, Ottawa, Ontario, Canada K1H 8L1 ( macdonald_n@cheo.on.ca). Reprints not available from the author. WITH THE CONTROL of invasive Haemophilus influenzae type b disease by routine immunization, Neisseria meningitidis has become a major cause of bacterial meningitis in North America and Europe, with 45% of meningococcal cases caused by N meningitidis serogroup C. 1,2 Although meningococcal vaccines containing N meningitidis serogroup C polysaccharide have been available for more than 20 years, their routine use is not currently recommended 3 becausethevaccinesarepoorly immunogenic in the age group at highest risk (ie, infants and toddlers), and the serum antibody response is short-lived in young children. 4-7 Furthermore, data suggest that administration of plain meningococcal polysaccharide vaccine to infants may induce a hyporesponsive state to meningococcal C polysaccharide (ie, impaired serum antibody responses to a second injection given 6 to 12 months later) compared with responses of controls of similar age immunized for the first time. 8,9 In contrast, a hyporesponsive state is not observed after vaccination with the N meningitidis serogroup A polysaccharide. 9 polysaccharideprotein conjugated vaccines are currently being studied in infants and toddlers for the prevention of disease caused by meningococcal C strains. 10,11 Preliminary work suggests that these thymicdependent antigens are more immunogenic in infants and toddlers than plain meningococcal C polysaccharide, which is thought to evoke serum antibody responses by a thymic-independent mechanism. Furthermore, the conjugate vaccines, but not the plain polysaccharide vaccines, elicit long-term memory to plain meningococcal C polysaccharide. 9,11 The present study was a phase-2, observerblinded, randomized controlled trial to evaluate the comparative safety and im- JAMA, November 18, 1998 Vol 280, No. 19 Conjugated vs Plain C Vaccine MacDonald et al 1685
2 Parents of Toddlers Formally Approached (N = 297) Met Eligibility Criteria and Agreed to Inclusion in Study (N = 211) Adverse Event Group 1 ( C Conjugate Vaccine) and Received Dose 1 (n = 69) Adverse Event Consent Group 2 ( Vaccine) and Received Dose 1 (n = 72) Group 3 (Hepatitis B Virus Vaccine) and Received Dose 1 (n = 70) Consent (n = 4) Lost to Follow-up (n = 2) Consent (n = 2) (n = 65) (n = 70) (n = 66) Protocol Violation (n = 61) (n = 67) (n = 63) (n = 60) (n = 67) (n = 62) Consent Figure 1. Trial profile. munogenicity in toddlers of meningococcal C conjugate vaccine compared with meningococcalpolysaccharidevaccine. We also assessed whether vaccination induces immunologic memory or a hyporesponsive state to meningococcal C polysaccharide. METHODS The study design is outlined in Figure 1. Institutional ethics review was obtained at the 3 study sites (Ottawa, Ontario; Halifax, Nova Scotia; and Winnipeg, Manitoba). Healthy toddlers 15 to 23 months of age with no underlying serious disease or previous meningococcal disease were recruited through family or pediatric suburban and urban practices. The study was introduced either by letter or by the primary care physician and followed up by formal discussions with a research assistant. Of the 297 parents formally approached by the research assistants, 211 (71%) met the eligibility criteria and agreed to participate. After parental informed consent, 211 healthy toddlers aged 15 to 23 months on enrollment were randomized centrally according to a prearranged, computer-generated randomization schedule for each study site into 3 vaccine groups. Each group received 2 doses of the designated vaccine 2 months apart. Group 1 received meningococcal C conjugate vaccine from a single lot (J35021L1) containing 10 µg of meningococcal C oligosaccharide conjugated to the protein carrier, CRM197 (Chiron Vaccines, Chiron Corp, Emeryville, Calif). Group 2 received a licensed quadrivalent plain polysaccharide vaccine (Menomune, Connaught Laboratories Ltd, Willowdale, Ontario) containing 50 µg each of the A, C, Y, and W135 meningococcal polysaccharides. Group 3 (control) received a licensed hepatitis B virus vaccine (Recombivax Hb, Merck, Sharp and Dohme, Kirkland, Quebec). No other vaccines were administered concurrently. The selected sample size of 70 subjects per group had greater than 98% power to detect a 2-fold pair wise difference among the 3 groups with respect to geometric mean antibody concentrations at 1 month following the second immunization. All 3 vaccines were prepared for administration by research assistants who were not involved in the assessment of the vaccines, the assessment of adverse events, or serum collection to ensure observer blinding. To assess induction of immunologic B-cell memory or a state of hyporesponsiveness to meningococcal C polysaccharide, children in all 3 groups received a follow-up dose of the plain meningococcal polysaccharide vaccine 12 months after their second study vaccine dose (ie, 14 months after study entry). Local and systemic reactions were noted by the subject s parent or guardian daily for 7 days in the subject diary following each immunization and reviewed during the follow-up and clinic visits. Serum samples were obtained immediately before the first vaccine dose and at 2 and 3 months after study entry (just before and 1 month after the second dose of vaccine). Additional samples were obtained at 14 and 15 months after study entry (just before and 1 month after the plain booster polysaccharide vaccine injection). The following assays were performed on coded serum samples: (1) Serum IgG anti N meningitidis serogroup C polysaccharide antibody concentrations were measured by an enzymelinked immunosorbent assay (ELISA) 12 using an alkaline-phosphatase conjugated mouse monoclonal antibody specific for human IgG (clone HP 6043). 12 The buffer used to dilute the serum samples contained 75 mmol/l of ammonium thiocyanate, which favored detection of high-avidity anticapsular antibodies. 13 (2) Complement-mediated bactericidal antibody titers to N meningitidis serogroup C were measured on a convenience sample of approximately 50% of the serum samples, performed as previously described. 14,15 For the present study, the test strain, N meningitidis serogroup C 60E (obtained from Wendell Zollinger, PhD, Walter Reed Institute for Medical Research, Washington, DC), was grown for approxi JAMA, November 18, 1998 Vol 280, No. 19 Conjugated vs Plain C Vaccine MacDonald et al
3 mately 2 hours in Mueller-Hinton broth containing 0.25% glucose. The complement source was pooled serum samples obtained from 3 healthy adults who had no detectable anticapsular antibody to meningococcal C and whose sera lacked intrinsic bactericidal activity when tested at concentrations of up to 40%. When carrying out the bactericidal assays, the complement source was used at a final concentration of 20% in the reaction mixture. Antibody concentrations were transformed (logarithm to base 10) for calculation of geometric means. IgG antibody concentrations of less than 0.4 U/mL were assigned a value of 0.2 U/mL and bactericidal titers of less than 1:8 were assigned a value of 1:4. Geometric means and 95% confidence intervals were calculated using the least squares means and SEs were computed from a 2-way analysis of variance model. Differences in terms of group, center, and group by center interaction with respect to geometric means were tested by using the P values from the analysis of variance model. There were 1 primary and 3 secondary planned comparisons. The primary comparison was to test the null hypothesis that there was no difference between the 2 meningococcal vaccine groups (group 1 and group 2) in the antibody response of toddlers to N meningitidis serogroup C as measured by ELISA or serum bactericidal assay 1 month after the second immunization. Secondary comparisons were to test the null hypothesis that (1) there was no difference between the 2 meningococcal vaccines (group 1 and group 2) in the antibody response to N meningitidis serogroupcasmeasuredbyelisaandbactericidal assay 2 months after the first injection; (2) there was no difference between the 2 meningococcal vaccines (group 1 and group 2) in the antibody response to N meningitidis serogroup C as measured by ELISA and bactericidal assay 12 months after the second injection; and (3) there was no difference among all 3 groups in the antibody response to N meningitidis serogroup C as measured by ELISA and bactericidal assay1monthaftertheboosterdosethat was given 12 months after the second injection. If the null hypothesis for this objective was rejected, then all pairwise comparisons would be performed. RESULTS Of the 211 toddlers enrolled, 69, 72, and 70 were randomized to groups 1, 2, Table 1. Reactogenicity Within 48 Hours Following First and Second Doses of Vaccine* C Conjugate (n = 69) Subjects With Reaction, % (n = 72) Hepatitis B Virus (n = 70) P Value Dose 1 Temperature 38 C Induration 25 mm Change in eating habits Persistent crying Urticarial rash Irritability Dose 2 Temperature 38 C Induration 25 mm Change in eating habits Persistent crying Urticarial rash Irritability *The numbers of subjects studied following the second dose were for meningococcal C conjugate, n = 65; meningococcal polysaccharide, n = 70; and hepatitis B virus, n = 66. P value is from the Pearson 2 test for vaccine group differences. If 50% or more of the expected cell counts were less than 5, the P value of the Fisher exact test is presented. and 3, and 87%, 93%, and 89% completed the study, respectively. The primary reason for not completing the study was withdrawal of consent between doses 1 and 2 or doses 2 and 3 (7%, 6%, and 11% of toddlers assigned to groups 1, 2, and 3, respectively). The 3 groups did not differ significantly with respect to mean age at enrollment (20.9 months, 20.8 months, and 21.2 months); male-female ratio (0.97, 1.25, and 0.94); or ethnic background (86%, 90%, and 94% were white). No vaccine-related serious adverse events were observed during the study and all 3 vaccines were well tolerated. Table 1 presents data on reactogenicity within 48 hours following the first and second doses of vaccine. Table 2 and Table 3 summarize the vaccine antibody response data. Since no significant differences were noted among the 3 study sites and the vaccineby-site interactions were not significant, only aggregated data are presented. The IgG anticapsular antibody responses expressed as geometric mean titer are presented in Table 2. Before vaccination, the geometric mean was 0.20 to 0.21 U/mL in all groups. The magnitude of the antibody response to the meningococcal C conjugate vaccine (group 1) was more than 4-fold higher after dose 1 and more than 10-fold higher after dose 2 than the corresponding responses to the meningococcal polysaccharide vaccine (group 2). Twelve months after the last primary dose, the IgG antibody concentrations in the meningococcal C conjugate vaccine group (group 1) were 2-fold higher than those in the meningococcal polysaccharide group (group 2) (P.001). Following the plain meningococcal C polysaccharide booster dose 12 months after the last dose of the priming vaccine, group 1 showed evidence of induction of immunologic B-cell memory by the conjugate vaccination (25-fold higher anticapsular antibody responses than control toddlers [group 3] vaccinated with the polysaccharide vaccine for the first time). In contrast, group 2 primed with 2 doses of plain meningococcal polysaccharide showed evidence of a hyporesponsive state (2-fold lower responses to the 1-year follow-up injection than control Table 2. IgG Anticapsular Antibody Responses* Geometric Mean Antibody Concentration, U/mL (95% Confidence Interval) Prior to Vaccine 2 mo After Dose 1 1 mo After Dose 2 Prior to Booster 1 mo After Booster Group 1, meningococcal C conjugate 0.20 ( ) (n = 69) 5.0 ( ) (n = 66) 20.0 ( ) (n = 65) 1.6 ( ) (n = 59) 69.0 (50-96) (n = 60) Group 2, meningococcal polysaccharide 0.21 ( ) (n = 70) 1.2 ( ) (n = 69) 1.5 ( ) (n = 67) 0.83 ( ) (n = 65) 1.3 ( ) (n = 65) Group 3, hepatitis B virus (control) 0.21 ( ) (n = 70) 0.20 ( ) (n = 66) 0.20 ( ) (n = 65) 0.21 ( ) (n = 62) 2.5 ( ) (n = 61) *Toddlers were given 2 injections separated by 2 months of either meningococcal C conjugate vaccine, plain meningococcal polysaccharide vaccine, or hepatitis B virus vaccine (control). Twelve months after dose 2, all subjects received a booster dose of plain meningococcal polysaccharide vaccine. Prior to vaccination, P =.54 for group 1 vs group 2; P =.78 for group 1 vs group 3; and P =.73 for group 2 vs group 3. For 2 months after dose 1, 1 month after dose 2, and prior to the booster vaccination, P.001 for all comparisons. One month after the booster vaccination, P.001 for group 1 vs group 2 and for group 1 vs group 3; P.006 for group 2 vs group 3. JAMA, November 18, 1998 Vol 280, No. 19 Conjugated vs Plain C Vaccine MacDonald et al 1687
4 Table 3. Percentage of Toddlers in Each Group With Serum Bactericidal Antibody Response of at Least 1:8* Subjects, % (95% Confidence Interval) Prior to Vaccine 2 mo After Dose 1 1 mo After Dose 2 Prior to Booster 1 mo After Booster Group 1, meningococcal C conjugate 2 (0-12) (n = 43) 90 (79-97) (n = 52) 98 (88-100) (n = 45) 88 (72-97) (n = 33) 100 (89-100) (n = 33) Group 2, meningococcal polysaccharide 2 (0-12) (n = 45) 32 (19-47) (n = 47) 32 (19-47) (n = 47) 22 (9-40) (n = 32) 19 (7-36) (n = 32) Group 3, hepatitis B virus (control) 0 (0-13) (n = 26) 0 (0-13) (n = 27) 0 (0-13) (n = 27) 15 (4-34) (n = 27) 54 (34-72) (n = 28) *Toddlers were given 2 injections separated by 2 months of either meningococcal C conjugate vaccine, plain meningococcal polysaccharide vaccine, or hepatitis B virus vaccine (control). Twelve months after dose 2, all subjects received a booster dose of plain meningococcal polysaccharide vaccine. For vaccination schedule see Table 2. Prior to vaccination, P =.36 for group 1 vs group 2; P =.69 for group 1 vs group 3; and P =.31 for group 2 vs group 3. For 2 months after dose 1 and 1 month after dose 2, P.001 for all comparisons. Prior to the booster vaccination, P.001 for group 1 vs group 2 and for group 1 vs group 3; P =.57 for group 2 vs group 3. One month after the booster vaccination, P.001 for group 1 vs group 2 and for group 1 vs group 3; P.002 for group 2 vs group 3. 1/Geometric Mean Titer ±95% Confidence Interval <8 C Conjugate Hepatitis B (Control) Prior to Vaccination 2 mo After Vaccination 1 Priming Vaccination 1 mo After Vaccination 2 Prior to After Booster Figure 2. Serum bactericidal antibody responses to vaccination. Each child received 2 doses of the respective vaccine, separated by 2 months. Serum samples were obtained prior to vaccination, 2 months after first injection, and 1 month after second injection. All children were boosted 14 months after study entry with plain meningococcal polysaccharide. Serum samples were obtained immediately before the booster and 1 month later. Compared with the polysaccharide priming group, subjects in the conjugate vaccine priming group had higher geometric means at all points after priming or booster vaccination (P.001). Compared with the hepatitis B virus vaccine control group, subjects assigned to the meningococcal polysaccharide priming group had higher responses 2 months after first injection and 1 month after second injection (P =.02), and lower responses after the booster vaccination (P =.02). toddlers vaccinated for the first time [P =.006]). Figure 2 summarizes the geometric mean bactericidal antibody responses of the3groupsateachtimepoint.themagnitude of the bactericidal response paralleled the corresponding anticapsular antibody responses(after dose 1, r = 0.84, n = 126; after dose 2, r = 0.89, n = 118). Table 3 summarizes the percentage of subjects in each vaccine group with titers of at least 1:8, considered sufficient to confer protection. 16 Importantly, 88% of toddlers previously given the meningococcal C conjugate vaccine (group 1) still had a bactericidal titer of at least 1:8 (presumed to confer protection) prior to the 1-year follow-up injection vs 22% of the meningococcal polysaccharide group (group2)and15%ofcontrolsgivenhepatitis B virus vaccine (group 3) (P.001 for group 1 vs group 2 and group 1 vs group 3). After the 1-year booster injection with meningococcal polysaccharide, for group 2 the percentage with bactericidal antibody titers of at least 1:8 did not increase (22% vs 19% of the 32 samples assayed at both time points). In contrast, more than 50% of control toddlers (group 3) given meningococcal polysaccharide vaccine for the first time showed responses of at least 1:8 (P =.002 vs group 2) and 100% of group 1 primed by the conjugate vaccine (P.001 vs groups 2 and 3). The data set was too small to show a correlation in response with age. COMMENT The results of this study demonstrate that the meningococcal C conjugate vaccine is highly immunogenic in toddlers and induces immunologic memory to meningococcal C polysaccharide that persists for at least 12 months. Although 1 dose of conjugated vaccine in this age group elicited bactericidal titers of at least 1:8 (protective) in 90% of subjects, the second dose 2 months later boosted the titers more than 8-fold (Figure 2). However, this study does not allow an assessment of the adequacy of a single dose of conjugate vaccine with respect to duration of protection because all toddlers in group 1 received 2 doses. Further studies are needed to evaluate this question. In direct contrast with the response to the conjugate vaccine, 1 or 2 doses of plain meningococcal C polysaccharide resulted in much lower primary antibody responses than the conjugate vaccine. Furthermore, group 2, when given polysaccharide for the priming vaccination, showed evidence of a hyporesponsive state 12 months later. Previous suggestions that the plain meningococcal C polysaccharide could induce a state of hyporesponsiveness were based on small numbers of infants immunized in the first 6 months of life. 8,9,17 Due to the poor immunogenicity of plain meningococcal polysaccharide in this age group and the question of induction of an immunologic hyporesponsive state, the plain meningococcal polysaccharide vaccine is not used routinely in this age group. The present study demonstrates that toddlers are also susceptible to the induction of hyporesponsiveness by immunization with meningococcal polysaccharide vaccine. A recent small study by Granoff et al 18 also suggests that induction of hyporesponsiveness to plain meningococcal C polysaccharide may extend to adults. The duration of the hyporesponsive state following immunization with plain meningococcal C polysaccharide vaccine is unknown. In this toddler study, it was present for at least 1 year after 2 doses of plain meningococcal C polysaccharide, whereas in the adult study, evidence of hyporesponsiveness was observed 4 years after receipt of 1 dose of the meningococcal polysaccharide vaccine. The clinical importance in toddlers of the development of hyporesponsiveness to meningococcal C polysaccharide after vaccination with plain meningococcal polysaccharide vaccine is unknown. However, the data are consistent with impaired serum anticapsular antibody response when encountering meningococcal C organisms, which might lead to an 1688 JAMA, November 18, 1998 Vol 280, No. 19 Conjugated vs Plain C Vaccine MacDonald et al
5 increase in the risk of developing invasive disease. Although there are no epidemiological data supporting an increased risk of disease in previously vaccinated toddlers, the present results suggest caution in administering plain meningococcal C polysaccharide vaccine to toddlers, especially if the risk of meningococcal C disease is low. The results of this study also emphasize the importance of maintaining surveillance for meningococcal C disease in the large cohort of infants and toddlers who received 1 dose of the quadrivalent meningococcal vaccine in Canada during the meningococcal C outbreaks in 1991 and Further work also is needed to determine if toddlers who have been rendered hyporesponsive to plain meningococcal C polysaccharide by previous polysaccharide vaccination can be boosted with conjugated meningococcal C vaccine. In a previous study of Gambian infants who showed evidence of hyporesponsiveness to plain meningococcal C polysaccharide vaccine, the conjugate vaccine appeared to be effective. 9 In contrast with the plain meningococcal polysaccharide vaccine, the meningococcal C conjugate vaccine appears to have very similar properties to those of the conjugated H influenzae type b vaccines, which have been highly effective in controlling H influenzae type b invasive disease. 20 These properties include increased immunogenicity in toddlers vs plain polysaccharide and the induction of robustimmunologicmemoryasshownby theiggandbactericidalboosterresponse to the plain meningococcal polysaccharide vaccine 12 months after priming. Similar results have recently been shown in infants given this meningococcal C conjugate vaccine. 21 Although immunization with H influenzae type b vaccine also leads to decreased pharyngeal carriage, 22 no data are yet available on the impact of meningococcal C conjugate vaccine on carriage of N meningitidis serogroup C or other serogroups. To examine this question, a very large sample size would be necessary since even in an outbreak situation, carriage of N meningitidis regardless of serogroup is a rare event in infants and young children. 23 Extrapolation from the H influenzae type b conjugate vaccine experience, together with the data from this study and the recent infant meningococcal C study, suggest that a universal meningococcal C conjugate vaccine program in infants and toddlers may be effective in controlling invasive meningococcal C disease and may be particularly useful in control of outbreak situations. This study was supported by a grant from Chiron Vaccines, Chiron Corp, Emeryville, Calif. We acknowledge the important contributions of the following individuals to this study: Wai Ping Leong, MS, for statistical analysis; George Santos and Bill Wacknov for performing the laboratory assays; Howard Raff, PhD, for review of the manuscript and project management; and Helen Etherington, RN, Patricia Pottie, RN, and Joyce Good, RN, the research coordinators at the study sites. References 1. Jafari HS, Perkins BA, Wenger JD. Control and prevention of meningococcal disease: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep. 1997;46: Ramsay M, Kaczmarski E, Rush M, Mallard R, Farrington P, White J. Changing patterns of case ascertainment and trends in meningococcal disease in England and Wales. Commun Dis Rep CDR Rev. 1997;7:R49-R Committee on Infectious Disease of the American Academy of Pediatrics. disease preventionandcontrolstrategiesforpractice-based physicians. Pediatrics. 1996;97: Amato NV, Finger H, Gotschlich EC, et al. Serologic response to serogroup C meningococcal vaccine in Brazilian preschool children. Rev Inst Med Trop Sao Paulo. 1974;16: Peltola HA, Safary A, Kayhty H, et al. Evaluation of 2 tetravalent (ACY W 135) meningococcal vaccinesininfantsandsmallchildren:aclinicalstudy comparingimmunogenicityof 0-acetyl-negativeand 0-acetyl-positive serogroup C polysaccharides. Pediatrics. 1985;76: Gold R, Lepow ML, Goldschneider I, et al. Kinetics of antibody production to group A and group C meningococcal polysaccharide vaccines administered during the first six years of life: prospects for routine immunization of infants and children. J Infect Dis. 1979;140: King WJ, MacDonald NE, Wells G, et al. Total and functional antibody response to a quadrivalent meningococcal vaccine among children. J Pediatr. 1996;128: Gold R, Lepow ML, Goldschneider I, Gotschlich EC. Immune response of human infants to polysaccharide vaccines of group A and C Neisseria meningitidis. J Infect Dis. 1977;136(suppl):S31-S Leach A, Twumasi PA, Kumah S, et al. Induction ofimmunologicmemoryingambianchildrenbyvaccination in infancy with a group A plus group C meningococcal polysaccharide protein conjugate vaccine. J Infect Dis. 1997;175: Fairley CK, Begg N, Borrow R, Fox AJ, Jones DM, Cartwright K. Conjugate meningococcal serogroup A and C vaccine: reactogenicity and immunogenicity in United Kingdom infants. J Infect Dis. 1996;174: Lieberman JM, Chiu SS, Wong VK, et al. Safety and immunogenicity of a serogroup A/C Neisseria meningitidis oligosaccharide-protein conjugate vaccine in young children: a randomized trial. JAMA. 1996;275: Granoff DM, Kelsey SK, Bijlmer HA, et al. AntibodyresponsestocapsularpolysaccharideofNeisseria meningitidis serogroup B in patients with meningococcal disease. Clin Diagn Lab Immunol. 1995;2: Granoff DM, Bartoloni A, Ricci S, et al. A modified enzyme-linked immunoabsorbent assay for measurement of antibody responses to meningococcal C polysaccharide that correlates with bactericidal responses. Clin Diagn Lab Immunol. 1998;5: Granoff DM, McHugh YE, Raff HV, Mokatrin AS, Van Nest GA. MF 59 adjuvant enhances antibody responses of infant baboons immunized with Haemophilus influenzae type b and Neisseria meningitidis group C oligosaccharide CRM 197 conjugate vaccine. Infect Immun. 1997;65: Mandrell RE, Azmi FH, Granoff DM. Complement-mediated bactericidal activity of human antibodies to poly-alpha-2-8-n-acetylneuramic acid, the capsular polysaccharide of Neisseria meningitidis serogroup B. J Infect Dis. 1995;172: GoldschneiderI, GotschlichEC, ArtensteinMS. Human immunity to the meningococcus, 1: the role of humoral antibodies. J Exp Med. 1969;129: Goldschneider I, Lepow ML, Gotschlich EC, Mauck FT, Bachl F, Randolph M. Immunogenicity of group A and group C meningococcal polysaccharides in human infants. J Infect Dis. 1973;128: Granoff DM, Gupta RK, Belshe RB, Anderson EL. Induction of immunologic refractoriness in adults by meningococcal C polysaccharide vaccination. J Infect Dis. 1998;178: Hume SE. Mass voluntary immunization campaigns for meningococcal disease in Canada: media hysteria. JAMA. 1992;267: Robbins JB, Schneerson R, Anderson P, Smith DH. The 1996 Albert Lasker Medical Research Awards: prevention of systemic infections, especially meningitis, caused by Haemophilus influenzae type b: impact on public health and implications for other polysaccharide-based vaccines. JAMA. 1996;276: MacLennan J, Shackley F, Health P, et al. Induction of immunologic memory by a Neisseria meningitidis group C conjugate vaccine. Paper presented at: 15th Annual Meeting of the European Society for PaediatricInfections;May21-23,1997;Paris,France. 22. Takala AK, Eskola J, Leinonen M, et al. Reduction of oropharyngeal carriage of Haemophilus influenzae type B (Hib) in children immunized with an Hib conjugate vaccine. J Infect Dis. 1991;164: King WJ, MacDonald NE, Wells G, Manion D, Allen U. Relationship between parental occupation and children s oropharyngeal colonization with Neisseriameningitidis.JPediatr.1995;126: JAMA, November 18, 1998 Vol 280, No. 19 Conjugated vs Plain C Vaccine MacDonald et al 1689
Induction of Immunologic Refractoriness in Adults by Meningococcal C Polysaccharide Vaccination
870 Induction of Immunologic Refractoriness in Adults by Meningococcal C Polysaccharide Vaccination Dan M. Granoff, Rajesh K. Gupta, Robert B. Belshe, and Edwin L. Anderson Chiron Vaccines, Chiron Corp.,
More informationRecommendations for the production and control of group C meningococcal conjugate vaccines
Technical Report Series No. 1 Recommendations for the production and control of group C meningococcal conjugate vaccines Addendum 2003 The Expert Committee on Biological Standardization, at its fifty-second
More informationAnnex 3 Recommendations for the production and control of group C meningococcal conjugate vaccines (Addendum 2003)
World Health Organization WHO Technical Report Series, No. 926, 2004 Annex 3 Recommendations for the production and control of group C meningococcal conjugate vaccines (Addendum 2003) At its fifty-second
More informationNEISSERIA MENINGITIDIS HAS BEcome
ORIGINAL CONTRIBUTION Safety, Immunogenicity, and Induction of Immunologic Memory by a Serogroup C onjugate Vaccine in Infants A Randomized Controlled Trial Jenny M. MacLennan, MRC, MRCCH Fiona Shackley,
More informationImmunologic Memory 5 Years after Meningococcal A/C Conjugate Vaccination in Infancy
97 Immunologic Memory 5 Years after Meningococcal A/C Conjugate Vaccination in Infancy Jenny MacLennan, 1 Stephen Obaro, 4 Jonathan Deeks, 2 Derrick Lake, 5 Cheryl Elie, 5 George Carlone, 5 E. Richard
More informationEffectiveness Analyses May Underestimate Protection of Infants after Group C Meningococcal Immunization
MAJOR ARTICLE Effectiveness Analyses May Underestimate Protection of Infants after Group C Meningococcal Immunization David M. Vu, 1 Dominic Kelly, 2 Paul T. Heath, 4 Noel D. McCarthy, 3 Andrew J. Pollard,
More informationImpact of meningococcal C conjugate vaccine in the UK
J. Med. Microbiol. Vol. 51 (22), 717 722 # 22 Society for General Microbiology ISSN 22-2615 REVIEW ARTICLE Impact of meningococcal C conjugate vaccine in the UK P. BALMER, R. BORROW and E. MILLER Meningococcal
More informationPart C. Clinical evaluation of group C meningococcal conjugate vaccines (Revised 2007)
Part C. Clinical evaluation of group C meningococcal conjugate vaccines (Revised 2007) C.1 Introduction 227 C.1.1 Background 227 C.1.2 General considerations for clinical studies 227 C.1.3 Scope of the
More informationHyporesponsiveness: Time To Stop Using Meningococcal Polysaccharide Vaccines?
Hyporesponsiveness: Time To Stop Using Meningococcal Polysaccharide Vaccines? Lee H. Harrison, M.D. Professor of Medicine and Epidemiology University of Pittsburgh First Regional Meningococcal Symposium
More informationMulticomponent MenB Vaccine (4CMenB): An Innovative Step In the Global Fight Against Serogroup B Meningococcal Disease
Multicomponent MenB Vaccine (4CMenB): An Innovative Step In the Global Fight Against Serogroup B Meningococcal Disease Jeffrey J. Stoddard, MD, FAAP Head, Global Medical Affairs Novartis Vaccines and Diagnostics
More informationChanges to the Meningococcal C conjugate (MenC) vaccine schedule. Questions and Answers
Changes to the Meningococcal C conjugate (MenC) vaccine schedule Questions and Answers Background The meningococcal C (MenC) vaccination programme was first introduced into the UK routine immunisation
More informationReceived 28 May 2004/Returned for modification 21 July 2004/Accepted 26 August 2004
CLINICAL AND DIAGNOSTIC LABORATORY IMMUNOLOGY, Nov. 2004, p. 1100 1104 Vol. 11, No. 6 1071-412X/04/$08.00 0 DOI: 10.1128/CDLI.11.6.1100 1104.2004 Copyright 2004, American Society for Microbiology. All
More informationImmune Response to Meningococcal Serogroup C Conjugate Vaccine in Asplenic Individuals
INFECTION AND IMMUNITY, Jan. 2004, p. 332 337 Vol. 72, No. 1 0019-9567/04/$08.00 0 DOI: 10.1128/IAI.72.1.332 337.2004 Copyright 2004, American Society for Microbiology. All Rights Reserved. Immune Response
More informationWHO Position Paper on Meningococcal Vaccines, Nov 2011
WHO Position Paper on Meningococcal Vaccines, Nov 2011 Extended list of references and summaries for the position paper and associated grading Tables Advisory Committee on Immunization Practices (ACIP).
More informationBacterial diseases caused by Streptoccus pneumoniae in children
Bacterial diseases caused by Streptoccus pneumoniae in children Bactermia 85% Bacterial pneumonia 66% Bacterial meningitis 50% Otitis media 40% Paranasal sinusitis 40% 0% 10% 20% 30% 40% 50% 60% 70% 80%
More informationChanges to the meningococcal C conjugate (MenC) vaccine schedule 2014 first-time university entrants under the age of 25 An update for registered
Changes to the meningococcal C conjugate (MenC) vaccine schedule 2014 first-time university entrants under the age of 25 An update for registered healthcare practitioners Frequently asked questions August
More informationSplenectomy Vaccine Protocol PIDPIC
Splenectomy Vaccine Protocol PIDPIC 6.24.14 Rationale Spleen clears encapsulated bacteria and infected erythrocytes Serves as one of the largest lymphoid tissues where B cells are educated against encapsulated
More informationReceived 22 May 2009/Returned for modification 7 July 2009/Accepted 29 September 2009
CLINICAL AND VACCINE IMMUNOLOGY, Dec. 2009, p. 1810 1815 Vol. 16, No. 12 1556-6811/09/$12.00 doi:10.1128/cvi.00207-09 Copyright 2009, American Society for Microbiology. All Rights Reserved. Quadrivalent
More informationCONJUGATE VACCINES A BREAKTHROUGH IN VACCINE DEVELOPMENT
CONJUGATE VACCINES A BREAKTHROUGH IN VACCINE DEVELOPMENT P Helena Mäkelä National Public Health Institute, Helsinki, Finland Abstract. The encapsulated bacteria Streptococcus pneumoniae (the pneumococcus),
More informationThe legally binding text is the original French version TRANSPARENCY COMMITTEE OPINION. 21 October 2009
The legally binding text is the original French version TRANSPARENCY COMMITTEE OPINION 21 October 2009 MENINGITEC suspension for injection in prefilled syringes meningococcal group C oligosaccharide conjugate
More informationRecommended Childhood Immunization Schedu...ates, January - December 2000, NP Central
Recommended Childhood Immunization Schedule United States, January - December 2000 Vaccines 1 are listed under routinely recommended ages. Solid-colored bars indicate range of recommended ages for immunization.
More informationvaccination in Canada Bernard Duval, md, mph, frcpc Institut National de Santé Publique du Québec Québec, Canada Sevilla,
Follow-up of hepatitis B vaccination in Canada Bernard Duval, md, mph, frcpc Institut National de Santé Publique du Québec Québec, Canada Sevilla, 2004-03 03-11 HB in Canada Low endemicity: HBsAg+ : 0.5%
More informationSummary of Product Characteristics
Summary of Product Characteristics 1) NAME OF THE MEDICINAL PRODUCT Meningococcal A conjugate vaccine 5 micrograms, Lyophilized Brand name- MenAfriVac 2) QUALITATIVE AND QUANTITATIVE COMPOSITION After
More informationSafety and immunogenicity of three doses of a Neisseria meningitidis A + C diphtheria conjugate vaccine in infants from Niger
3 Pediatr Infect Dis J, 2000;19:144-50 Copyright O 2000 by Lippincott Williams & Wilkins, Inc. Vol. 19, No. 2 Printed in U.S.A. Safety and immunogenicity of three doses of a Neisseria meningitidis A +
More information/IAI Updated information and services can be found at:
REFERENCES CONTENT ALERTS Effect of Vaccination with Carrier Protein on Response to Meningococcal C Conjugate Vaccines and Value of Different Immunoassays as Predictors of Protection Moya Burrage, Andrew
More informationStudy No.: Title: Rationale: Note: Phase: Study Period: Study Design: Centres: Indication: Treatment: Hib-MenCY F1 Group Hib-MenCY F2 Group
The study listed may include approved and non-approved uses, formulations or treatment regimens. The results reported in any single study may not reflect the overall results obtained on studies of a product.
More informationESCMID Online Lecture Library
What would be the best schedule for prevention of meningococcal disease in all ages? Ray Borrow ray.borrow@phe.gov.uk Public Health England, Manchester, UK MCC vaccine programme - UK In November 1999,
More informationPotential Impact of Conjugate Vaccine on the Incidence of Invasive Pneumococcal Disease among Children in Scotland
JOURNAL OF CLINICAL MICROBIOLOGY, Apr. 2006, p. 1224 1228 Vol. 44, No. 4 0095-1137/06/$08.00 0 doi:10.1128/jcm.44.4.1224 1228.2006 Copyright 2006, American Society for Microbiology. All Rights Reserved.
More informationHaemophilus influenzae Type b Conjugate Vaccine
Committee on Infectious Diseases Haemophilus influenzae Type b Conjugate Vaccine On Dec 22, 1987, the first conjugate vaccine was licensed by the FDA for the prevention of infections due to Haemophilus
More informationReceived 24 September 2009/Returned for modification 26 October 2009/Accepted 3 November 2009
CLINICAL AND VACCINE IMMUNOLOGY, Jan. 2010, p. 154 159 Vol. 17, No. 1 1556-6811/10/$12.00 doi:10.1128/cvi.00384-09 Copyright 2010, American Society for Microbiology. All Rights Reserved. Kinetics of Antibody
More informationPRODUCT MONOGRAPH. Menactra. Meningococcal (Groups A, C, Y and W-135) Polysaccharide. Diphtheria Toxoid Conjugate Vaccine. Solution for Injection
PRODUCT MONOGRAPH Menactra Meningococcal (Groups A, C, Y and W-135) Polysaccharide Diphtheria Toxoid Conjugate Vaccine Solution for Injection Active Immunizing Agent for the Prevention of Meningococcal
More informationImmunisation Update for Occupational Health
Immunisation Update for Occupational Health Dr Gayatri Amirthalingam Immunisation, Hepatitis & Blood Safety department Public Health England 29 th April 2016 Session Outline Epidemiology of vaccine preventable
More informationMeningococcal Polysaccharide Vaccine Groups A, C, Y and W-135 Combined Menomune A/C/Y/W-135
AHFS Category 80:12 Meningococcal Polysaccharide Vaccine Groups A, C, Y and W-135 Combined Menomune A/C/Y/W-135 Page 1 of 5 Caution: Federal (USA) law prohibits dispensing without prescription. DESCRIPTION
More informationMeningococcal Conjugate (Groups A, C, Y and W-135) Vaccine Biological Page
Meningococcal Conjugate (Groups A, C, Y and W-135) Vaccine Biological Page Section 7: Biological Product Information Standard #: 07.281 Created by: Approved by: Province-wide Immunization Program Standards
More informationSafety and Immunogenicity of Meningococcal A and C Polysaccharide Conjugate Vaccine in Adults
INFECTION AND IMMUNITY, Aug. 1994, p. 3391-3395 Vol. 62, No. 8 0019-9567/94/$04.00 + 0 Copyright 1994, American Society for Microbiology Safety and Immunogenicity of Meningococcal A and C Polysaccharide
More informationPRODUCT MONOGRAPH MENJUGATE. Meningococcal Group C CRM197 Conjugate Vaccine. House Standard. Powder for Suspension. Active Immunizing Agent
PRODUCT MONOGRAPH MENJUGATE Meningococcal Group C CRM197 Conjugate Vaccine House Standard Powder for Suspension Active Immunizing Agent GlaxoSmithKline Inc. 7333 Mississauga Road Mississauga, Ontario L5N
More informationBooster response to the tetanus and diphtheria toxoid carriers of 11-valent pneumococcal conjugate vaccine in adults and toddlers
Vaccine 20 (2002) 336 341 Booster response to the tetanus and diphtheria toxoid carriers of 11-valent pneumococcal conjugate vaccine in adults and toddlers Rose-Marie Ölander a,, Tomi Wuorimaa a, Helena
More informationTo demonstrate that DTPa-HBV-IPV/Hib-MenC-TT co-administered with 10Pn, is non-inferior to DTPa-HBV-IPV/Hib coadministered
The study listed may include approved and non-approved uses, formulations or treatment regimens. The results reported in any single study may not reflect the overall results obtained on studies of a product.
More informationImmunological Characterization of Conjugated Haemophilus influenzae Type b Vaccine Failure in Infants
MAJOR ARTICLE Immunological Characterization of Conjugated Haemophilus influenzae Type b Vaccine Failure in Infants Mijke A. Breukels, 1 Lodewijk Spanjaard, 2 Lieke A. M. Sanders, 1 and Ger T. Rijkers
More informationStudy No.: Title: Rationale: Phase: Study Period: Study Design: Centres: Indication: Treatment: Objectives: Primary Outcome/Efficacy Variable:
The study listed may include approved and non-approved uses, formulations or treatment regimens. The results reported in any single study may not reflect the overall results obtained on studies of a product.
More informationCarbohydrate Based Vaccines
Carbohydrate Based Vaccines READ (on the WEB SITE): Lindberg, A.A. 1999. Glycoprotein vaccines. Vaccine:S28 :S28-S36S36 Weintraub,, A. 2003. Immunology of bacterial polysaccharide antigens. Carbohydr..
More informationStudy No.: Title: Rationale: Phase: Study Periods: Study Design: Centers: Indication: Treatment: Objectives:
The study listed may include approved and non-approved uses, formulations or treatment regimens. The results reported in any single study may not reflect the overall results obtained on studies of a product.
More informationMeningococcal Update. Disclosure. Meningococal and Influenza Vaccines Update! Robert Wittler, MD Sept 12, 2014 KAAP Fall CME Meeting
1 Meningococal and Influenza Vaccines Update! Robert Wittler, MD Sept 12, 2014 KAAP Fall CME Meeting 2 Disclosure Speakers Bureau: Sanofi Pasteur Vaccines and Novartis! I do not intend to discuss an unapproved/
More informationReceived 17 December 1996/Accepted 20 February 1997
INFECTION AND IMMUNITY, May 1997, p. 1710 1715 Vol. 65, No. 5 0019-9567/97/$04.00 0 Copyright 1997, American Society for Microbiology MF59 Adjuvant Enhances Antibody Responses of Infant Baboons Immunized
More informationPRODUCT MONOGRAPH. MENJUGATE Liquid. 10 micrograms suspension for injection. Meningococcal Group C Conjugate Vaccine.
PRODUCT MONOGRAPH MENJUGATE Liquid 10 micrograms suspension for injection Meningococcal Group C Conjugate Vaccine House Standard Suspension for Injection Active Immunizing Agent ATC Code J07A H Sponsor:
More informationNew Jersey Department of Health Vaccine Preventable Disease Program Childhood and Adolescent Recommended Vaccines
New Jersey Department of Health Vaccine Preventable Disease Program Childhood and Adolescent Recommended Vaccines Antigens Vaccine Approved Age Daptacel Diphtheria, Tetanus, and acellular Pertussis (DTaP)
More informationMeningitis B Epidemiology
Recently Licensed Meningitis B Vaccines: Latest Practice Guidelines and Implications Mary Koslap Petraco, DNP PNP BC CPNP FAANP Suffolk County Department of Health Services New York State Immunization
More informationJ. D. HOLMES 1 *, D. MARTIN 2,C.RAMSAY 3,E.YPMA 4 AND P. OSTER 5. (Accepted 19 June 2007; first published online 3 August 2007)
Epidemiol. Infect. (2008), 136, 790 799. f 2007 Cambridge University Press doi:10.1017/s0950268807009211 Printed in the United Kingdom Combined administration of serogroup B meningococcal vaccine and conjugated
More information2/16/2015 IMMUNIZATION UPDATE Kelly Ridgway, RPh February 21, Today s Overview NEW RECOMMENDATIONS
IMMUNIZATION UPDATE 2015 Kelly Ridgway, RPh February 21, 2015 Today s Overview 1 2 3 4 5 6 Pneumococcal Vaccine Recommendations Meningococcal Vaccine Recommendations HPV Vaccine Recommendations Patient
More informationCurrent and future trends in immunization against meningitis
Journal of Antimicrobial Chemotherapy (1993) 31, Suppl. B. 93-99 Current and future trends in immunization against meningitis D. M. Jones Manchester Public Health Laboratory, Withington Hospital, Manchester
More informationPreventative Vaccines. Vaccines for Special Populations. Vaccinations for Adults: An Update. Vaccines Generally Available in the U.S.
Vaccinations for Adults: An Update Preventative Vaccines Need to be extremely safe Even greater issue as disease prevalence wanes or uncommon diseases targeted Lisa G. Winston, MD University of California,
More informationQ21. Where can I find more information on meningococcal disease and vaccines?
FREQUENTLY ASKED QUESTIONS This fact sheet provides responses to some common questions about meningococcal vaccines, focusing on quadrivalent meningococcal conjugate vaccines (4vMenCVs). More detailed
More informationReceived 7 March 2001/Returned for modification 25 June 2001/Accepted 17 August 2001
CLINICAL AND DIAGNOSTIC LABORATORY IMMUNOLOGY, Nov. 2001, p. 1115 1119 Vol. 8, No. 6 1071-412X/01/$04.00 0 DOI: 10.1128/CDLI.8.6.1115 1119.2001 Copyright 2001, American Society for Microbiology. All Rights
More information2018 Adult Immunization Schedule
Centers for Disease Control and Prevention National Center for Immunization and Respiratory Diseases 2018 Adult Immunization Schedule National Adult Immunization Coordinators Partnership Quarterly Meeting
More informationPRODUCT MONOGRAPH NIMENRIX. Meningococcal polysaccharide groups A, C, W-135 and Y conjugate vaccine. Powder and diluent for solution for injection
PRODUCT MONOGRAPH Meningococcal polysaccharide groups A, C, W-135 and Y conjugate vaccine Powder and diluent for solution for injection Active Immunizing Agent Pfizer Canada Inc. 17,300 Trans-Canada Highway
More informationTABULAR FORMAT REFERRING TO PART OF THE DOSSIER Volume: Page:
Title of the study : A phase III, multicentric open study to evaluate the immunological memory induced by a 3-dose primary vaccination followed by a booster dose with GSK Biologicals 11-valent conjugate
More informationStudy No.: Title: Rationale: Phase: Study Period: Study Design Centers: Indication: Treatment: Objectives: Primary Outcome/Efficacy Variable:
The study listed may include approved and non-approved uses, formulations or treatment regimens. The results reported in any single study may not reflect the overall results obtained on studies of a product.
More informationMeningococcal Group C and W135 Immunological Hyporesponsiveness in African Toddlers
CLINICAL AND VACCINE IMMUNOLOGY, Sept. 2011, p. 1492 1496 Vol. 18, No. 9 1556-6811/11/$12.00 doi:10.1128/cvi.05020-11 Copyright 2011, American Society for Microbiology. All Rights Reserved. Meningococcal
More informationAMERICAN ACADEMY OF PEDIATRICS
AMERICAN ACADEMY OF PEDIATRICS Committee on Infectious Diseases Haemophilus influenzae Type b Conjugate Vaccines: Recommendations for Immunization of Infants and Children 2 Months of Age and Older: Update
More informationImmunogenicity of Haemophilus influenzae Type b Conjugate Vaccines in Korean Infants: A Meta-analysis
J Korean Med Sci 2010; 25: 90-6 ISSN 1011-8934 DOI: 10.3346/jkms.2010.25.1.90 Immunogenicity of Haemophilus influenzae Type b Conjugate Vaccines in Korean Infants: A Meta-analysis A meta-analysis was performed
More informationDevelopment of a Group A meningococcal conjugate vaccine for sub-saharan Africa: clinical trial results
Development of a Group A meningococcal conjugate vaccine for sub-saharan Africa: clinical trial results Global Immunization Meeting 2009, United Nations HQ New York City, February 2009 MenA conjugate vaccine
More informationPRODUCT MONOGRAPH MENINGITEC. Meningococcal Serogroup C Conjugate Vaccine (Diphtheria CRM 197 Protein) Suspension For Intramuscular Injection
PRODUCT MONOGRAPH MENINGITEC Meningococcal Serogroup C Conjugate Vaccine (Diphtheria CRM 197 Protein) Suspension For Intramuscular Injection Therapeutic Classification Active Immunizing Agent Nuron Biotech
More informationClinical Trials of Pandemic Vaccines: Key Issues. John Treanor University of Rochester Rochester, NY
Clinical Trials of Pandemic Vaccines: Key Issues John Treanor University of Rochester Rochester, NY Inactivated vaccine approach Proven technology Used successfully in 1957 and 1968 Abundant efficacy data
More informationREVIEW. Carbohydrate protein conjugate vaccines G. Ada 1 and D. Isaacs 2. Australia
REVIEW Carbohydrate protein conjugate vaccines G. Ada 1 and D. Isaacs 2 1 John Curtin School of Medical Research, Australian National University, Canberra, ACT and 2 Department of Immunology and Infectious
More informationImmunization Update: New CDC Recommendations. Blaise L. Congeni M.D. 2012
Immunization Update: New CDC Recommendations Blaise L. Congeni M.D. 2012 Polysaccharide Vaccines Vaccine Hib capsule polysaccharide PRP (polyribose ribitol phosphate) Not protective in infants
More informationSee 17 for PATIENT COUNSELING INFORMATION. Revised: xx/2012
HIGHLIGHTS OF PRESCRIBING INFORMATION These highlights do not include all the information needed to use MENHIBRIX safely and effectively. See full prescribing information for MENHIBRIX. MENHIBRIX (Meningococcal
More informationInvasive Meningococcal Disease - prevention through vaccination
Invasive Meningococcal Disease - prevention through vaccination Dr Shamez Ladhani Paediatric Infectious Diseases Consultant Public Health England Email: shamez.ladhani@phe.gov.uk a pain you cannot describe
More informationFULL PRESCRIBING INFORMATION: CONTENTS*
HIGHLIGHTS OF PRESCRIBING INFORMATION These highlights do not include all the information needed to use TRUMENBA safely and effectively. See full prescribing information for TRUMENBA. TRUMENBA (Meningococcal
More informationMEDICAL ASSISTANCE BULLETIN
ISSUE DATE August 30, 2010 EFFECTIVE DATE August 30, 2010 MEDICAL ASSISTANCE BULLETIN NUMBER 01-10-27, 08-10-28, 09-10-29, 31-10-30, 33-10-05 SUBJECT: Updates to the Medical Assistance Program Fee Schedule
More informationWHAT S NEW WITH VACCINATIONS IN 2016?
WHAT S NEW WITH VACCINATIONS IN 2016? MenB and a Few Other Changes Lynn Bahta, RN, PHN Immunization Clinical Consultant Minnesota Department of Health May 2016 Disclosure No conflict of interest Will discuss
More informationInvasive Meningococcal Disease - prevention through vaccination
Invasive Meningococcal Disease - prevention through vaccination Dr Shamez Ladhani Paediatric Infectious Diseases Consultant Public Health England Email: shamez.ladhani@phe.gov.uk a pain you cannot describe
More informationManitoba Health, Healthy Living and Seniors
Manitoba Health, Healthy Living and Seniors Manitoba Annual Immunization Surveillance Report, 2012 and 2013 January 1, 2012 to December 31, 2013 with 5-year average comparison (January 1, 2007 to December
More informationChanges to the meningococcal C conjugate (MenC) vaccine schedule Information for healthcare professionals
Changes to the meningococcal C conjugate (MenC) vaccine schedule 2013-2015 Information for healthcare professionals 1 About Public Health England Public Health England s mission is to protect and improve
More informationMENVEO powder and solvent for solution for injection Meningococcal (Groups A, C, W-135 and Y) Oligosaccharide CRM197 Conjugate Vaccine
1 NAME OF THE MEDICINE powder and solvent for solution for injection Meningococcal (Groups A, C, W-135 and Y) Oligosaccharide CRM197 Conjugate Vaccine Pharmacotherapeutic group: Meningococcal vaccines,
More informationPolysaccharide and conjugate vaccine responses
Hyporesponsiveness Kim Mulholland Murdoch Childrens Research Institute, Melbourne London School of Hygiene and Tropical Medicine, UK University of Melbourne, Australia Hyporesponsiveness Reduced or absent
More informationvaccination. Children enrolled in these clusters between 6 weeks and 6 months of age received a 2-dose primary vaccination schedule.
The study listed may include approved and non-approved uses, formulations or treatment regimens. The results reported in any single study may not reflect the overall results obtained on studies of a product.
More information1.3 Meningococcal Disease (Neisseria meningitidis) (invasive)
1.3 Meningococcal Disease (Neisseria meningitidis) (invasive) Summary Number of cases, 214: 82 Number of cases, 213: 81 Number of cases, 212: 66 Crude incidence rate, 214:1.8/1, Between and 212, a marked
More informationPneumococcal vaccination in UK: an update. Dr Richard Pebody Immunisation Department Health Protection Agency Centre for Infections
Pneumococcal vaccination in UK: an update Dr Richard Pebody Immunisation Department Health Protection Agency Centre for Infections Leading infectious causes of mortality, 2000 WHO estimates 3.5 Deaths
More informationIntroduction of a meningococcal ACWY immunisation programme for adolescents
Introduction of a meningococcal ACWY immunisation programme for adolescents Information for registered healthcare practitioners Acknowledgement: This resource has been adapted with the permission of Public
More informationThe New England Journal of Medicine BACTERIAL MENINGITIS IN THE UNITED STATES IN 1995
BACTERIAL MENINGITIS IN THE UNITED STATES IN 1995 ANNE SCHUCHAT, M.D., KATHERINE ROBINSON, M.P.H., JAY D. WENGER, M.D., LEE H. HARRISON, M.D., MONICA FARLEY, M.D., ARTHUR L. REINGOLD, M.D., LEWIS LEFKOWITZ,
More informationHaemophilus influenzae Type b Reemergence after Combination Immunization
Haemophilus influenzae Type b Reemergence after Combination Immunization Nik G. Johnson,* Jens U. Ruggeberg,* Gail F. Balfour,* Y. Chen Lee, Helen Liddy, Diane Irving, Joanna Sheldon, Mary P.E. Slack,
More informationMeningococcal disease and vaccination in the UK
Meningococcal disease and vaccination in the UK Ray Borrow Professor of Vaccine Preventable Diseases, Vaccine Evaluation Unit, Health Protection Agency, Manchester Royal Infirmary, Manchester, U.K. ray.borrow@hpa.org.uk
More informationVaccinations for Adults
Case: Vaccinations for Adults Lisa Winston, MD University of California, San Francisco San Francisco General Hospital A 30-year old healthy woman comes for a routine visit. She is recently married and
More informationEvaluation of Serogroup A Meningococcal Vaccines in Africa: A Demonstration Project
J HEALTH POPUL NUTR 2004 Sep;22(3):275-285 2004 ICDDR,B: Centre for Health and Population Research ISSN 1606-0997 $ 5.00+0.20 Evaluation of Serogroup A Meningococcal Vaccines in Africa: A Demonstration
More informationA Licensed Combined Haemophilus influenzae Type b- Serogroups C and Y Meningococcal Conjugate Vaccine
Infect Dis Ther (2013) 2:1 13 DOI 10.1007/s40121-013-0007-5 REVIEW A Licensed Combined Haemophilus influenzae Type b- Serogroups C and Y Meningococcal Conjugate Vaccine Kirsten P. Perrett Terry M. Nolan
More informationPrevention of Meningococcal Disease. Marco Aurélio P. Sáfadi, MD, PhD FCM da Santa Casa de São Paulo
Prevention of Meningococcal Disease Marco Aurélio P. Sáfadi, MD, PhD FCM da Santa Casa de São Paulo Outline of the presentation Brief overview on the burden of MD Lessons learned with plain polysaccharide
More informationMeningococcal Education Program for Quebec Physicians: How Results Have Changed 2 Years after the Initial Program
Meningococcal Education Program for Quebec Physicians: How Results Have Changed 2 Years after the Initial Program Marc H. Lebel, MD, FRCPC John Yaremko, MD, FRCPC Anne Dionne, MD, FRCPC Anne-Julie Gaudreau,
More informationAppendix An Assessment Tool to Determine the Validity of Vaccine Doses
Appendix 4.4 - An Assessment Tool to Determine the Validity of Vaccine Doses Note: Refer to the Canadian Immunization Guide and New Brunswick (NB) immunization program directives for recommendations for
More informationImmunization Report Public Health September 2013
Immunization Report Public Health September 2013 Daycare, school entry and school program immunization enrollment rates, up to 2012 Table of Contents 1. Introduction... 2 2. Data Source... 2 3. Limitations...
More informationPrevention of Meningococcal Disease
The new england journal of medicine clinical practice Prevention of Meningococcal Disease Pierce Gardner, M.D. This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence
More informationAdult Vaccine Update. NB Internal Medicine Update, April 22 nd, 2016 Dan Smyth, MD, FRCPC, DTMH
Adult Vaccine Update NB Internal Medicine Update, April 22 nd, 2016 Dan Smyth, MD, FRCPC, DTMH Summary points: Canadian adults > 18 should be regularly assessed to ensure recommended vaccinations are up
More informationJ O U R N A L C L U B
J O U R N A L C L U B Immunogenicity and Safety of a Heptavalent (Diphtheria, Tetanus, Pertussis, Hepatitis B, Poliomyelitis, Haemophilus influenzae b, and Meningococcal Serogroup C) Vaccine SOURCE CITATION:
More informationBackground Rationale of resource Please note:
Background In 2010, the Joint Committee on Vaccination and Immunisation (JCVI) convened a meningococcal subcommittee to conduct a comprehensive and detailed assessment of the evidence on the meningococcal
More informationVaccines, Not Just for Babies
Vaccines, Not Just for Babies Meg Fisher, MD Medical Director Disclosures I have no relevant financial relationships with the manufacturers of any commercial products or commercial services discussed in
More informationNOTE: The above recommendations must be read along with the footnotes of this schedule.
Figure 1. Recommended immunization schedule for persons aged 0 through 18 years 2013. (FOR THOSE WHO FALL BEHIND OR START LATE, SEE THE CATCH-UP SCHEDULE [FIGURE 2]). These recommendations must be read
More informationHemagglutinin Neuraminidase
Evolving Vaccine Guidance: Influenza, Meningococcal & HPV Vaccines H. Cody Meissner, M.D. Professor of Pediatrics Tufts University School of Medicine Maine Chapter AAP Bar Harbor, Maine October 16, 2016
More informationAntibody Persistence 1 5 Years Following Vaccination With MenAfriVac in African Children Vaccinated at Months of Age
SUPPLEMENT ARTICLE Antibody Persistence 1 5 Years Following Vaccination With MenAfriVac in African Children Vaccinated at 12 23 Months of Age Milagritos D. Tapia, 1 Helen Findlow, 2 Olubukola T. Idoko,
More informationS. Michael Marcy Memorial Lecture
S. Michael Marcy Memorial Lecture Lessons Learned from Making Vaccine Recommendations Larry K. Pickering, MD, FAAP April 16, 2016 Los Angeles, CA FINANCIAL DISCLOSURE: Larry K. Pickering, M.D., F.A.A.P.
More information