MAINTENNANCE OF IMMUNE RESPONSE THROUGHOUT CHILDHOOD FOLLOWING SEROGROUP C MENINGOCOCCAL CONJUGATE VACCINATION IN EARLY CHILDHOOD
ESPID Education. Khatami A. Jun 7, 2011; 7771
Dr. Ameneh Khatami
Dr. Ameneh Khatami

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MAINTENNANCE OF IMMUNE RESPONSE THROUGHOUT CHILDHOOD FOLLOWING SEROGROUP C MENINGOCOCCAL CONJUGATE VACCINATION IN EARLY CHILDHOOD
Khatami A, Peters A, Robinson H, Thompson A, Findlow H, Pollard AJ,Snape MD.

Background: Serogroup C meningococcal (MenC) conjugate vaccines were introduced into the UK routine infant immunisation schedule in 1999, along with a “catch-up” campaign for those aged 1-25 years. Previous cross-sectional studies demonstrated children immunised in early childhood have lower MenC bactericidal antibody 5 years after immunisation than children immunised in late childhood, however the kinetics of antibody decline through childhood have not been evaluated in a longitudinal study of a single cohort.

Methods: Stored sera obtained at multiple time-points between 2001 and 2010 from children who had received a single dose of MenC vaccine at age 1 to 3.5 years, were analysed for MenC serum bactericidal antibody using rabbit complement (rSBA).

Results: The MenC rSBA geometric mean titre (GMT) at age 3.5 to 5 years, approximately one year after immunisation, was 8.0 (95% confidence interval [CI] 6.5 – 9.9, n = 292). Over the subsequent 9 years, rSBA GMT declined to 3.3 (CI 2.5 – 4.4, n = 98) at age 11.5-13.5 years. The percentage of children with rSBA titres >1:8 (threshold for protection) also declined from 38% (CI 35% – 41%) to 15% (CI 12% – 19%).

Conclusion: MenC rSBA titres wane rapidly following vaccination in early childhood, without evidence of natural boosting of antibody levels through cross-reactive antigens. In the UK, consideration should be given to a routine adolescent booster of MenC vaccine to protect this cohort of children who are entering the potentially high risk period of adolescence, and to prevent a resurgence in nasopharyngeal carriage and maintain herd immunity.
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