THE IMPACT OF AGE AT VACCINATION ON INFANT VACCINE RESPONSES: AN ANALYSIS OF IMMUNITY IN 7630 CHILDREN
ESPID Education. Voysey M. May 26, 2017; 179668
Disclosure(s): Merryn Voysey is funded by a National Institute for Health Research Doctoral Research Fellowship (DRF-2015-08-048)
Merryn Voysey
Merryn Voysey

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Abstract
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Background
Global infant immunisation programmes vary in the age at which infants are first vaccinated. The magnitude of the infant antibody response to vaccination is thought to be affected by the age of the infant and the level of maternal antibody present at the time of vaccination. Since trans-placentally acquired antibody decays over time, the interference with vaccine responses reduces with age and observed age effects on vaccine responses may therefore be due to reduced maternal antibody interference.
Methods
We conducted an analysis of serology from vaccine trials in infants. We assessed the effect of age at vaccination on antibody responses to both priming and booster doses of most vaccines included in global infant immunisation programmes.
Results
A total of 7630 infants from 17 countries had pre-vaccination sera available for at least one antigen. For antibodies against 18 out of the 21 antigens studied, children who were older when initially immunised had significantly higher vaccine responses, with between 10% and 71% higher post-vaccination antibody per additional month of age. These effects were independent of the level of pre-existing antibody. For diphtheria, pertussis antigens PT and FHA, inactivated polio and 5/10 (50%) serotypes of pneumococcus, the age at first vaccination had a persistent positive effect on post-booster antibody levels.
Conclusions
A delay in age at first immunisation results in a combined beneficial effect on immunogenicity due to a reduction in maternal antibody interference associated with antibody decay, and an increase in infant age. A delayed start immunisation policy may be a cost-effective method of enhancing vaccine responses in infants and be of particular benefit for countries with prenatal immunisation programmes.
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