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Reactogenicity and immunogenicity of combined vaccines for bacteraemic diseases caused by Haemophilus influenzae type b, meningococci and pneumococci in 24-month-old children.

To find a wide spectrum vaccine against bacteraemic disease in childhood, we immunized 293 Finnish children at 24 months of age intramuscularly with different combinations of the currently available vaccines, namely Haemophilus influenzae type b polysaccharide-protein conjugate vaccine (PRP-D) mixed with meningococcal and/or pneumococcal capsular polysaccharide vaccines. All the vaccines were immunogenic. The increase in antibody concentration after vaccinations was not affected by the number of polysaccharide antigens. Although no serious reactions were seen, the frequency of both local and fever reactions was greater in groups that received several vaccine antigens. Halving of the vaccine dose decreased the reactogenicity without impairing the immunogenicity.

Bacterial Infections↗

Validation of the serum bactericidal assay for measurement of functional antibodies against group B meningococci associated with vaccine trials.

Provisional licensure of the trial vaccine, MeNZB, required demonstration of immune responses in vaccines, as measured by a validated Serum Bactericidal Assay (SBA). Reported are the investigations undertaken to define test parameters, lower limits of quantitation and measurement of SBA reproducibility. Results helped to formulate the operating procedure for the measurement of serum bactericidal antibodies during six age-group MeNZB vaccine trials. The lower limit of quantitation was determined as a titre of 4. A four-fold rise in antibody (sero-conversion) from a pre-vaccination titre of 2 (<4) required a minimum post-vaccination titre of 8, a more stringent measurement than has been used in other published studies.

Antibodies, Bacterial↗

Underestimation of meningococci in tonsillar tissue by nasopharyngeal swabbing.

The relation between carriage of Neisseria meningitidis and progression to invasive disease is not fully understood. We assessed the rate of N. meningitidis carriage by conventional swabbing and immunohistochemistry in patients undergoing tonsillectomy. Swabbing detected only a quarter of carriers, and bacteria were identified beneath the mucosal surface in tonsillar tissue by immunochemical testing. Our results indicate that N. meningitidis is more widespread in the population than previously thought, and have broad implications for disease prevention and cure.

Adolescent↗

Production of low-avidity antibody by infants after infection with serogroup B meningococci.

Experimental serogroup B meningococcal vaccines have induced only poor immune responses and have had little protective efficacy in children younger than 1 year of age. We used ELISA with potassium thiocyanate to compare the average avidity of antibody produced by infants with that of children older than 10 years after systemic disease. Infants produced specific antibody of lower average avidity than older children--a finding that correlates with absence of serum bactericidal activity in the serum samples of the same infants.

Age Factors↗