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1.
J Infect Dis ; 184(10): 1293-9, 2001 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-11679918

RESUMO

We compared the antibody response to Haemophilus influenzae type b capsular polysaccharide (PRP) after 1, 2, or 3 doses of a diphtheria-tetanus toxoids-acellular pertussis (DTaP) vaccine combined with a PRP-tetanus conjugate (PRP-T) vaccine, followed by separate injections of DTaP and PRP-T vaccines for the last 1 or 2 doses. Healthy infants were recruited from pediatric practices and were immunized according to recommended schedules. A significant decrease in the mean anti-PRP (from 5.25 to 2.68 microg/mL) and anti-tetanus toxoid antibody responses (from 0.13 to 0.09 Eq/mL) was observed as the number of doses of the DTaP/PRP-T combination vaccine increased (P<.02 and P=.01, respectively). In contrast, the mean anti-diphtheria toxoid antibody response increased with increasing numbers of DTaP/PRP-T doses (P=.0001). The effects of interference were not eliminated by the completion of the primary series with 1 or 2 doses of the DTaP and PRP-T vaccines given separately.


Assuntos
Anticorpos Antibacterianos/análise , Anticorpos Antivirais/análise , Vacinas contra Difteria, Tétano e Coqueluche Acelular/administração & dosagem , Vacinas Anti-Haemophilus/administração & dosagem , Toxoide Tetânico/administração & dosagem , Vacinação , Difteria/prevenção & controle , Toxoide Diftérico/imunologia , Vacinas contra Difteria, Tétano e Coqueluche Acelular/imunologia , Relação Dose-Resposta Imunológica , Feminino , Infecções por Haemophilus/prevenção & controle , Vacinas Anti-Haemophilus/imunologia , Humanos , Lactente , Masculino , Vacina Antipólio de Vírus Inativado/administração & dosagem , Vacina Antipólio de Vírus Inativado/imunologia , Vacina Antipólio Oral/administração & dosagem , Vacina Antipólio Oral/imunologia , Tétano/prevenção & controle , Toxoide Tetânico/imunologia , Vacinas Conjugadas/administração & dosagem , Coqueluche/prevenção & controle
2.
Pediatr Infect Dis J ; 19(8): 710-7, 2000 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-10959738

RESUMO

BACKGROUND: We compared the antibody response to Haemophilus influenzae type b capsular polysaccharide (PRP) after three doses of a diphtheria toxoid, tetanus toxoid and acellular pertussis vaccine (DTaP) combined with a PRP-tetanus conjugate (PRP-T) in infants randomized to receive oral polio vaccine (OPV) or inactivated polio vaccine (IPV). The polio vaccine was given separately at the same visit. METHODS: Three hundred fifty-six infants from pediatric practices in suburban Chicago and New Orleans were randomized into two groups. Group A received OPV at 2 and 4 months of age; Group B received IPV at 2 and 4 months of age. Both groups received DTaP/PRP-T at 2, 4 and 6 months of age and hepatitis B vaccine at 2 and 4 months of age. A serum sample was obtained before immunization (age 2 months) and 1 month after 3 doses of DTaP/PRP-T (age 7 months). Sera were assayed for antibody responses to all relevant vaccine antigens. RESULTS: No significant vaccine antigen interference was found when polio immunization was provided by IPV or OPV for anti-PRP, diphtheria, tetanus or pertussis antibodies. OPV recipients had a significantly higher mean antibody response to serotype 1 (P = 0.03) and 2 (P = 0.0001) poliovirus. CONCLUSION: Whether polio immunization was accomplished with IPV or OPV did not significantly influence the antibody responses in sera obtained at 7 months of age for anti-PRP, anti-diphtheria and anti-tetanus toxoid antibodies and antibodies to pertussis antigens, when DTaP/PRP-T was given in the primary series.


Assuntos
Anticorpos Antibacterianos/imunologia , Anticorpos Antivirais/imunologia , Vacinas contra Difteria, Tétano e Coqueluche Acelular/administração & dosagem , Vacinas Anti-Haemophilus/administração & dosagem , Imunidade/fisiologia , Vacina Antipólio de Vírus Inativado/administração & dosagem , Vacina Antipólio Oral/administração & dosagem , Anticorpos Antibacterianos/análise , Anticorpos Antivirais/análise , Difteria/imunologia , Difteria/prevenção & controle , Feminino , Seguimentos , Humanos , Esquemas de Imunização , Lactente , Injeções Intramusculares , Masculino , Poliomielite/imunologia , Poliomielite/prevenção & controle , Tétano/imunologia , Tétano/prevenção & controle , Vacinas Combinadas/administração & dosagem , Coqueluche/imunologia , Coqueluche/prevenção & controle
3.
Pediatrics ; 98(5): 898-904, 1996 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-8909483

RESUMO

OBJECTIVE: To evaluate two- or three-dose "mixed" regimens of Haemophilus influenzae type b conjugate vaccines in the priming series. DESIGN: Two randomized clinical trials with 140 and 181 infants, respectively. SETTING: Private practices in New Orleans and Chicago. METHODS: In trial I, infants received one of four regimens. Two were recommended regimens for polyribosylribitol phosphate (PRP)-meningococcal protein conjugate (M) and PRP-tetanus toxoid conjugate (T). Two mixed regimens consisted of M at 2 months followed by two doses of T or PRP-diphtheria toxoid conjugate (D) at 4 and 6 months. Trial II consisted of three groups. Two were recommended regimens for M and T. The third was a two-dose mixed regimen consisting of M at 2 months and T at 4 months. Parents were interviewed and instructed to record side effects after each vaccination. Serum was assayed for H influenzae type b anticapsular antibody (anti-PRP). RESULTS: Minor differences in safety profiles likely reflected alpha error. In trial I, M (lot 0884T, one of several known to have had decreased immunogenicity), probably primed for substantial increase in serum antibody when D or T was given at 4 and 6 months. In trial II, infants who received the two-dose mixed regimen (M from immunogenic lot 0116W at 2 months and T at 4 months) had a significantly higher mean area under the curve than recipients of the three-dose TTT regimen when antibody concentration was plotted against age, although the geometric mean anti-PRP antibody concentration for the MT-recipients was significantly lower at 7 months. CONCLUSIONS: M used in trial I may have primed infants despite poor immunogenicity. The two-dose mixed regimen (MT-) in trial II produced a mean anti-PRP antibody concentration with higher sustained anti-PRP concentrations from 2 to 7 months, as judged by the area under the curve, but a lower mean anti-PRP antibody concentration at 7 months.


Assuntos
Toxoide Diftérico/administração & dosagem , Vacinas Anti-Haemophilus/administração & dosagem , Polissacarídeos Bacterianos/administração & dosagem , Polissacarídeos/administração & dosagem , Toxoide Tetânico/administração & dosagem , Anticorpos Antibacterianos/sangue , Formação de Anticorpos , Cápsulas Bacterianas/imunologia , Vacinas Bacterianas/administração & dosagem , Vacinas Bacterianas/efeitos adversos , Toxoide Diftérico/efeitos adversos , Feminino , Vacinas Anti-Haemophilus/efeitos adversos , Haemophilus influenzae/imunologia , Humanos , Esquemas de Imunização , Lactente , Masculino , Vacinas Meningocócicas , Polissacarídeos/efeitos adversos , Polissacarídeos Bacterianos/efeitos adversos , Toxoide Tetânico/efeitos adversos , Vacinas Conjugadas/administração & dosagem , Vacinas Conjugadas/efeitos adversos
4.
Pediatrics ; 95(4): 522-7, 1995 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-7700752

RESUMO

OBJECTIVE: To evaluate whether combining Haemophilus influenzae type b capsular polysaccharide covalently linked to tetanus toxoid (PRP-T) and diphtheria-tetanus-pertussis (DTP) in one syringe produced a vaccine that was safe and immunogenic. DESIGN: Randomized clinical trial. SETTING: Suburban New Orleans pediatric population. PARTICIPANTS: Convenience sample of 150 healthy infants. METHODS: Enrollees were randomized to receive DTP and PRP-T in one injection (Group 1), DTP and PRP-T separately (Group 2), or DTP and H influenzae type b capsular saccharide coupled to a nontoxic variant of diphtheria toxin, CRM197 (HbOC) separately (Group 3) at 2, 4, and 6 months of age. All infants received oral polio vaccine at 2 and 4 months of age. Parents were instructed to record side effects on a standardized form after each vaccine administration. Blood was drawn before each immunization and at 7 months of age; an additional blood and a urine specimen was obtained 2 to 3 days after one of the vaccination visits. Serum was assayed for H influenzae anticapsular antibody (anti-PRP), anti-pertussis toxoid, anti-fimbrial hemagglutinins, anti-diphtheria and anti-tetanus toxoid antibodies, and antibody to polio viruses. Urine was assayed for H influenzae type b capsular polysaccharide. RESULTS: The rate of occurrence of fever did not differ significantly between groups. Local swelling and erythema occurred more often at the administration site in Group 1 infants than at the DTP administration sites of infants in Groups 2 and 3 after the first and second vaccinations. The mean concentration of all antibodies we assayed did not differ significantly when Group 1 and 2 infants were compared. HbOC recipients (Group 3) had lower mean anti-H influenzae anticapsular antibody and higher mean anti-diphtheria and anti-tetanus antibody concentrations after two and three doses compared with Group 1 and Group 2 infants. No group had a significant change in mean anti-PRP antibody concentration 2 to 3 days after vaccination with any dose. After vaccination, antigenuria occurred less frequently in Group 1 infants (54%, 78%, and 72% in Groups 1, 2, and 3, respectively, P < .01). CONCLUSIONS: Combining PRP-T and DTP produced a combination vaccine associated with a slight increase in the rate of erythema and swelling but with similar immunogenicity of the vaccine components and oral polio vaccine.


Assuntos
Anticorpos Antibacterianos/sangue , Vacina contra Difteria, Tétano e Coqueluche/administração & dosagem , Vacinas Anti-Haemophilus/administração & dosagem , Toxoide Tetânico/administração & dosagem , Vacinas Conjugadas/administração & dosagem , Cápsulas Bacterianas/imunologia , Cápsulas Bacterianas/urina , Proteínas de Bactérias/administração & dosagem , Toxoide Diftérico/imunologia , Vacina contra Difteria, Tétano e Coqueluche/efeitos adversos , Vacina contra Difteria, Tétano e Coqueluche/imunologia , Vacinas Anti-Haemophilus/efeitos adversos , Vacinas Anti-Haemophilus/imunologia , Haemophilus influenzae/imunologia , Humanos , Lactente , Polissacarídeos Bacterianos/urina , Toxoide Tetânico/efeitos adversos , Toxoide Tetânico/imunologia , Vacinas Conjugadas/efeitos adversos , Vacinas Conjugadas/imunologia , Vacinas Sintéticas/administração & dosagem , Fatores de Virulência de Bordetella/imunologia
5.
J Infect Dis ; 164(6): 1154-9, 1991 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-1955715

RESUMO

Eight healthy adults and 48 infants 2 and 4 months old were immunized with Haemophilus influenzae type b-Neisseria meningitidis outer membrane protein complex conjugate vaccine (PRP-OMP) to evaluate antibody kinetics in the first days after immunization. Five adults (63%) had some decrease in antibody, although the geometric mean did not decrease significantly. With one exception, the nadir occurred on postimmunization day 3. Seven had an antibody increase by day 7. Of the children, 6 (75%) of 8 and 17 (77%) of 23 had a decrease in antibody in serum obtained on day 2-3 after the first or second dose, respectively, the magnitude of which directly correlated with the preimmunization antibody concentration. However, the geometric mean did not decrease significantly. Within 1 week of immunization, 85% of infants had an increase in antibody, significantly greater after the second dose than after the first. A high concentration of maternally derived antibody before immunization correlated negatively with antibody response. Thus, a transient decrease in antibody occurs in most adults and infants 2-3 days after immunization with PRP-OMP followed by a prompt increase by day 7.


Assuntos
Anticorpos Antibacterianos/biossíntese , Proteínas da Membrana Bacteriana Externa/imunologia , Vacinas Bacterianas/imunologia , Vacinas Anti-Haemophilus , Polissacarídeos Bacterianos/imunologia , Adulto , Fatores Etários , Anticorpos Antibacterianos/sangue , Humanos , Imunidade Materno-Adquirida , Imunização , Imunização Secundária , Lactente , Cinética , Vacinas Sintéticas/imunologia
7.
J Pediatr ; 119(2): 194-204, 1991 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-1907317

RESUMO

In a multicenter, double-blind, randomized, longitudinal study, 252 children received licensed Lederle diphtheria-tetanus toxoids and pertussis vaccine adsorbed (DTP) at 2, 4, and 6 months of age, and 245 children received a DTP vaccine with the Lederle/Takeda acellular pertussis component (APDT) at the same ages. Both groups of children received APDT vaccine at 18 months of age. After each of the first three immunizations, APDT vaccine recipients had fewer local and systemic reactions than did DTP vaccinees. Reactions after the 18-month APDT vaccination were minimal in severity regardless of the vaccine previously received. Antibody responses to lymphocytosis-promoting factor and agglutinogens were more pronounced in DTP recipients; however, APDT recipients had a better serologic response to filamentous hemagglutinin, and responses to the 69K protein were equivalent. This APDT vaccine produces fewer reactions than the standard whole-cell DTP vaccine. The protective significance of the serologic responses to the APDT vaccine is unknown, but the greater response to filamentous hemagglutinin and equivalent response to the 69K protein compared with those to DTP vaccine seem promising.


Assuntos
Vacina contra Difteria, Tétano e Coqueluche/imunologia , Testes de Aglutinação , Anticorpos Antibacterianos/sangue , Bordetella pertussis/imunologia , Clostridium tetani/imunologia , Corynebacterium diphtheriae/imunologia , Vacina contra Difteria, Tétano e Coqueluche/administração & dosagem , Vacina contra Difteria, Tétano e Coqueluche/efeitos adversos , Relação Dose-Resposta Imunológica , Método Duplo-Cego , Ensaio de Imunoadsorção Enzimática , Humanos , Lactente , Estudos Longitudinais , Fatores de Tempo
8.
J Infect Dis ; 161(3): 574-7, 1990 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-2107266

RESUMO

The occurrence of Haemophilus influenzae type b capsular polysaccharide antigenemia and antigenuria following immunization was studied in 48 healthy 2-month-old infants. Each received a conjugate vaccine consisting of H. influenzae type b capsular polysaccharide covalently linked to Neisseria meningitidis serotype b outer membrane protein at 2 and 4 months of age. Infants were alternated at enrollment for collection of blood and urine after either the first or second dose. Specimens were obtained "early" (2-3 days) after immunization and "late" (7 days) after immunization and assayed for antigen. Antigen was detected in the serum of 3 (6%) of 48 infants, uniformly in the "early" specimen obtained after the first dose of vaccine. Antigenuria occurred in 37 (80%) of 46 infants; for greater than or equal to 7 days in 12 (26%). Antigenuria was frequent after administration of the vaccine but antigenemia was not. These data should be considered in the evaluation of an infant with suspected H. influenzae type b invasive disease.


Assuntos
Antígenos de Bactérias/análise , Proteínas da Membrana Bacteriana Externa/imunologia , Vacinas Bacterianas/imunologia , Vacinas Anti-Haemophilus , Haemophilus influenzae/imunologia , Neisseria meningitidis/imunologia , Polissacarídeos Bacterianos , Fatores Etários , Antígenos de Bactérias/urina , Cápsulas Bacterianas , Feminino , Humanos , Lactente , Masculino , Vacinação
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