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Meningococcal serogroup C immunogenicity, antibody persistence and memory B-cells induced by the monovalent meningococcal serogroup C versus quadrivalent meningococcal serogroup ACWY conjugate booster vaccine: A randomized controlled trial.
Vaccine. 2017 08 24; 35(36):4745-4752.V

Abstract

BACKGROUND

Adolescents are considered the key transmitters of meningococci in the population. Meningococcal serogroup C (MenC) antibody levels wane rapidly after MenC conjugate vaccination in young children, leaving adolescents with low antibody levels. In this study, we compared MenC immune responses after booster vaccination in adolescence with either tetanus toxoid conjugated MenC (MenC-TT) or MenACWY (MenACWY-TT) vaccine, and aimed to establish an optimal age for this booster.

METHODS

Healthy 10-, 12-, and 15-year-olds, who received a single dose of MenC-TT vaccine in early childhood, were randomized to receive MenC-TT or MenACWY-TT vaccine. MenC serum bactericidal antibody (rSBA) titers, MenC polysaccharide (PS) specific IgG, IgG1 and IgG2 and MenC-specific IgG and IgA memory B-cells were determined before, one month and one year after the booster. Non-inferiority was tested by comparing geometric mean titers (GMTs) between vaccinees at one year.

RESULTS

Of 501 participants, 464 (92.6%) were included in the 'according to protocol' cohort analysis. At one month, all participants developed high MenC rSBA titers (>24,000 in all groups) and MenC-PS-specific IgG levels. Non-inferiority was not demonstrated one year after the booster with higher MenC GMTs after the monovalent vaccine, but 462/464 (99.6%) participants maintained protective MenC rSBA titers. IgG levels mainly consisted of IgG1, but similar levels of increase were observed for IgG1 and IgG2. Both vaccines induced a clear increase in the number of circulating MenC-PS specific IgG and IgA memory B-cells. Between one month and one year, the highest antibody decay rate was observed in the 10-year-olds.

CONCLUSION

Both MenC-TT and MenACWY-TT vaccines induced robust protective MenC immune responses after the booster vaccination, although non-inferiority could not be demonstrated for the MenACWY-TT vaccine after one year. Our results underline the importance of optimal timing of a meningococcal booster vaccination to protect against MenC disease in the long-term.

Authors+Show Affiliations

Centre for Infectious Disease Control (Cib), National Institute of Public Health and the Environment (RIVM), Bilthoven, The Netherlands; Department of Pediatric Immunology and Infectious Diseases, Wilhelmina Children's Hospital, University Medical Center, Utrecht, The Netherlands. Electronic address: mariette.van.ravenhorst@rivm.nl.Centre for Infectious Disease Control (Cib), National Institute of Public Health and the Environment (RIVM), Bilthoven, The Netherlands.Centre for Infectious Disease Control (Cib), National Institute of Public Health and the Environment (RIVM), Bilthoven, The Netherlands.Centre for Infectious Disease Control (Cib), National Institute of Public Health and the Environment (RIVM), Bilthoven, The Netherlands.Department of Medical Microbiology and Infection Control, VU University Medical Center, The Netherlands.Centre for Infectious Disease Control (Cib), National Institute of Public Health and the Environment (RIVM), Bilthoven, The Netherlands; Department of Pediatric Immunology and Infectious Diseases, Wilhelmina Children's Hospital, University Medical Center, Utrecht, The Netherlands.Centre for Infectious Disease Control (Cib), National Institute of Public Health and the Environment (RIVM), Bilthoven, The Netherlands. Electronic address: guy.berbers@rivm.nl.

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

28668575

Citation

van Ravenhorst, Mariëtte B., et al. "Meningococcal Serogroup C Immunogenicity, Antibody Persistence and Memory B-cells Induced By the Monovalent Meningococcal Serogroup C Versus Quadrivalent Meningococcal Serogroup ACWY Conjugate Booster Vaccine: a Randomized Controlled Trial." Vaccine, vol. 35, no. 36, 2017, pp. 4745-4752.
van Ravenhorst MB, van der Klis FRM, van Rooijen DM, et al. Meningococcal serogroup C immunogenicity, antibody persistence and memory B-cells induced by the monovalent meningococcal serogroup C versus quadrivalent meningococcal serogroup ACWY conjugate booster vaccine: A randomized controlled trial. Vaccine. 2017;35(36):4745-4752.
van Ravenhorst, M. B., van der Klis, F. R. M., van Rooijen, D. M., Knol, M. J., Stoof, S. P., Sanders, E. A. M., & Berbers, G. A. M. (2017). Meningococcal serogroup C immunogenicity, antibody persistence and memory B-cells induced by the monovalent meningococcal serogroup C versus quadrivalent meningococcal serogroup ACWY conjugate booster vaccine: A randomized controlled trial. Vaccine, 35(36), 4745-4752. https://doi.org/10.1016/j.vaccine.2017.06.053
van Ravenhorst MB, et al. Meningococcal Serogroup C Immunogenicity, Antibody Persistence and Memory B-cells Induced By the Monovalent Meningococcal Serogroup C Versus Quadrivalent Meningococcal Serogroup ACWY Conjugate Booster Vaccine: a Randomized Controlled Trial. Vaccine. 2017 08 24;35(36):4745-4752. PubMed PMID: 28668575.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Meningococcal serogroup C immunogenicity, antibody persistence and memory B-cells induced by the monovalent meningococcal serogroup C versus quadrivalent meningococcal serogroup ACWY conjugate booster vaccine: A randomized controlled trial. AU - van Ravenhorst,Mariëtte B, AU - van der Klis,Fiona R M, AU - van Rooijen,Debbie M, AU - Knol,Mirjam J, AU - Stoof,Susanne P, AU - Sanders,Elisabeth A M, AU - Berbers,Guy A M, Y1 - 2017/06/28/ PY - 2017/02/24/received PY - 2017/06/19/revised PY - 2017/06/20/accepted PY - 2017/7/3/pubmed PY - 2018/4/20/medline PY - 2017/7/3/entrez KW - Adolescent KW - Antibody KW - Conjugate vaccine KW - Neisseria meningitidis KW - Non-inferiority KW - Quadrivalent meningococcal vaccine SP - 4745 EP - 4752 JF - Vaccine JO - Vaccine VL - 35 IS - 36 N2 - BACKGROUND: Adolescents are considered the key transmitters of meningococci in the population. Meningococcal serogroup C (MenC) antibody levels wane rapidly after MenC conjugate vaccination in young children, leaving adolescents with low antibody levels. In this study, we compared MenC immune responses after booster vaccination in adolescence with either tetanus toxoid conjugated MenC (MenC-TT) or MenACWY (MenACWY-TT) vaccine, and aimed to establish an optimal age for this booster. METHODS: Healthy 10-, 12-, and 15-year-olds, who received a single dose of MenC-TT vaccine in early childhood, were randomized to receive MenC-TT or MenACWY-TT vaccine. MenC serum bactericidal antibody (rSBA) titers, MenC polysaccharide (PS) specific IgG, IgG1 and IgG2 and MenC-specific IgG and IgA memory B-cells were determined before, one month and one year after the booster. Non-inferiority was tested by comparing geometric mean titers (GMTs) between vaccinees at one year. RESULTS: Of 501 participants, 464 (92.6%) were included in the 'according to protocol' cohort analysis. At one month, all participants developed high MenC rSBA titers (>24,000 in all groups) and MenC-PS-specific IgG levels. Non-inferiority was not demonstrated one year after the booster with higher MenC GMTs after the monovalent vaccine, but 462/464 (99.6%) participants maintained protective MenC rSBA titers. IgG levels mainly consisted of IgG1, but similar levels of increase were observed for IgG1 and IgG2. Both vaccines induced a clear increase in the number of circulating MenC-PS specific IgG and IgA memory B-cells. Between one month and one year, the highest antibody decay rate was observed in the 10-year-olds. CONCLUSION: Both MenC-TT and MenACWY-TT vaccines induced robust protective MenC immune responses after the booster vaccination, although non-inferiority could not be demonstrated for the MenACWY-TT vaccine after one year. Our results underline the importance of optimal timing of a meningococcal booster vaccination to protect against MenC disease in the long-term. SN - 1873-2518 UR - https://www.unboundmedicine.com/medline/citation/28668575/Meningococcal_serogroup_C_immunogenicity_antibody_persistence_and_memory_B_cells_induced_by_the_monovalent_meningococcal_serogroup_C_versus_quadrivalent_meningococcal_serogroup_ACWY_conjugate_booster_vaccine:_A_randomized_controlled_trial_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0264-410X(17)30850-2 DB - PRIME DP - Unbound Medicine ER -