Five-year antibody persistence and safety following a booster dose of combined Haemophilus influenzae type b-Neisseria meningitidis serogroup C-tetanus toxoid conjugate vaccine.

BACKGROUND: Booster vaccination with the combined Haemophilus influenza type b-Neisseria meningitides serogroup C-tetanus toxoid vaccine (Hib-MenC-TT) has been reported to induce different MenC antibody responses depending on the priming vaccines, with a possible impact on long-term protection. Here, the five-year persistence of immune responses induced by a booster dose of Hib-MenC-TT was evaluated in toddlers primed with either Hib-MenC-TT or MenC-TT. METHODS: This is the follow-up of a phase III, open, randomized study, in which a Hib-MenC-TT booster dose was given at 13.14 months of age to toddlers primed with either 3 doses of Hib-MenC-TT or 2 doses of MenC-TT in infancy. Children in the control group had received 3 primary doses and a booster dose of MenC-CRM197. Functional antibodies against MenC were measured by a serum bactericidal assay with rabbit complement (rSBA-MenC) and antibodies against Hib polyribosylribitol phosphate by enzyme-linked immunosorbent assay. Serious adverse events considered by the investigator to be possibly related to vaccination were to be reported throughout the study. RESULTS: At 66 months postbooster, rSBA-MenC titers ≥8 were retained by 82.6% of children primed with Hib-MenC-TT, 94.1% of children primed with MenC-TT, and 60.9% of children in the control group. All children who received the Hib-MenC-TT booster dose retained anti- polyribosylribitol phosphate concentrations ≥0.15 µg/mL. No serious adverse events considered possibly related to vaccination were reported. CONCLUSIONS: There is evidence of good antibody persistence against MenC and Hib for more than five years postbooster vaccination with Hib-MenC TT in toddlers primed with Hib-MenC-TT or MenC-TT.

Cribratge neonatal per a la detecció precoç d'hemoglobinopaties / Neonatal screening for early detection of Haemoglobinopaties

Objectiu. Determinar la incidència d’hemoglobinopaties en la població que és natural de zones considerades d’alta prevalença, amb l’elaboració d’un arbre genealògic dels nounats afectats. Determinar la necessitat de fer un cribratge neonatal universal. Mètode. Electroforesi en gel d’agarosa, en medi alcalí, de sang obtinguda de cordó umbilical de tots els nadons nascuts al nostre hospital, els pares dels quals provinguin de zones considerades de risc (subsaharians, magribins, sud-americans i asiàtics). En cas que el cribratge resulti positiu, efectuem un estudi electroforètic a tota la família. Resultats. De 472 nadons valorats, s’han detectat 32 casos d’hemoglobinopaties (6.78%), 27 dels quals eren heterozigots i 5 homozigots o doble heterozigots. Després de l’estudi familiar, el nombre de diagnosticats ha estat de 87 heterozigots i 6 homozigots o doble heterozigots. Conclusions. L’electroforesi d’hemoglobines en gel d’agarosa en medi alcalí és un bon mètode de cribratge neonatal, i la tècnica està a l’abast de tots els hospitals. La incidència de les hemoglobinopaties detectades i les repercussions mèdiques que tenen expliquen la necessitat del cribratge. Hem de valorar fer universal el cribratge en el futur (AU)

Objective. To determine the incidence of haemoglobinopathies among immigrant population from endemic areas, to elaborate a genealogical tree of the affected newborns, and to determine the need for the implementation of a universal neonatal screening. Methodology. Agarose gel electrophoresis in alkaline media of umbilical blood samples obtained from all newborns whose parents emigrated from endemic areas (Subsaharian nd North Africa, South America, and Asia). In cases of positive screening, an electrophoresis study of all family members was performed. Results. 472 newborns were evaluated, and 32 cases (6.8%) of haemoglobinopathy were detected (27 homozygous, 5 heterozygous of double heterozygous). After the families were studied, 87 heterozygous and 6 homozygous or double heterozygous were detected. Conclusion. Hemoglobin agarose gel electrophoresis is a good neonatal screening method, which can be easily implemented in most hospitals. The detected incidence and the potential impact of an early diagnosis suggest that universal screening is needed (AU)

Antibody persistence after primary vaccination with a hexavalent DTPa-HBV-IPV/HiB vaccine coadministered with a meningococcal C-CRM197 vaccine and response to a DTPa-IPV/HiB booster at 18 months of age.

Children 17-20 months of age (N = 344) received a diphtheria-tetanus toxoids-acellular pertussis (DTPa)-inactivated poliovirus vaccine (IPV)/Haemophilus influenzae (Hib) booster after a 3-dose primary vaccination course with DTPa-hepatitis B vaccine-IPV/Hib plus conjugate meningococcal C vaccine-CRM. Seroprotection rates were >80% (diphtheria, tetanus, hepatitis B, polio and polyribosylribitol phosphate) before and > or =96.6% (diphtheria, tetanus, polio and polyribosylribitol phosphate) after booster vaccination. The booster was well-tolerated (fever >39.5 degrees C after <2% of doses; large swelling reactions after 6.3% of doses).

Immunogenicity and reactogenicity of a three-dose primary vaccination course with a combined diphtheria-tetanus-acellular pertussis-hepatitis B-inactivated polio-haemophilus influenzae type b vaccine coadministered with a meningococcal C conjugate vaccine.

AIM: To evaluate the immunogenicity and safety of 3 doses of the combined diphtheria-tetanus toxoids-acellular pertussis-hepatitis B virus-inactivated poliovirus/Haemophilus influenzae type b (DTPa-HBV-IPV/Hib) vaccine (Infanrix hexa) when coadministered with a CRM197-conjugated meningococcal C vaccine (Meningitec) at different injection sites during the same visit or during separate visits. METHODS: Healthy infants were randomized in an open randomized multicenter study to receive either the DTPa-HBV-IPV/Hib and meningococcal C conjugate vaccines during the same vaccination visit at 2, 4 and 6 months of age (coadministration group) or the DTPa-HBV-IPV/Hib vaccine at 2, 4 and 6 months of age and the meningococcal C conjugate vaccine at 3, 5 and 7 months of age (separate administration group). RESULTS: The immunogenicity analysis included 452 infants, 228 in the coadministration group and 224 in the separate administration group. One month after primary vaccination, 99.1% of subjects in both groups achieved anti-polyribosylribitol phosphate antibody concentrations >/=0.15 microg/mL. The vaccine response against pertussis antigens was at least 99.1% in both groups. For all other DTPa-HBV-IPV/Hib vaccine antigens, at least 97.8% of all subjects of both groups were seroprotected. In addition, 99.5% of all subjects had meningococcal C bactericidal antibody titers >/=1/8 and 99.1% >/=1/128. Coadministration of both vaccines did not result in an increased local or general reactogenicity compared with separate administration. CONCLUSION: Coadministration of the combined DTPa-HBV-IPV/Hib vaccine and the meningococcal C conjugate vaccine during the same vaccination visit was immunogenic and safe.