Systematic Review of the Effect of Pneumococcal Conjugate Vaccine Dosing Schedules on Immunogenicity

Details

• Alternative Title:
  Pediatr Infect Dis J
• Personal Author:
  Deloria Knoll, Maria ; Park, Daniel E. ; Johnson, T. Scott ; Chandir, Subash ; Nonyane, Bareng Aletta S. ; Conklin, Laura ; Fleming-Dutra, Katherine E. ; Loo, Jennifer D. ; Goldblatt, David ; Whitney, Cynthia G. ; O’Brien, Katherine L.
• Description:
  Background:
  
  Despite the breadth of studies demonstrating benefits of pneumococcal conjugate vaccine (PCV), uncertainty remains regarding the optimal PCV dosing schedule in infants.
  
  Methods:
  
  We conducted a systematic literature review of PCV immunogenicity published from 1994 to 2010 (supplemented post hoc with studies from 2011). Studies included for analysis evaluated ≥2 doses of 7-valent or higher product (excluding Aventis-Pasteur PCV11) administered to nonhigh-risk infants ≤6 months of age. Impact of PCV schedule on geometric mean antibody concentration (GMC) and proportion of subjects over 0.35 mcg/mL were assessed at various time points; the GMC 1 month postdose 3 (for various dosing regimens) for serotypes 1, 5, 6B, 14, 19F and 23F was assessed in detail using random effects linear regression, adjusted for product, acellular diphtheria-tetanus-pertussis/whole-cell diphtheria- tetanus-pertussis coadministration, laboratory method, age at first dose and geographic region.
  
  Results:
  
  From 61 studies, we evaluated 13 two-dose (2+0) and 65 three-dose primary schedules (3+0) without a booster dose, 11 “2+1” (2 primary plus booster) and 42 “3+1” schedules. The GMC after the primary series was higher following 3-dose schedules compared with 2-dose schedules for all serotypes except for serotype 1. Pre- and postbooster GMCs were generally similar regardless of whether 2 or 3 primary doses were given. GMCs were significantly higher for all serotypes when dose 3 was administered in the second year (2+1) compared with ≤6 months of age (3+0).
  
  Conclusions:
  
  While giving the third dose in the second year of life produces a higher antibody response than when given as part of the primary series in the first 6 months, the lower GMC between the 2-dose primary series and booster may result in less disease protection for infants in that interval than those who completed the 3-dose primary series. Theoretical advantages of higher antibodies induced by giving the third dose in the second year of life, such as increased protection against serotype 1 disease, longer duration of protection or more rapid induction of herd effects, need to be evaluated in practice.
  
  
• Subjects:
  Antibodies, Bacterial Humans Immunization Schedule Immunogenicity Infant Pneumococcal Conjugate Vaccine Pneumococcal Infections Pneumococcal Vaccines Streptococcus Pneumoniae Supplement Vaccines, Conjugate

  More +
• Source:
  Pediatr Infect Dis J. 2014; 33(Suppl 2 Optimum Dosing of Pneumococcal Conjugate Vaccine For Infants 0 A Landscape Analysis of Evidence Supportin g Different Schedules):S119-S129.
• Document Type:
  Journal Article
• Volume:
  33
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:8c61592e21b0823e060c9028c97d76b5ba8b85f6b64bb710a26138b56ee2966f
• Download URL:
  https://stacks.cdc.gov/view/cdc/22042/cdc_22042_DS1.pdf
• File Type:
  [PDF - 1.91 MB ]