Elsevier

The Journal of Pediatrics

Volume 128, Issue 2, February 1996, Pages 196-202
The Journal of Pediatrics

Total and functional antibody response to a quadrivalent meningococcal polysaccharide vaccine among children,☆☆,,★★

Presented in part at a meeting of the Society for Pediatric Research in Seattle, Washington, May 1994.
https://doi.org/10.1016/S0022-3476(96)70389-XGet rights and content

Abstract

OBJECTIVE: To determine total and functional serogroup C antibody response after vaccination with a quadrivalent meningococcal polysaccharide vaccine. DESIGN: Prospective, before and after intervention study. SUBJECTS: Study subjects were between the ages of 0.5 and 19.9 years, and were eligible for a community-wide public health immunization campaign against Neisseria meningitidis serogroup C. METHODS: Total and functional antibody response was measured by enzyme-linked immunosorbent assay and bactericidal assay, respectively. RESULTS: One month after vaccination, total capsular polysaccharide antibody significantly increased in all age groups; a significant rise in bactericidal antibody, that correlated with total capsular polysaccharide antibody, was seen in children 18 months of age and older. At 1 year bactericidal antibody titers were maintained but capsular polysaccharide antibody declined substantially in children younger than 5 years. CONCLUSION: Total capsular polysaccharide antibody concentration appears to be a useful surrogate measure of bactericidal antibody in children 18 months and older. Children who originally received the vaccine at less than 18 months of age should be considered for revaccination if there is a new or continuing risk of disease. Because of the differences in the total and bactericidal antibodies formed, vaccine efficacy trials are required to define which serologic measures are associated with protection. (J PEDIATR 1996;128:196-202)

Section snippets

Study design

This prospective, before-after study was performed during a regional health department vaccination campaign against serogroup C meningococcal disease involving 225,000 children, aged 6 months to 19.9 years, in eastern Ontario and western Quebec, Canada.20 The study was approved by our research ethics review committee and informed consent was obtained from all participants/guardians.

Study participants

Participants were 6 months to 19.9 years of age, eligible for the health department vaccination program, and

RESULTS

A total of 2240 children participated in this study with a median age of 4.7 years (range 6 months to 19.9 years) and a 1.1:1 male/female ratio. The median total family size was 4.0, number of children per household 2.1, and family income, derived from postal code data,26 $49,600 (Canadian). In comparison, our population's regional median family size was 3.8, number of children per household 1.2, and income $50,800 (Canadian).26, 27 At 1 month, 86% (1922) of the participants returned for

DISCUSSION

The vaccine used in this study was safe, confirming previous reports that the majority of side effects are minor and consist of transient reactions at the site of injection.28 Oropharyngeal carriage of N. meningitidis at the time of the serogroup C outbreak in our community was low, the majority of the isolates being of low virulence. This is consistent with previous reports documenting low carriage rates, particularly in young children, of both the involved clone and of total N. meningitidis

Acknowledgements

We thank Drs. Ian Gemmil and Steve Corber from the Ottawa-Carleton Regional Department of Health, Drs. Pierre Lavigne, Bob Wittes, and Luis Barreto from Connaught Laboratories Limited, and Dr. Doug Manion and Terry Sutcliffe for their assistance and support of this project.

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    From the Department of Pediatrics, Children's Hospital Eastern Ontario, University of Ottawa, the Clinical Epidemiology Unit, Ottawa Civic Hospital, University of Ottawa, and the Bureau of Microbiology, Laboratory Centre for Disease Control, Ottawa, Ontario, Canada

    ☆☆

    Supported by funding from Connaught Laboratories, the Ontario Ministry of Health, and the Research Institute of the Children's Hospital of Eastern Ontario with the exception of the laboratory investigations, which were performed in collaboration with the Bureau of Microbiology, Laboratory Centre for Disease Control, Ottawa, Ontario, Canada.

    Reprint requests: W. James King, MD, FRCPC, c/o Ambulatory Care, Department of Pediatrics, Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, Ontario K1H 8L1, Canada.

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