Persistence of bactericidal antibodies following booster vaccination with 4CMenB at 12, 18 or 24 months and immunogenicity of a fifth dose administered at 4 years of age-a phase 3 extension to a randomised controlled trial. Issue 2 (5th January 2017)

• Record Type: Journal Article
• Authors: Iro, Mildred A.; Snape, Matthew D.; Voysey, Merryn; Jawad, Sena; Finn, Adam; Heath, Paul T.; Bona, Gianni; Esposito, Susanna; Diez-Domingo, Javier; Prymula, Roman; Odueyungbo, Adefowope; Toneatto, Daniela; Dull, Peter; Pollard, Andrew J.
• Is Part Of: Vaccine. Volume 35:Issue 2(2017)
• Page Start: 395
• Page End: 402
• Publication Date: 2017-01-05
• Subjects: 4CMenB -- Neisseria meningitidis -- Vaccine -- Reactogenicity -- MenW -- Toddler; Vaccines -- Periodicals; 615.372
• DOI: 10.1016/j.vaccine.2016.11.009
• Languages: English
• ISSNs: 0264-410X

Abstract

Abstract: Background: 4CMenB is immunogenic in infants and toddlers. We assessed persistence of human complement serum bactericidal activity (hSBA) following a fourth dose administered at 12, 18 or 24 months and characterised the antibody response to a fifth dose administered at 4 years of age. Methods: A phase 3, open label, multi-centre extension to a randomised controlled trial (ClinicalTrials.gov identifier NCT01717638) conducted in four countries (number of centres): Czech Republic (nineteen), Italy (four), Spain (four) and the United Kingdom (four). Four-year-old children who were either 4CMenB-naïve or had previously received a variety of 3-dose infant priming schedules and a booster vaccine as toddlers (follow-on group) were recruited. Venous blood samples were obtained to determine hSBA against four reference strains; acting as targets to assess immunity to each of the vaccine antigens, NadA (5/99), fHbp (H44/76), PorA (NZ98/254), and NHBA (M10713) at baseline (prior to vaccination, all participants) and one month following a dose of 4CMenB for all vaccine-naïve and follow-on participants primed with the 2, 3, 4 schedule, and a third of follow-on participants primed with a 2, 4, 6 month schedule. Results: At baseline (prior to vaccination), the proportion of participants (n = 468) with hSBA titers ⩾ 5 was similar across all followon groups: 89–100% against 5/99; 12–35% for H44/76; 8–12% for NZ98/254 and 53–80% for M10713 compared with 5%, 0%, 0%; and 60% respectively, for the vaccine-naïve controls (n = 206). Following a dose of 4CMenB at 4 years of age, this increased to 100% (5/99), 97–100% (H44/76), 80–95 % (NZ98/254) and 84–100% (M10713) (n = 210), compared with 89%, 70%, 24%, and 76% respectively for vaccine-naïve controls (n = 192). Conclusion: Waning of protective antibodies occurred 12–36 months after toddler booster regardless of age at boost. This was least marked against target strains 5/99 and M10713. A robust memory response occurred after a booster dose given at 4 years of age.