Vaccine 32 (2014) 417–424

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Decreased immune response to pneumococcal conjugate vaccine after 23-valent pneumococcal polysaccharide vaccine in children夽 Sigurveig Th. Sigurdardottir a,b , Kimberly J. Center c,d , Katrin Davidsdottir e , Vilhjalmur A. Arason e , Bjorn Hjalmarsson e , Ragnheidur Elisdottir e , Gunnhildur Ingolfsdottir a , Robert Northington c , Daniel A. Scott d , Ingileif Jonsdottir a,b,∗ a

Department of Immunology, Landspitali, The National University Hospital of Iceland, Hringbraut, 101 Reykjavik, Iceland Faculty of Medicine, University of Iceland, Reykjavik, Iceland c Pfizer Inc., 500 Arcola Road, Collegeville, PA 19426, USA d Pfizer Inc., 401 North Middletown Road, Pearl River, NY 10965 USA e Centre for Child Health Services, The Primary Health Care of the Reykjavik Capital Area, Alfabakka 16, 109 Reykjavik, Iceland b

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Article history: Received 28 March 2013 Received in revised form 17 September 2013 Accepted 6 November 2013 Available online 2 December 2013 Keywords: Antibody persistence Conjugate vaccine Hyporesponsiveness Memory Pneumococcus Polysaccharide

a b s t r a c t Background: Pneumococcal polysaccharide vaccine (PPV) is used in children at high risk of IPD. PPV is generally not considered to induce immunologic memory, whereas pneumococcal conjugate vaccines (PCVs) elicit protective antibody responses in infants and induce immunologic memory. Little is known about the characteristics of immune responses to PCV in children who previously received PCV and PPV in series. Objective: To characterize immune responses to 13-valent pneumococcal CRM197 conjugate vaccine (PCV13; serotypes 1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F, and 23F) in children vaccinated in infancy with 9-valent pneumococcal–meningococcal C-CRM197 conjugate combination vaccine (PCV9-MnCC), followed by a toddler dose of PCV9-MnCC or 23-valent pneumococcal polysaccharide vaccine (PPV23). Methods: Children (n = 89) who received PCV9-MnCC in infancy and PPV23 or PCV9-MnCC at age 12 months in a previous (2002–2003) study were vaccinated at age 7.5 years with PCV13; groups PPV23/PCV13 (n = 50) and PCV9/PCV13 (n = 39). Immunoglobulin (Ig)G antibodies, avidity, and opsonophagocytic activity (OPA) were measured before and at 1 and 4 weeks postvaccination. Results: One week postvaccination, IgG levels increased significantly for all serotypes in both groups, and >97% of vaccinees achieved IgG ≥0.35 ␮g/ml 4 weeks after PCV13 vaccination. The PCV9/PCV13 group had higher IgG responses compared with the PPV23/PCV13 group. The upper limits of the 95% confidence intervals of the PPV23/PCV13:PCV9/PCV13 IgG geometric mean concentration ratios were

Decreased immune response to pneumococcal conjugate vaccine after 23-valent pneumococcal polysaccharide vaccine in children.

Pneumococcal polysaccharide vaccine (PPV) is used in children at high risk of IPD. PPV is generally not considered to induce immunologic memory, where...
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