TY  - JOUR
TI  - Schedules for Pneumococcal Vaccination of Preterm Infants: An RCT
EP  - 11
AV  - public
VL  - 138
KW  - Science & Technology
KW  -  Life Sciences & Biomedicine
KW  -  Pediatrics
KW  -  Acellular Pertussis-vaccine
KW  -  C Conjugate Vaccine
KW  -  B-cell Responses
KW  -  United-kingdom
KW  -  Immunological Memory
KW  -  Controlled-trial
KW  -  Immune-response
KW  -  Uk Infants
KW  -  Immunogenicity
KW  -  Age
N2  - BACKGROUND AND OBJECTIVE: Premature infants have a higher risk of invasive pneumococcal disease and are more likely to have lower vaccine responses compared with term infants. Increasingly, immunization schedules are including a reduced, 2-dose, pneumococcal conjugate vaccine priming schedule. Our goal was to assess the immunogenicity of 3 commonly used 13-valent pneumococcal conjugate vaccine (PCV13) priming schedules in premature infants and their response to a 12-month booster dose.

METHODS: Premature infants (<35 weeks? gestation) were randomized to receive PCV13 at 2 and 4 months (reduced schedule); 2, 3, and 4 months (accelerated schedule); or 2, 4, and 6 months (extended schedule). All infants received a 12-month PCV13 booster. Serotype-specific pneumococcal immunoglobulin G (IgG) for PCV13 serotypes was measured by using enzyme-linked immunosorbent assay 1 month after the primary and booster vaccinations.

RESULTS: A total of 210 infants (median birth gestation, 29+6 weeks; range, 23+2?34+6 weeks) were included. After the primary vaccination, 75% (95% confidence interval [CI], 62?85), 88% (95% CI, 76?95), and 97% (95% CI, 87?99) of participants had protective antibody concentrations for at least one-half the PCV13 serotypes for the reduced, accelerated, and extended schedules, respectively. After the booster vaccination, participants receiving the extended schedule had significantly lower (P < .05) geometric mean concentrations compared with reduced (for 9 of 13 serotypes) and accelerated (for 4 of 13 serotypes) schedules, but nearly all participations, regardless of schedule or serotype, had seroprotective IgG concentrations.

CONCLUSIONS: A reduced priming schedule of PCV13 resulted in higher post-booster IgG concentrations but lower post-primary concentrations. The optimum vaccine schedule for preterm infants will therefore depend on when they are most at risk for invasive pneumococcal disease.
JF  - Pediatrics
UR  - http://doi.org/10.1542/peds.2015-3945
PB  - AMER ACAD PEDIATRICS
N1  - Copyright © 2017 by the American Academy of Pediatrics
published, and trademarked by the American Academy of Pediatrics. All rights reserved.
IS  - 3
Y1  - 2016/09/01/
ID  - discovery1508331
SN  - 0031-4005
A1  - Kent, A
A1  - Ladhani, SN
A1  - Andrews, NJ
A1  - Scorrer, T
A1  - Pollard, AJ
A1  - Clarke, P
A1  - Hughes, SM
A1  - Heal, C
A1  - Menson, E
A1  - Chang, J
A1  - Satodia, P
A1  - Collinson, AC
A1  - Faust, SN
A1  - Goldblatt, D
A1  - Miller, E
A1  - Heath, PT
ER  -