Antibody kinetics following vaccination with MenAfriVac: an analysis of serological data from randomised trials

Autor: Beate Kampmann, Aldiouma Diallo, Ray Borrow, Samba O. Sow, Caroline Trotter, Olubukola T. Idoko, Michael T. White
Přispěvatelé: Trotter, Caroline [0000-0003-4000-2708], Apollo - University of Cambridge Repository, Vecteurs - Infections tropicales et méditerranéennes (VITROME), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut de Recherche Biomédicale des Armées (IRBA), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut de Recherche Biomédicale des Armées [Brétigny-sur-Orge] (IRBA)
Rok vydání: 2019
Předmět:
0301 basic medicine
Male
Time Factors
medicine.disease_cause
Mali
0302 clinical medicine
[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases
Neisseria meningitidis
Serogroup A
030212 general & internal medicine
Longitudinal Studies
Child
ComputingMilieux_MISCELLANEOUS
Randomized Controlled Trials as Topic
[SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases
Neisseria meningitidis
Meningitis Vaccine Project
Antibodies
Bacterial
Senegal
3. Good health
Vaccination
Infectious Diseases
Child
Preschool
[SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology
Female
Gambia
African meningitis belt
Meningitis
Adult
medicine.medical_specialty
Blood Bactericidal Activity
Adolescent
Enzyme-Linked Immunosorbent Assay
Meningococcal Vaccines
Meningitis
Meningococcal
03 medical and health sciences
Young Adult
[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system
Conjugate vaccine
Internal medicine
medicine
Humans
[SDV.MP.PAR]Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology
business.industry
Infant
Vaccine efficacy
medicine.disease
[SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology
030104 developmental biology
Antibody Formation
business
MenAfriVac
Zdroj: The Lancet Infectious Diseases
The Lancet Infectious Diseases, New York, NY : Elsevier Science ; The Lancet Pub. Group, 2001-, 2019, 19 (3), pp.327-336. ⟨10.1016/S1473-3099(18)30674-1⟩
The Lancet Infectious Diseases, 2019, 19 (3), pp.327-336. ⟨10.1016/S1473-3099(18)30674-1⟩
ISSN: 1473-3099
1474-4457
DOI: 10.1016/S1473-3099(18)30674-1⟩
Popis: Summary Background A meningococcal group A conjugate vaccine, PsA-TT (also known as MenAfriVac), was developed with the support of the Meningitis Vaccine Project. Around 280 million individuals aged 1–29 years have been immunised across the African meningitis belt. We analysed the kinetics of vaccine-induced antibody response and assessed the possible implications for duration of protection. Methods We obtained data from two longitudinal studies done in The Gambia, Mali, and Senegal of antibody responses in 193 children aged 12–23 months and 604 participants aged 2–29 years following MenAfriVac vaccination. Antibodies were measured using two methods: group A serum bactericidal antibody (SBA) assay and group A-specific IgG ELISA. Data on antibody responses were analysed using a mixed-effects statistical model accounting for the mean response and variation in patterns of antibody kinetics. Determinants of antibody duration were investigated using regression analysis. Findings In children age 12–23 months, the reduction in MenAfriVac-induced antibody levels assessed by SBA titres had two phases: with 97·0% (95% credible interval [CrI] 95·1–98·3) of the response being short lived and decaying within the first 6 months and the remainder being long lived and decaying with a half-life of 2690 days (95% CrI 1016–15 078). Antibody levels assessed by SBA titres in participants aged 2–29 years were more persistent, with 95·0% (85·7–98·1) of the response being short lived, and the long lived phase decaying with a half-life of 6007 days (95% CrI 2826–14 279). Greater pre-vaccination antibody levels were associated with greater immunogenicity following vaccination, as well as greater antibody persistence. Despite rapid antibody declines in the first phase, antibodies in the second phase persisted at SBA titres greater than 128. Although there is no strong evidence base for a correlate of protection against infection with Neisseria meningitidis serogroup A, we use an assumed SBA titre of 128 as a threshold of protection to predict that 20 years after vaccination with a single dose of MenAfriVac, vaccine efficacy will be 52% (29–73) in children vaccinated at age 12–23 months and 70% (60–79) in participants vaccinated at age 2–29 years. Interpretation Population-level immunity induced by routine vaccination with the Expanded Programme on Immunization is predicted to persist at levels sufficient to confer more than 50% protection over a 20-year time period. Further increases in population-level immunity could be obtained via mass campaigns or by delaying the age of vaccination through the Expanded Programme on Immunization. However, the benefits of such a strategy would need to be weighed against the risks of leaving young children unvaccinated for longer. Funding Meningitis Vaccine Project and Institut Pasteur.
Databáze: OpenAIRE
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