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PubMedDate not supplied

A two-dose combined vaccine against hepatitis A and hepatitis B in healthy children and adolescents compared to the corresponding monovalent vaccines.

BACKGROUND: Immunization against hepatitis A and B has been available for some time, protecting against both infections. With a view to achieving further reduction in the number of interventions and increasing convenience of the vaccinee, we investigated the reactogenicity and immunogenicity of a combined hepatitis A and B vaccine in healthy 4- to 20-year-old subjects at a 0, 6-month schedule. METHODS: Two hundred forty-eight study subjects were allocated to two study groups and received either two doses of the combined hepatitis A and B vaccine (68% of subjects) or the corresponding monovalent hepatitis A and hepatitis B vaccines (32% of subjects) concomitantly in opposite arms. Reactogenicity was assessed via diary cards after each vaccination. Serum samples were analyzed at months 1, 2, 6, and 7. RESULTS: All vaccines were well tolerated and very few symptoms were scored as severe. All but one subject seroconverted for anti-hepatitis A virus (anti-HAV) antibodies (98.6%) and 100% of subjects seroconverted for anti-hepatitis B (HBs) antibodies, with respective seroprotection rates of 98.7% for the combined vaccine group and 95.9% for the concomitant vaccine group (p >0.05), respectively. Geometric mean titers were higher in the group receiving the combined vaccine: 6,635 mIU/mL vs. 2,728 mIU/mL (p = 0.0001) for anti-HAV and 3,362 mIU/mL vs. 1,724 mIU/mL (p = 0.0205) for anti-HBs, respectively. Younger subjects had a stronger immune response compared to older subjects. CONCLUSIONS: The combined hepatitis A and B vaccine was well tolerated at this two-dose schedule. The combined vaccine had higher immunogenicity, probably explained by a adjuvant effect of the antigens. Vaccination programs requiring fewer injections will most likely have a positive impact on compliance rate and comfort of the vaccinee.

Adolescent↗

PubMed2001

Reactogenicity of DTPa-HBV/Hib vaccine administered as a single injection vs DTPa-HBV and Hib vaccines administered simultaneously at separate sites, to infants at 2, 4 and 6 months of age.

An open, randomised, multicentre trial was performed to assess the reactogenicity and safety profile of the administration of a candidate Haemophilus influenzae type b (Hib) conjugate vaccine with a quadrivalent diphtheria-tetanus-acellular pertussis-hepatitis B (DTPa-HBV) vaccine as a single injection (Group 1) versus the simultaneous administration of the latter vaccine (DTPa-HBV) and an available Hib conjugate vaccine (Group 2) in opposite thighs, as a primary vaccination course to healthy infants at 2, 4 and 6 months of age. Eight hundred and eighty five infants (9.3+/-1.4 weeks old) were randomly allocated to Group 1 (n=665) and Group 2 (n=221). Oral polio vaccine was given concomitantly to all subjects. Blood samples (pre-vaccination and 1 month after the third dose) were obtained from a subset of infants (Group 1, 73; Group 2, 22) for serological determinations. Local and general symptoms were recorded by parents on diary cards. 2614 diary cards (Group 1, 1966; Group 2, 648) were collected. There were no statistically significant differences in the incidence of local and general symptoms between groups. Pain such that the infant cried when limb was moved was reported in 0.6 and 0.2% in groups 1 and 2, respectively. Redness and swelling (>20 mm in diameter) were recorded between 2.1 and 3% in both groups. Fussiness preventing normal activities was the most frequently reported general symptom in both groups (1.6 and 1.9% in groups 1 and 2, respectively). Fever (rectal temperature >39.5 degrees C) was reported in 0.4% (Group 1) and 0.3% (Group 2). All subjects included in the immunogenicity analysis had seroprotective or seropositive titres to the diphtheria, tetanus, hepatitis B and pertussis components of the vaccines. About 99 and 100% of infants had anti-PRP titres > or =0.15 mcg/ml in groups 1 and 2, respectively. This study indicates that DTPa-HBV vaccine given in a single injection with a candidate Hib conjugate vaccine has a similar reactogenicity profile to that of two commercially available vaccines (DTPa-HBV, Hib) given in two simultaneous injections to infants 2, 4 and 6 months of age.

Bacterial Capsules↗

PubMed2003

Hepatitis B DNA vaccine induces protective antibody responses in human non-responders to conventional vaccination.

A novel DNA vaccine against hepatitis B virus was administered intraepidermally by particle-mediated epidermal delivery (PMED) to 16 human subjects who demonstrated absent or non-sustainable responses to conventional hepatitis B vaccination. Eleven subjects received three doses of vaccine at 56-day intervals, and five subjects received only a single vaccination. Each dose of vaccine contained 4 microg of plasmid DNA encoding the hepatitis B surface antigen (HBsAg). The vaccine was safe and well tolerated. Remarkably, the DNA vaccine elicited antibody responses in 12 of the 16 subjects after a licensed subunit vaccine failed to induce a lasting response after >/=3 vaccinations. This study provides evidence in humans for protective immunogenicity of a particle-mediated DNA vaccine in subjects who have responded suboptimally to conventional vaccination.

Adolescent↗

PubMedDate not supplied

Critical value of prevalence for vaccination programmes. The case of hepatitis A vaccination in Spain.

Programmes using screening and vaccination are efficient in populations with higher levels of antibodies, while in those with lower levels is more efficient to vaccine the whole target population. The prevalence that makes the cost-effectiveness of vaccination programmes equal to that obtained for programmes using screening and vaccination is defined as the critical value of prevalence p*. In this study, a mathematical procedure to obtain the critical value of prevalence is developed. The formula obtained is used to decide the best vaccination strategy against hepatitis A in Spain. If V is the vaccination cost, S the screening cost, PV the predictive value of a positive test result, D the mean disease cost, A the attack rate in susceptible individuals, E the vaccine efficacy and C the vaccination compliance, the critical value of prevalence is equal to: [formula: see text] The critical value of prevalence obtained for vaccination against hepatitis A in Spain with three doses of vaccine Havrix 720 is 22%. This result show that the optimal decision is to implement vaccination programmes without screening for immunity in individuals aged < 15 years and with screening in those aged > 15 years.

Adolescent↗

PubMed1988

Anti-chlamydial immunity in ewes conferred by vaccination with a combination of three live chlamydia, brucella and salmonella vaccines.

Live attenuated vaccines against Chlamydia psittaci var ovis, Brucella melitensis and Salmonella abortus ovis have previously been shown to be compatible in mice by subcutaneous administration. Immunity against challenge with virulent chlamydia was, however, slightly decreased in associations including the B melitensis Rev 1 vaccine. The chlamydia strain 1B vaccine was administered to four- to five-month-old female lambs, either alone or in combination with the B melitensis Rev1 and the S abortus ovis Rv6 vaccines. Clinical, serological and bacteriological observations demonstrated the compatibility of the three vaccines. Control, singly and triply vaccinated ewes were challenged with a virulent strain of chlamydia during their second pregnancy, 15 months after vaccination. Five of the 12 control ewes lambed normally and 10 of them were infected, as shown by the excretion of the challenge chlamydia in genital secretions. Sixteen of the 17 ewes in the triple vaccine group lambed normally and none was infected. All 12 in the single vaccine group lambed normally and three of the 12 were infected. In spite of this unusually poor protection by the single vaccine, antichlamydial immunity was clearly not decreased by the association with the two other vaccines.

Animals↗

PubMed2005

The dream of a vaccine against tuberculosis; new vaccines improving or replacing BCG?

In the last 10 yrs, work with experimental laboratory models has developed many new vaccine candidates against tuberculosis (TB). They include subunit vaccines, modified bacilli Calmette-Guérin (BCG) and attenuated Mycobacterium tuberculosis. Phase I clinical trials of new TB vaccine candidates have begun for the first time after 80 yrs of use of BCG. Many of these new trials involve recombinant BCG or improve BCG immunity by boosting with vaccines consisting of subunits or attenuated vaccinia virus expressing TB antigens. However, effective vaccination against TB presents diverse and complex challenges. For example, TB infection can become reactivated years later and infection does not guarantee resistance to a subsequent second infection. A truly effective TB vaccine may, therefore, have to elicit an immune response that is greater than that induced by natural infection. In addition, various different populations have to be protected including those vaccinated with BCG and those infected with M. tuberculosis or HIV. The goal is a new generation of vaccines effective against respiratory forms of tuberculosis. As a first step, good candidate vaccines able to boost bacille Calmette-Guérin and thereby improve protection could be a reality in the near future. Tuberculosis vaccine candidates, able to replace the currently used bacille Calmette-Guérin and/or make the eradication of tuberculosis feasible, can only be expected in the long-term, and safe live vaccines could be promising candidates.

BCG Vaccine↗

PubMed2005

A mass vaccination campaign targeting adults and children to prevent typhoid fever in Hechi; expanding the use of Vi polysaccharide vaccine in southeast China: a cluster-randomized trial.

BACKGROUND: One of the goals of this study was to learn the coverage, safety and logistics of a mass vaccination campaign against typhoid fever in children and adults using locally produced typhoid Vi polysaccharide (PS) and group A meningococcal PS vaccines in southern China. METHODS: The vaccination campaign targeted 118,588 persons in Hechi, Guangxi Province, aged between 5 to 60 years, in 2003. The study area was divided into 107 geographic clusters, which were randomly allocated to receive one of the single-dose parenteral vaccines. All aspects regarding vaccination logistics, feasibility and safety were documented and systematically recorded. Results of the logistics, feasibility and safety are reported. RESULTS: The campaign lasted 5 weeks and the overall vaccination coverage was 78%. On average, the 30 vaccine teams gave immunizations on 23 days. Vaccine rates were higher in those aged < or = 15 years (90%) than in adolescents and young adults (70%). Planned mop-up activities increased the coverage by 17%. The overall vaccine wastage was 11%. The cold chain was maintained and documented. 66 individuals reported of adverse events out of all vaccinees, where fever (21%), malaise (19%) and local redness (19%) were the major symptoms; no life-threatening event occurred. Three needle-sharp events were reported. CONCLUSION: The mass immunization proved feasible and safe, and vaccine coverage was high. Emphasis should be placed on: injection safety measures, community involvement and incorporation of mop-up strategies into any vaccination campaign. School-based and all-age Vi mass immunizations programs are potentially important public health strategies for prevention of typhoid fever in high-risk populations in southern China.

Adolescent↗

PubMed1992

Influence of vaccination route on the efficacy of Aujeszky's disease deletion-mutant vaccine.

In order to compare the effect of the route of immunization on the efficacy of a modified live Aujeszky's disease (AD) vaccine, which had deletions in both thymidine kinase (TK-) and glycoprotein gIII genes (gpIII-), 20 six-week-old pigs were vaccinated by either the intramuscular (IM) (n = 10) or subcutaneous (SC) (n = 10) route. All the animals, including five non-vaccinated control animals, were challenged with virulent AD virus 22 days after vaccination. Four of five non-vaccinated animals died within 12 days after challenge. Although none of vaccinated animals died, three of animals in the SC group exhibited clinical signs, and average daily gains in the SC group were depressed. The animals in the IM group were not found to shed challenge virus, but those in the SC group shed the virus up to 9 days. Virus neutralizing antibody titers in the vaccinated animals were low or non-detectable by 21 days after vaccination. A glycoprotein gII (gpII) screening ELISA detected gpII antibody in all animals in the IM group. While, only 30% of animals in the SC group were positive by the same test. The results of this study indicate that TK-, gpIII modified live AD virus vaccine is effective against challenge with virulent AD virus; however, vaccination by the SC route reduced vaccine efficacy in comparison with IM route.

Animals↗

PubMedDate not supplied

Protection of chickens from infectious bronchitis by in ovo and intramuscular vaccination with a DNA vaccine expressing the S1 glycoprotein.

We have constructed a DNA vaccine (pDKArkS1-DPI) expressing the S1 glycoprotein (Arkansas DPI) of infectious bronchitis virus (IBV) to examine protective immunity after in ovo and intramuscular DNA immunization. Birds receiving in ovo DNA followed by live virus vaccination at 2 wk of age were 100% protected from clinical disease. Birds receiving only live virus vaccine or only in ovo DNA vaccination were < or = 80% protected. IBV was detected up to 10 days postchallenge in unvaccinated control groups, whereas birds receiving in ovo DNA and live virus vaccination cleared IBV from tracheal samples before day 5 postchallenge. Transcription of the S1 gene was confirmed in lung tissue after in ovo vaccination by an antisense riboprobe, and the S1 protein was detected by immunohistology in the heart and bursa. In a separate experiment, birds were injected intramuscularly with either 50, 100, or 150 microg of the DNA vaccine at 1 day of age and then again with either 100, 200, or 300 microg of the DNA vaccine, respectively, at 14 days of age. At 10 days postchallenge, no clinical signs were observed and no challenge virus was reisolated from the birds vaccinated with 150 microg and 300 microg of DNA. Between DNA-vaccinated birds and nonvaccinated control birds, no statistical differences were observed for IBV-specific serum antibodies as detected by enzyme-linked immunosorbent assay or the virus neutralization test. These data indicate that DNA vaccination with the S1 gene either in ovo or intramuscularly can provide birds with some protection against clinical disease after homologous IBV challenge.

Animals↗

PubMed2000

[Preventive effects of three kinds of inactive vaccines against epidemic hemorrhagic fever (EHF) after 5 years of vaccination].

OBJECTIVE: To observe the safety and the preventive effects of three kinds of vaccines as Mongolian gerbils kidney vaccine, mouse brains vaccine and hamster kidney vaccine inoculated 5 years ago. METHODS: Field study and laboratory tests were carried out by random grouping and IFAT, MCPENT, ELISA, HI tests. RESULTS: The antibody-dependent enhancement did not appear in all individuals who received vaccines after four or five years. The seroconversion rates of MCPENT were 8.97%, 11.76% and 18.75% while the seroconversion rates of IFAT were 20.73%, 30.22% and 23.40% respectively for Mongolian gerbils kidney vaccine, mouse brains vaccine and hamster kidney vaccine. The protection rates were 100% for all three kinds of inactive vaccines which showed good epidemiological efficacy. CONCLUSION: The vaccines can protect clinical infection of EHF effectively after four or five years of the initial vaccination.

Animals↗

PubMed1999

[Comparison of subclinical infection rates between vaccinated group with type I inactivated vaccine against hemorrhagic fever and controls].

OBJECTIVE: To compare subclinical infection rate in the vaccinated group with type I inactivated vaccine against hemorrhagic fever with renal syndrome (HFRS) with that in the controls and to understand its enhancement. METHODS: A trial field was selected in Jiande County, Zhejiang Province during July 1974 to November 1997. Paired-sera before and after vaccination were collected from 401 vaccinee and 360 controls, respectively. Serum titer of indirect immunofluorescent IgG antibody (IFAT) against HFRS was detected for each of them, and its cut-off value depended on the distribution of serum antibody titer in the second determination in the controls, which could be used to evaluate subclinical infection before vaccination. RESULTS: There was no significant difference in subclinical infection between those with positive and negative IFAT before vaccination, with different cut-off values for identifying subclinical infection. In both vaccinated and control groups with negative IFA before vaccination, subclinical infection rate was 7.62% in the controls, and 2.17% and 1.63% in the vaccinated ones, with cut-off values of 1:160 and 1:320, respectively, significantly different from that in the former. Subclinical infection rate was 11.38% and 6.78% in the vaccinated ones, as cut-off values of 1:20 and 1:40, respectively, without significant difference from the controls. CONCLUSION: No increase in subclinical infection in the vaccinated group with type I inactivated vaccine against HFRS was found.

Adolescent↗

PubMed2006

Effect of vaccination with recombinant canine distemper virus vaccine immediately before exposure under shelter-like conditions.

Vaccination with modified-live virus (MLV) canine distemper virus (CDV) vaccine has historically been recommended for animals in high-risk environments because of the rapid onset of immunity following vaccination. Recombinant CDV (rCDV) vaccine was deemed a suitable alternative to MLV-CDV vaccination in pet dogs, but insufficient data precluded its use where CDV was a serious threat to puppies, such as in shelters, kennels, and pet stores. In this study, dogs experimentally challenged hours after a single dose of rCDV or MLV vaccine became sick but recovered, whereas unvaccinated dogs became sick and died. Dogs vaccinated with a single dose of rCDV or MLV vaccine 1 week before being experimentally challenged remained healthy and showed no clinical signs. Dogs given one dose of rCDV vaccine hours before being placed in a CDV-contaminated environment did not become sick. These findings support the hypothesis that rCDV vaccine has a similar time-to-immunity as MLV-CDV vaccines and can likewise protect dogs in high-risk environments after one dose.

Animals↗

PubMed1982

Field evaluation of a canine parvovirus vaccination program, using feline origin modified live virus vaccine.

Antibody titers measured by hemagglutination inhibition testing were determined in previously vaccinated dogs at the time of booster vaccination and 2 weeks later. All vaccines consisted of modified live panleukopenia virus. The booster injection was administered approximately 6 months after the initial parvovirus vaccination series was given. Fecal and serum specimens were collected immediately before and 2 weeks after administration of the booster vaccine for hemagglutination and hemagglutination inhibition testing, respectively. All dogs were privately owned and were from the Columbus, Ohio, area but were from environments with various exposure potentials to canine parvovirus. Results of hemagglutination (HA) testing on feces were negative in all dogs before and after booster vaccination. Therefore, these vaccinations did not interfere with interpretation of HA testing of feces. Results of serum hemagglutination inhibition (HI) testing indicated that 50% of the dogs had serum titers less than 1:80 prior to vaccination and that, of these dogs, 65.2% still had serum titers less than 1:80 2 weeks after the booster vaccination. Only 10.9% of all dogs had a marked increase in serum HI titer after the booster vaccination, indicating that overall serologic response to vaccination was poor. High HI titers (greater than or equal to 1:640) were associated with exposure to other dogs and cats in the neighborhood or to dogs suspected of having had parvovirus infection.

Animals↗

PubMed1994

Studies on the immune response of foot-and-mouth disease vaccine type Asia-1 in pregnant ewes, lambs and evaluation of type O vaccine by challenge.

Seven pregnant ewes at the 10th to 12th week of pregnancy were vaccinated with foot-and-mouth disease (FMD) vaccine type Asia-1. All pregnant animals responded well with antibody production without any adverse effects. The maximum antibody titer was noted 3 to 4 weeks after the vaccination. In the colostrum a high level of maternal antibodies persisted from 12 hrs to 6 weeks after birth. Irrespective of the presence of the maternal antibodies, the vaccinated lambs responded with antibody production within the first week of vaccination. The antibodies persisted up to the 12th week of vaccination. In another experiment five sheep were vaccinated with FMD type O vaccine and challenged with 10,000 TCID50 of virulent type O cell culture-adapted virus. The antibody titers in the vaccinated animals prior to challenge ranged between 1.26 to 1.65, while the four control sheep remained free from detectable antibody against virus type O. Pyrexia and viraemia developed present in all the control sheep but were absent in the vaccinated ones. Characteristic primary lesions on the dorsum of the tongue were observed after 48 hrs of virus challenge in the control sheep but were absent in the vaccinated ones.

Animals↗

PubMedDate not supplied

Randomised trial of the effect of co-administration with acellular pertussis DTP vaccine on immunogenicity of Haemophilus influenzae type b conjugate vaccine.

BACKGROUND: Inclusion of new vaccines in vaccination programmes for children would be easier if they could be combined with existing vaccines. Vaccines containing acellular pertussis in the diphtheria/tetanus/pertussis (DTP-a) combination are expected to replace the conventional whole-cell vaccines (DTP-w). We tested the immunogenicity and safety of a combination of DTP-a with the Haemophilus influenzae type b (Hib) conjugate of Hib capsular polysaccharide and tetanus toxid (PRP-T), and inactivated poliovirus vaccine (i.p.v.). METHODS: 120 infants were enrolled and randomised to four groups to receive DTP-a at ages 2, 4, and 6 months. At 4 and 6 months they also received Hib conjugate and i.p.v., either as separate injections or mixed with DTP-a. All injections were given intramuscularly in the anterolateral area of the thigh. Any reactions after each vaccination were noted by the parents. EIA was used to measure titres of diphtheria, tetanus, and pertussis antibodies, RIA for Hib anticapsular antibodies, and microneutralisation assay for poliovirus antibodies from serum samples collected at the ages of 2, 4, 6, and 7 months. FINDINGS: There were 30 infants in each group. Only mild adverse events were reported. There was a tendency towards slightly lower concentrations of filamentous haemagglutinin, tetanus, and poliovirus 1 antibodies when the vaccines were mixed. However, there was a more pronounced difference (p = 4 x 10(-6)) in Hib antibodies between groups receiving Hib capsular polysaccharide mixed with DTP-a (geometric mean concentrations 0.37 microgram/mL and 0.56 microgram/mL) compared with groups receiving the vaccines separately (3.10 micrograms/mL and 3.94 micrograms/mL). INTERPRETATION: Administration of premixed DTP-a, Hib conjugate, and i.p.v. affect the immune response significantly. The mechanism of this interference is not clear. The immunogenicity of all antigens must be tested before new combinations can be accepted for vaccination programmes for infants.

Antibodies, Bacterial↗

PubMed1996

Large scale, postlicensure, selective vaccination of Chilean infants with PRP-T conjugate vaccine: practicality and effectiveness in preventing invasive Haemophilus influenzae type b infections.

BACKGROUND: Haemophilus influenzae type b (Hib) conjugate vaccines have demonstrated an impressive impact in diminishing Hib disease in industrialized countries. However, their high cost prompts nonindustrialized countries to corroborate their effectiveness under local conditions before considering their programmatic implementation. Such a postlicensure evaluation of vaccine effectiveness was undertaken in Chile. METHODS: After its licensure in Chile polyribosylribitol phosphate-tetanus toxoid protein conjugate vaccine (PRP-T), combined with diphtheria-tetanus-pertussis vaccine, was introduced into the Expanded Program on Immunization schedules in 36 health centers throughout metropolitan Santiago for 12 months, whereas 35 similar health centers administered only diphtheria-tetanus toxoid-pertussis vaccine. Bacteriologic surveillance data for invasive Hib cases collected over the ensuing 30 months were analyzed. RESULTS: In an intent-to-vaccinate (effectiveness) analysis, PRP-T provided 90.2% protection (95% confidence interval, 74.5 to 100%) against invasive Hib disease (40 vs. 4 cases, P < 0.001). Vaccine effectiveness was 91.3% against meningitis (22 vs. 2 cases) and 80% against pneumonia and empyema (10 vs. 2 cases, P = 0.039). Vaccine efficacy among infants who received all three doses of PRP-T was 91.7% (95% confidence interval, 64.8 to 100%). CONCLUSIONS: Programmatic use of Hib conjugate vaccine administered in combination with diphtheria-tetanus-pertussis vaccine constitutes a highly effective and practical intervention in Chile, a newly industrializing country.

Bacterial Capsules↗

PubMed1998

Acute encephalopathy followed by permanent brain injury or death associated with further attenuated measles vaccines: a review of claims submitted to the National Vaccine Injury Compensation Program.

OBJECTIVE: To determine if there is evidence for a causal relationship between acute encephalopathy followed by permanent brain injury or death associated with the administration of further attenuated measles vaccines (Attenuvax or Lirugen, Hoechst Marion Roussel, Kansas City, MO), mumps vaccine (Mumpsvax, Merck and Co, Inc, West Point, PA), or rubella vaccines (Meruvax or Meruvax II, Merck and Co, Inc, West Point, PA), combined measles and rubella vaccine (M-R-Vax or M-R-Vax II, Merck and Co, Inc, West Point, PA), or combined measles, mumps, and rubella vaccine (M-M-R or M-M-R II, Merck and Co, Inc, West Point, PA), the lead author reviewed claims submitted to the National Vaccine Injury Compensation Program. METHODS: The medical records of children who met the inclusion criteria of receiving the first dose of these vaccines between 1970 and 1993 and who developed such an encephalopathy with no determined cause within 15 days were identified and analyzed. RESULTS: A total of 48 children, ages 10 to 49 months, met the inclusion criteria after receiving measles vaccine, alone or in combination. Eight children died, and the remainder had mental regression and retardation, chronic seizures, motor and sensory deficits, and movement disorders. The onset of neurologic signs or symptoms occurred with a nonrandom, statistically significant distribution of cases on days 8 and 9. No cases were identified after the administration of monovalent mumps or rubella vaccine. CONCLUSIONS: This clustering suggests that a causal relationship between measles vaccine and encephalopathy may exist as a rare complication of measles immunization.

Acute Disease↗

PubMed2001

Antibody responses of healthy infants to concurrent administration of a bivalent haemophilus influenzae type b-hepatitis B vaccine with diphtheria-tetanus-pertussis, polio and measles-mumps-rubella vaccines.

OBJECTIVE: To confirm that children given a bivalent Haemophilus influenzae type b-hepatitis B vaccine (bivalent Hib-HB vaccine; COMVAX) concurrently with priming doses of diphtheria-tetanus-pertussis vaccine (DTP), a booster dose of diphtheria-tetanus-acellular pertussis vaccine (DTaP), inactivated or oral polio vaccine (IPV or OPV) and measles-mumps-rubella vaccine (M-M-R(II)) have satisfactory antibody responses to all antigens. DESIGN: 126 healthy 2-month-old infants were scheduled to receive bivalent Hib-HB vaccine concurrently with DTP (2 and 4 months of age), OPV or IPV (random allocation to OPV or IPV at 2 months of age; OPV at 4 and 14 to 15 months of age), DTaP and M-M-R(II) (14 to 15 months of age). A response was judged "adequate" if the lower bound of the 95% confidence interval on the proportion of vaccinees having a critical antibody level was <10 percentage points below prediction. RESULTS: Antibodies to hepatitis B virus surface antigen, H. influenzae polysaccharide, diphtheria toxin, tetanus toxin, pertussis agglutinogens, pertussis toxin (as measured by enzyme immunoassay but not by Chinese hamster ovary cell assay), pertussis filamentous haemagglutinin after a booster dose of DTaP, poliovirus type 2, measles virus, and mumps virus all equalled or exceeded expected levels. Antibodies to rubella virus and pertussis filamentous haemagglutinin (after priming doses of DTP) fell slightly, and in the case of rubella significantly, below predicted levels. Antibodies to poliovirus types 1 and 3 were also below expectation after 2 doses of polio vaccine but were adequate following a third dose of vaccine. CONCLUSION: Concurrent administration of bivalent Hib-HB vaccine with priming doses of DTP, a booster dose of DTaP, OPV, IPV, or M-M-R(II) was well tolerated and, with the possible exception of rubella, did not substantially impair the antibody response to any antigen.

Antibodies, Bacterial↗