Skip Navigation LinksHome > July 2010 - Volume 29 - Issue 7 > Heptavalent Pneumococcal Conjugate Vaccine Immunogenicity in...
Pediatric Infectious Disease Journal:
doi: 10.1097/INF.0b013e3181d264a6
Original Studies

Heptavalent Pneumococcal Conjugate Vaccine Immunogenicity in Very-Low-Birth-Weight, Premature Infants

D'Angio, Carl T. MD*; Heyne, Roy J. MD†; O'Shea, T. Michael MD, MPH‡; Schelonka, Robert L. MD§¶; Shankaran, Seetha MD∥; Duara, Shahnaz MD**; Goldberg, Ronald N. MD††; Stoll, Barbara J. MD‡‡; Van Meurs, Krisa P. MD§§; Vohr, Betty R. MD¶¶; Das, Abhik PhD∥∥; Li, Lei PhD∥∥; Burton, Robert L. MS§¶; Hastings, Betty∥∥; Phelps, Dale L. MD*; Sanchez, Pablo J. MD†; Carlo, Waldemar A. MD§¶; Stevenson, David K. MD§§; Higgins, Rosemary D. MD***; on behalf of the NICHD Neonatal Research Network

Supplemental Author Material
Collapse Box

Abstract

Background: The heptavalent pneumococcal CRM197 conjugate vaccine (PCV-7) has been incompletely studied in very-low-birth-weight (≤1500 g) infants.

Objective: To assess PCV-7 immunogenicity in very-low-birth-weight, premature infants. We hypothesized that the frequency of postvaccine antibody concentrations ≥0.15 μg/mL would vary directly with birth weight.

Methods: This was a multicenter observational study. Infants 401 to 1500 g birth weight and <32 0/7 weeks gestation, stratified by birth weight, were enrolled from 9 National Institute of Child Health and Human Development Neonatal Research Network centers. Infants received PCV-7 at 2, 4, and 6 months after birth and had blood drawn 4 to 6 weeks following the third dose. Antibodies against the 7 vaccine serotypes were measured by enzyme-linked immunosorbent assay.

Results: Of 369 enrolled infants, 244 completed their primary vaccine series by 8 months and had serum obtained. Subjects were 27.8 ± 2.2 (mean ± standard deviation) weeks gestation and 1008 ± 282 g birth weight. Twenty-six percent had bronchopulmonary dysplasia and 16% had received postnatal glucocorticoids. Infants 1001 to 1500 g birth weight were more likely than those 401 to 1000 g to achieve antibody concentrations ≥0.15 μg/mL against the least 2 immunogenic serotypes (6B: 96% vs. 85%, P = 0.003 and 23F: 97% vs. 88%, P = 0.009). In multiple logistic regression analysis, lower birth weight, postnatal glucocorticoid use, lower weight at blood draw, and Caucasian race were each independently associated with antibody concentrations <0.35 μg/mL against serotypes 6B and/or 23F.

Conclusions: When compared with larger premature infants, infants weighing ≤1000 g at birth have similar antibody responses to most, but not all, PCV-7 vaccine serotypes.

© 2010 Lippincott Williams & Wilkins, Inc.

Login

Article Tools

Share

Article Level Metrics

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.