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Bulletin of the World Health Organization

Print version ISSN 0042-9686

Abstract

PANPITPAT, C. et al. Elevated levels of maternal anti-tetanus toxin antibodies do not suppress the immune response to a Haemophilus influenzae type b polyribosylphosphate-tetanus toxoid conjugate vaccine. Bull World Health Organ [online]. 2000, vol.78, n.3, pp. 364-371. ISSN 0042-9686.  http://dx.doi.org/10.1590/S0042-96862000000300012.

Reported are the effects of elevated levels of anti-tetanus antibodies on the safety and immune response to a Haemophilus influenzae type b polyribosylphosphate (PRP)-tetanus toxoid conjugate (PRP-T) vaccine. A group of Thai infants (n = 177) born to women immunized against tetanus during pregnancy were vaccinated with either a combined diphtheria-tetanus- pertussis (DTP) PRP-T vaccine or DTP and a PRP-conjugate vaccine using Neisseria meningitidis group B outer-membrane proteins as a carrier (PedVax HIB). Although most infants possessed high titres (>1 IU/ml) of anti-tetanus antibodies, the DTP-PRP-T combined vaccine engendered an excellent antibody response to all vaccine components. In both vaccine groups >98% of infants attained anti-PRP antibody titres >0.15 mg/ml. The geometric mean anti-PRP antibody titres were 5.41 mg/ml and 2.1 mg/ml for infants immunized with three doses of PRP-T versus two doses of PedVax HIB vaccines, respectively ( P< 0.005). Similarly, the proportion of infants who achieved titres >1 mg/ml was higher in the PRP-T group (87.8%) than in the group immunized with PedVax HIB (74.2%) (P = 0.036). A subgroup analysis showed that there was no significant difference in the anti-PRP antibody response for infants exhibiting either <1 IU of anti-tetanus antibody per millilitre or >1 IU/ml at baseline. These finding indicate that pre-existing anti-carrier antibody does not diminish the immune response to the PRP moiety. All infants possessed protective levels of anti-D and anti-T antibody levels after immunization.

Keywords : diphtheria-tetanus-pertussis vaccine [antagonists and inhibitors]; drug antagonism; Haemophilus influenzae type B [immunology]; Haemophilus vaccines [antagonists and inhibitors]; tetanus immunology [tetanus toxoid, antagonists and inhibitors]; Thailand.

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