[[[ Objective: ]]] To describe the immune response of preterm infants, with a reduced response to primary Haemophilus influenzae type B (Hib) immunisation, to a fourth dose of Hib conjugate vaccine given in early life. [[[ Design: ]]] Prospective observational study. [[[ Setting: ]]] Five Wessex Neonatal Units. [[[ Patients: ]]] Infants born at < 32 weeks and immunised with three doses of combined acellular pertussis-Hib vaccine, with a Hib IgG geometric mean concentration (GMC) < 1.0 microg/ml after these primary immunisations. [[[ Interventions: ]]] An additional fourth dose of Hib conjugate vaccine given before 1 year of age. Blood taken to assess Hib IgG concentration and avidity after immunisation. [[[ Main outcome measures: ]]] Hib IgG GMC and avidity index. [[[ Results: ]]] Ninety six infants (mean gestational age at birth 29.1 weeks) received a fourth dose of Hib at a mean age of 7.8 months. Hib IgG GMC after the primary immunisations was 0.17 microg/ml (95% confidence interval (CI) 0.14 to 0.20) rising to 4.68 microg/ml (95% CI 3.36 to 6.57) after the fourth dose (p < 0.0001). The IgG response to the fourth dose correlated positively with the response after the primary immunisations (p < 0.001). Hib IgG geometric mean avidity index (GMAI) after the primary immunisations was 30.87 (95% CI 20.40 to 46.73). This increased to 124.73 (95% CI 109.93 to 141.51) after the fourth dose (p < 0.0001). [[[ Conclusion: ]]] Preterm infants with very low IgG responses to Hib after primary immunisations with a combined acellular pertussis-Hib vaccine mount a good response to a fourth dose of Hib. This study suggests that all infants will benefit from a fourth dose of Hib, regardless of the age at which it is given.
Responses to a fourth dose of Haemophilus influenzae type B conjugate vaccine in early life
초기 생애에서 B형 헤모필루스 인플루엔자 접합 백신의 네 번째 접종에 대한 반응
[Category] 백일해,
[Article Type] journal-article
[Source] pubmed
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