Safety and immunogenicity of quadrivalent meningococcal conjugate vaccine in 2-to 10-year-old human immunodeficiency virus-infected children

George K. Siberry*, Meredith G. Warshaw, Paige L. Williams, Stephen A. Spector, Michael D. Decker, Patrick Jean-Philippe, Ram Yogev, Barbara E. Heckman, Adam Manzella, Jhoanna Roa, Sharon Nachman, Jorge Lujan-Zilbermann

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

22 Scopus citations

Abstract

Background: Human immunodeficiency virus (HIV)-infected children are at increased risk of meningococcal infection and poor response to quadrivalent meningococcal conjugate vaccine (MCV4), but MCV4 has not been studied in preadolescent HIV-infected children. Methods: The P1065 trial enrolled 2-to 10-year-old HIV-infected children with CD4 ≥25% to receive MCV4 at entry and at week 24. Rates of response (≥4-fold increase in rabbit serum bactericidal antibody) against each meningococcal serogroup (A, C, Y, W-135), geometric mean titers, and rates of seroprotection (rabbit serum bactericidal antibody titer ≥1:128) were determined from sera obtained at entry and weeks 4, 24, 28, and 72. Adverse events were assessed for 6 weeks after each MCV4 dose. Results: At entry, 47% of the 59 participants were male, 56% black, 31% Latino, median age was 6 years, 88% were receiving antiretroviral therapy, and 75% had viral load <400 copies/mL. There were no serious adverse events within 6 weeks after MCV4 doses; all vaccination reactions were mild. Response after a single MCV4 dose was high to serogroup A (92%) and W-135 (98%); responses improved after a second dose for serogroup C (43%-80%) (P < 0.0001) and Y (76%-84%) (P = 0.38). By week 72, seroprotection rates were 93%, 91%, 78%, and 46% for serogroups W-135, Y, A, and C, respectively. Conclusions: Two doses of MCV4 were safe and immunogenic in 2-to 10-year-old HIV-infected children. The second dose increased the proportion of children who made a response to serogroup C. Seroprotection waned substantially for serogroups A and C within 1 year of last MCV4 dose.

Original languageEnglish (US)
Pages (from-to)47-52
Number of pages6
JournalPediatric Infectious Disease Journal
Volume31
Issue number1
DOIs
StatePublished - Jan 2012

Keywords

  • conjugate vaccine
  • meningococcal vaccine
  • pediatric HIV infection

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Microbiology (medical)
  • Infectious Diseases

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