Safety and Immunogenicity of a Conjugate Vaccine against<i>Haemophilus influenzae</i>Type b in Splenectomized and Nonsplenectomized Patients with Cooley Anemia

Cimaz, Rolando; Mensi, Carolina; D’Angelo, Emanuela; Fantola, E; Milone, Vittoria; Biasio, Luigi Roberto; Carnelli, V.; Zanetti, Alessandro

doi:10.1086/320727

Cited by 27 publications

(16 citation statements)

References 13 publications

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“…The immunogenicity of the Hib conjugate vaccine was assessed in 57 patients with thalassemia, 32 of whom had undergone splenectomy (70). All patients achieved protective antibody levels (Ͼ1 g/ml).…”

Section: Immunizationmentioning

confidence: 99%

Infections of People with Complement Deficiencies and Patients Who Have Undergone Splenectomy

2010

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SUMMARY The complement system comprises several fluid-phase and membrane-associated proteins. Under physiological conditions, activation of the fluid-phase components of complement is maintained under tight control and complement activation occurs primarily on surfaces recognized as “nonself” in an attempt to minimize damage to bystander host cells. Membrane complement components act to limit complement activation on host cells or to facilitate uptake of antigens or microbes “tagged” with complement fragments. While this review focuses on the role of complement in infectious diseases, work over the past couple of decades has defined several important functions of complement distinct from that of combating infections. Activation of complement in the fluid phase can occur through the classical, lectin, or alternative pathway. Deficiencies of components of the classical pathway lead to the development of autoimmune disorders and predispose individuals to recurrent respiratory infections and infections caused by encapsulated organisms, including Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae. While no individual with complete mannan-binding lectin (MBL) deficiency has been identified, low MBL levels have been linked to predisposition to, or severity of, several diseases. It appears that MBL may play an important role in children, who have a relatively immature adaptive immune response. C3 is the point at which all complement pathways converge, and complete deficiency of C3 invariably leads to severe infections, including those caused by meningococci and pneumococci. Deficiencies of the alternative and terminal complement pathways result in an almost exclusive predisposition to invasive meningococcal disease. The spleen plays an important role in antigen processing and the production of antibodies. Splenic macrophages are critical in clearing opsonized encapsulated bacteria (such as pneumococci, meningococci, and Escherichia coli) and intraerythrocytic parasites such as those causing malaria and babesiosis, which explains the fulminant nature of these infections in persons with anatomic or functional asplenia. Paramount to the management of patients with complement deficiencies and asplenia is educating patients about their predisposition to infection and the importance of preventive immunizations and seeking prompt medical attention.

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Section: Immunizationmentioning

confidence: 99%

Infections of People with Complement Deficiencies and Patients Who Have Undergone Splenectomy

2010

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“…18 Compared with antibody responses to Hib conjugate vaccine among adults with immunocompromising illnesses including chronic lymphocytic leukemia, multiple myeloma, HIV infection and bone marrow transplant recipients, the Alaska Native adults had a more vigorous response. [22][23][24][25][26][27] Anti-PRP IgG and IgM concentrations and SBA titers tended to be higher among persons younger than age 45 years and among women. It is possible that females and persons less than age 45 have more frequent or closer contact with young children who may be more likely to be recent Hib OP carriers.…”

Section: Discussionmentioning

confidence: 99%

“…This is consistent with other studies among vaccinated adults. [18][19][20][21][22][23][24][25][26][27] The most commonly reported side effect, mild to moderate pain at the injection site in the first 24 hours after the injection, was less frequently reported in this cohort compared with a cohort of Alaska non-natives who received a combination of Hib/hepatitis B vaccine. 19 No serious adverse events were reported among this cohort nor were serious adverse events reported among adult vaccine recipients in other studies.…”

Section: Discussionmentioning

confidence: 99%

“…19 No serious adverse events were reported among this cohort nor were serious adverse events reported among adult vaccine recipients in other studies. [18][19][20][21][22][23][24][25][26][27] The rate of invasive Hib disease among AN children has decreased in Alaska since 1996-97 when an increase in cases stimulated investigations and carriage studies; however, the rate remains substantially higher than among other U.S. children. Ongoing active surveillance for Hib invasive disease is critical to monitoring Hib disease in Alaska.…”

Section: Discussionmentioning

confidence: 99%

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Immunogenicity and Reactogenicity to Haemophilus influenzae Type b (Hib) Conjugate Vaccine Among Rural Alaska Adults

Dentinger

Hennessy²,

Bulkow³

et al. 2006

Human Vaccines

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Background: Despite routine vaccination and declining disease rates, Haemophilus influenzae type b (Hib) invasive disease still occurs in rural Alaska. Colonization studies indicate persistent transmission of Hib among village residents, including adults. As part of a project to eliminate Hib carriage in three rural villages, we evaluated a cohort of Alaska adults for antibody response and reactogenicity to a single dose of Hib conjugate vaccine (HbOC).Methods: 75 previously unvaccinated, randomly-selected adults in one village received a single dose of HbOC vaccine and completed a side-effects diary. Sera and oropharyngeal specimens were collected at baseline, two months and one year.Results: No participants were colonized with Hib or reported serious side-effects. At baseline, 97% of adults had IgG anti-PRP concentrations > 0.15 µg/mL, 69% > 1 µg/mL, and 28% > 5 µg/mL. Two months post-vaccination, 100% of participants had concentrations > 0.15 µg/mL, 93% > 1 µg/mL, and 86% > 5 µg/mL. After 1 year, 98% had IgG anti-PRP concentrations > 0.15 µg/mL, 86% > 1 µg/mL, and 67% > 5 µg/mL. GMCs were 1.9, 33.3 and 8.4 µg/mL at baseline, 2 months and 1 year post-vaccine, respectively (p < 0.01). Serum bactericidal activity increased from a baseline geometric mean titer of 2,205 to 8,349 two months post vaccination and declined to 1102 after one year.Conclusions: HbOC vaccine was immunogenic and well-tolerated among Alaskan adults. Nearly 90% of the adults developed an antibody level associated with protection against Hib colonization which persisted for 1 year in 67% of participants.

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“…The Hib conjugate vaccine has been shown to be immunogenic in both children and adults who have undergone splenectomy. 82,83 Data on revaccination against Hib are not available.…”

Section: Haemophilus Influenza B Vaccinementioning

confidence: 99%

Practical review of immunizations in adult patients with cancer

Ariza-Heredia¹,

Chemaly²

2015

Human Vaccines & Immunotherapeutics

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Safety and Immunogenicity of a Conjugate Vaccine againstHaemophilus influenzaeType b in Splenectomized and Nonsplenectomized Patients with Cooley Anemia

Cited by 27 publications

References 13 publications

Infections of People with Complement Deficiencies and Patients Who Have Undergone Splenectomy

Infections of People with Complement Deficiencies and Patients Who Have Undergone Splenectomy

Immunogenicity and Reactogenicity to Haemophilus influenzae Type b (Hib) Conjugate Vaccine Among Rural Alaska Adults

Practical review of immunizations in adult patients with cancer

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