Effect of neonatal immunization with diphtheria and tetanus toxoids on antibody responses to Haemophilus influenzae type b conjugate vaccines

• Published in: The Journal of pediatrics Vol. 126; no. 2; pp. 198 - 205
• Main Authors: Lieberman, Jay M., Greenberg, David P., Wong, Victor K., Partridge, Susan, Chang, Swei-Ju, Chiu, Chung-Yin, Ward, Joel I.
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.02.1995; Elsevier
• Subjects: Antibodies, Bacterial - blood; Bacterial Proteins - immunology; Biological and medical sciences; Carrier Proteins - immunology; Clostridium tetani - immunology; Corynebacterium diphtheriae - immunology; Diphtheria Toxoid - administration & dosage; Diphtheria Toxoid - adverse effects; Diphtheria Toxoid - immunology; Diphtheria-Tetanus Vaccine; Drug Combinations; Epidemiology. Vaccinations; General aspects; Haemophilus influenzae - immunology; Haemophilus Vaccines - administration & dosage; Haemophilus Vaccines - adverse effects; Haemophilus Vaccines - immunology; Humans; Immunization; Infant; Infant, Newborn; Infectious diseases; Injections, Intramuscular; Medical sciences; Safety; Tetanus Toxoid - administration & dosage; Tetanus Toxoid - adverse effects; Tetanus Toxoid - immunology; Vaccines, Conjugate - administration & dosage; Vaccines, Conjugate - adverse effects; Vaccines, Conjugate - immunology; DT; Hib; DTP; CRM 197; PRP-D; PRP-T; HbOC; ELISA; PRP; PRP-OMP; Human; Immunoprotection; Vaccination; Infant; Mixed vaccine; Diphtheria; Haemophilus influenzae; Active immunization; Infection; Pasteurellaceae; Prevention; Newborn; Bacteriosis; Bacteria; Tetanus
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/S0022-3476(95)70545-7

We randomly assigned 150 newborn infants to receive diphtheria and tetanus toxoids (DT) or Hib oligosaccharide conjugate (HbOC) at birth to determine whether exposure to the Haemophilus influenzae type b (Hib) conjugate vaccines' carrier proteins would enhance immune responses to subsequent administrations of HbOC or PRP-tetanus toxoid conjugate (PRP-T) at 2, 4, and 6 months of age. Their antibody responses were compared with those of 100 children immunized with HbOC or PRP-T beginning at 2 months of age. No serious adverse reactions were associated with neonatal vaccination. Administration of HbOC at birth did not lead to earlier or higher antibody levels. Newborn immunization with DT did not prime children for enhanced antibody responses. Moreover, Hib antibody levels were lower in DT-primed children than in children immunized beginning at 2 months of age. Diphtheria antibody levels, but not tetanus antibody levels, were also lower in children immunized with DT at birth. We conclude that neonatal immunization with Hib conjugate vaccines is not a means to provide earlier protection against invasive Hib disease. Newborn DT administration does not enhance subsequent antibody responses to Hib conjugate vaccines, and may lead to suppression of Hib and diphtheria antibody responses. (J P EDIATR 1995;126:198-205)