Heptavalent pneumococcal conjugate vaccine immunogenicity in very-low-birth-weight, premature infants.

Academic Article


  • BACKGROUND: The heptavalent pneumococcal CRM197 conjugate vaccine (PCV-7) has been incompletely studied in very-low-birth-weight (< or =1500 g) infants. OBJECTIVE: To assess PCV-7 immunogenicity in very-low-birth-weight, premature infants. We hypothesized that the frequency of postvaccine antibody concentrations > or =0.15 microg/mL would vary directly with birth weight. METHODS: This was a multicenter observational study. Infants 401 to 1500 g birth weight and <32 0/7 weeks gestation, stratified by birth weight, were enrolled from 9 National Institute of Child Health and Human Development Neonatal Research Network centers. Infants received PCV-7 at 2, 4, and 6 months after birth and had blood drawn 4 to 6 weeks following the third dose. Antibodies against the 7 vaccine serotypes were measured by enzyme-linked immunosorbent assay. RESULTS: Of 369 enrolled infants, 244 completed their primary vaccine series by 8 months and had serum obtained. Subjects were 27.8 +/- 2.2 (mean +/- standard deviation) weeks gestation and 1008 +/- 282 g birth weight. Twenty-six percent had bronchopulmonary dysplasia and 16% had received postnatal glucocorticoids. Infants 1001 to 1500 g birth weight were more likely than those 401 to 1000 g to achieve antibody concentrations > or =0.15 microg/mL against the least 2 immunogenic serotypes (6B: 96% vs. 85%, P = 0.003 and 23F: 97% vs. 88%, P = 0.009). In multiple logistic regression analysis, lower birth weight, postnatal glucocorticoid use, lower weight at blood draw, and Caucasian race were each independently associated with antibody concentrations <0.35 microg/mL against serotypes 6B and/or 23F. CONCLUSIONS: When compared with larger premature infants, infants weighing < or =1000 g at birth have similar antibody responses to most, but not all, PCV-7 vaccine serotypes.
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    Published In


  • Antibodies, Bacterial, Enzyme-Linked Immunosorbent Assay, Heptavalent Pneumococcal Conjugate Vaccine, Humans, Infant, Newborn, Infant, Premature, Infant, Very Low Birth Weight, Pneumococcal Vaccines, United States
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    Author List

  • D'Angio CT; Heyne RJ; O'Shea TM; Schelonka RL; Shankaran S; Duara S; Goldberg RN; Stoll BJ; Van Meurs KP; Vohr BR
  • Start Page

  • 600
  • End Page

  • 606
  • Volume

  • 29
  • Issue

  • 7