Evaluation of a Booster Dose of Pentavalent Rotavirus Vaccine Coadministered With Measles, Yellow Fever, and Meningitis A Vaccines in 9-Month-Old Malian Infants

Fadima C Haidara, Milagritos D Tapia, Samba O Sow, Moussa Doumbia, Flanon Coulibaly, Fatoumata Diallo, Awa Traoré, Mamoudou Kodio, Corey L Kelly, Meagan Fitzpatrick, Karen Kotloff, John C Victor, Kathleen Neuzil, Fadima C Haidara, Milagritos D Tapia, Samba O Sow, Moussa Doumbia, Flanon Coulibaly, Fatoumata Diallo, Awa Traoré, Mamoudou Kodio, Corey L Kelly, Meagan Fitzpatrick, Karen Kotloff, John C Victor, Kathleen Neuzil

Abstract

Background: Rotavirus vaccines given to infants are safe and efficacious. A booster dose of rotavirus vaccine could extend protection into the second year of life in low-resource countries.

Methods: We conducted an open-label, individual-randomized trial in Bamako, Mali. We assigned 600 infants aged 9-11 months to receive measles vaccine (MV), yellow fever vaccine (YFV), and meningococcal A conjugate vaccine (MenAV) with or without pentavalent rotavirus vaccine (PRV). We assessed the noninferiority (defined as a difference of ≤10%) of seroconversion and seroresponse rates to MV, YFV, and MenAV. We compared the seroresponse to PRV.

Results: Seroconversion to MV occurred in 255 of 261 PRV recipients (97.7%) and 246 of 252 control infants (97.6%; difference, 0.1% [95% confidence interval {CI}, -4.0%-4.2%]). Seroresponse to YFV occurred in 48.1% of PRV recipients (141 of 293), compared with 52.2% of controls (153 of 293; difference, -4.1% [95% CI, -12.2%-4.0%]). A 4-fold rise in meningococcus A bactericidal titer was observed in 273 of 292 PRV recipients (93.5%) and 276 of 293 controls (94.2%; difference, -0.7% [95% CI, -5.2%-3.8%]). Rises in geometric mean concentrations of immunoglobulin A and immunoglobulin G antibodies to rotavirus were higher among PRV recipients (118 [95% CI, 91-154] and 364 [95% CI, 294-450], respectively), compared with controls (68 [95% CI, 50-92] and 153 [95% CI, 114-207], respectively).

Conclusions: PRV did not interfere with MV and MenAV; this study could not rule out interference with YFV. PRV increased serum rotavirus antibody levels.

Clinical trials registration: NCT02286895.

Figures

Figure 1.
Figure 1.
Study profile. MenAV, meningococcal A conjugate vaccine; MV, measles vaccine; PRV, pentavalent rotavirus vaccine; YFV, yellow fever vaccine.
Figure 2.
Figure 2.
Noninferiority of immune responses to concomitantly administered vaccines between recipients of measles vaccine (MV), yellow fever vaccine (YFV), meningococcal A conjugate vaccine (MenAV), and pentavalent rotavirus vaccine (PRV) and recipients of MV, YFV, and MenAV—per-protocol population. The dotted line indicates no difference, and the dashed line indicates the noninferiority margin of 10%. SBT, serum bactericidal titer .

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