The safety profile of Haemophilus influenzae type b-Neisseria meningitidis serogroups C and Y tetanus toxoid conjugate vaccine (HibMenCY)

Stephen Rinderknecht, Kristina Bryant, Terry Nolan, Noris Pavia-Ruz, Carlos Aranza Doniz, Miguel Angel Rodriguez Weber, Christopher Cohen, Emmanuel Aris, Narcisa Mesaros, Jacqueline M Miller, Stephen Rinderknecht, Kristina Bryant, Terry Nolan, Noris Pavia-Ruz, Carlos Aranza Doniz, Miguel Angel Rodriguez Weber, Christopher Cohen, Emmanuel Aris, Narcisa Mesaros, Jacqueline M Miller

Abstract

The safety profile of HibMenCY was compared with licensed Hib conjugate vaccines in a pooled analysis that included more than 8,500 subjects who were administered a four-dose series of HibMenCY or commercially available Hib vaccines at 2, 4, 6 and 12-15 mo of age in two primary vaccination and two fourth dose phase 3 studies. In all studies, HibMenCY or Hib vaccine was co-administered with age-appropriate, routinely recommended vaccines. In one primary and one fourth dose study (n = 4180), local and general symptoms were solicited using diary cards for 4 d after each dose. Serious adverse events (SAEs) and the occurrence of adverse events (AEs) indicating new onset of chronic disease (NOCD), rash, and conditions prompting Emergency Room (ER) visits were reported from dose 1 until 6 mo after dose 4. The incidences of solicited local and general symptoms were similar following HibMenCY and commercially available Hib vaccines. For some solicited symptoms (pain at the injection site and irritability), rates were lower in the HibMenCY group compared with the Hib control group (p value < 0.05). There were no statistically significant differences between groups in the incidences of SAEs, NOCDs, rash, or AEs leading to ER visits, with the exceptions of anemia and viral gastroenteritis, which occurred significantly less frequently in those receiving HibMenCY than those receiving commercially available Hib vaccines. In this pooled safety analysis, the safety profile of HibMenCY was similar to the safety profile of licensed monovalent Hib vaccines, despite the addition of meningococcal antigens. These studies are registered at www.clinicaltrials.gov NCT00345579 (primary vaccination study), NCT00345683 (fourth dose vaccination study) and NCT00289783 (primary and fourth dose vaccination studies).

Figures

Figure 1.
Figure 1.
Percentage of subjects reporting each solicited adverse event within the 4-d post-vaccination period after each dose, during the four-dose series (total vaccinated cohort, studies A/B). Grade 3, prevented normal activity; except for pain, cries when limb is moved/spontaneously painful; fever, > 40.0°C; and for loss of appetite, not eating at all; redness and swelling, > 30 mm. Local symptoms refers to symptoms occurring at any injection site. *p

References

    1. Cohn AC, MacNeil JR, Harrison LH, Hatcher C, Theodore J, Schmidt M, et al. Changes in Neisseria meningitidis disease epidemiology in the United States, 1998-2007: implications for prevention of meningococcal disease. Clin Infect Dis. 2010;50:184–91. doi: 10.1086/649209.
    1. FDA - Menactra approval letter April 22, 2011. . Accessed June 8, 2011.
    1. WHO position paper on Haemophilus influenzae type b conjugate vaccines. Wkly Epidemiol Rec. 2006;81:445–52.
    1. Marchant CD, Miller JM, Marshall GS, Blatter M, Aris E, Friedland LR, et al. Randomized trial to assess immunogenicity and safety of Haemophilus influenzae type b and Neisseria meningitidis serogroups C and Y-tetanus toxoid conjugate vaccine in infants. Pediatr Infect Dis J. 2010;29:48–52. doi: 10.1097/INF.0b013e3181c3ce88.
    1. Marshall GS, Marchant CD, Blatter M, Aris E, Boutriau D, Poolman JT, et al. Immune response and one-year antibody persistence after a fourth dose of a novel Haemophilus influenzae type b and Neisseria meningitidis serogroups C and Y-tetanus toxoid conjugate vaccine (HibMenCY) at 12 to 15 months of age. Pediatr Infect Dis J. 2010;29:469–71. doi: 10.1097/INF.0b013e3181cdd379.
    1. Nolan T, Lambert S, Roberton D, Marshall H, Richmond P, Streeton C, et al. A novel combined Haemophilus influenzae type b-Neisseria meningitidis serogroups C and Y-tetanus-toxoid conjugate vaccine is immunogenic and induces immune memory when co-administered with DTPa-HBV-IPV and conjugate pneumococcal vaccines in infants. Vaccine. 2007;25:8487–99. doi: 10.1016/j.vaccine.2007.10.013.
    1. Nolan T, Richmond P, Marshall H, McVernon J, Alexander K, Mesaros N, et al. Immunogenicity and safety of an investigational combined Haemophilus influenzae type B-Neisseria meningitidis serogroups C and Y-tetanus toxoid conjugate vaccine. Pediatr Infect Dis J. 2011;30:190–6. doi: 10.1097/INF.0b013e3181fcb2bf.
    1. Bryant KA, Marshall GS, Marchant CD, Pavia-Ruiz N, Nolan T, Rinderknecht S, et al. Immunogenicity and Safety of H influenzae Type b-N meningitidis C/Y Conjugate Vaccine in Infants. Pediatrics. 2011;127:e1375–85. doi: 10.1542/peds.2009-2992.
    1. Australian Government Department of Health and Ageing, National Health and Medical Research Council. The Australian Immunisation Handbook 9th Edition 2008. . Accessed August 9, 2011.

Source: PubMed

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