The quantity and quality of anti-PRP induced by the new Indonesian DTwP-HB-Hib vaccine compared to the Hib vaccine given with the DTwP-HB vaccine

  • Novilia Sjafri Bachtiar Bio Farma, Bandung, West Java
  • Kusnandi Rusmil Universitas Padjadjaran Medical School, Bandung, West Java
  • Sunarjati Sudigdoadi Universitas Padjadjaran Medical School, Bandung, West Java
  • Hadyana Sukandar Universitas Padjadjaran Medical School, Bandung, West Java
  • Rini Mulia Sari Universitas Padjadjaran Medical School, Bandung, West Java
  • Cissy B. Kartasasmita Department of Child Health, Universitas Padjadjaran Medical School/Dr. Hasan Sadikin Hospital, Bandung, West Java
Keywords: avidity, anti-PRP, bactericidal, DTwP-HB-Hib, immunization, titer

Abstract

Background A phase II study of DTwP-HB-Hib vaccine compared to Hib (monovalent) vaccine given simultaneously with DTwP-HB vaccine has been done following the success of phase I study in infants, where the new DTwP-HB-Hib has excellent safety profiles and antibody responses in infants.

Objective To evaluate the titer (quantity), avidity, and bactericidal capacity (quality of anti-polyribosylribitol phosphate/anti-PRP), of a new combined Bio Farma DTwP-HB-Hib (pentavalent) vaccine, compared to the Hib monovalent vaccine given simultaneously with the DTwP-HB vaccine (DTwP-HB+Hib).

Methods The study was a prospective, randomized, open label, phase II trial. Subjects aged 6-11 weeks were allocated according to the randomization list. The pentavalent group received the DTwP-HB-Hib vaccine, while the monovalent group received the Hib monovalent and DTwP-HB vaccines separately. Immunizations were given in three doses with 28-day intervals. Blood specimens were taken before the first dose and 28 days after the last dose. We evaluated anti-PRP titers quantity (geometric mean antibody concentration/GMC) and seroprotection), followed by avidity and bactericidal (quality) testing. Titer and avidity of anti-PRP were tested using a modified version of the improved Phipps ELISA. Bactericidal capacity was evaluated using a Hib killing assay. Immune responses against other antigens in the vaccine were reported separately.

Results One hundred five subjects in the pentavalent group and 106 subjects in the Hib monovalent group were tested for anti-PRP titers. Only 102 specimens for each group were available for bactericidal testing, due to insufficient volume for testing. Both vaccines induced similar anti-PRP titers, for GMC and seroprotection. Avidity increases were 82.9% and 76.4% in the pentavalent and Hib monovalent groups, respectively. Bactericidal activities were 94.1% and 89.2%, respectively. Both avidity and bactericidal activity were not significantly different between groups.

Conclusion DTwP-HB-Hib vaccine induced anti-PRP quantity and quality comparable to those of the Hib monovalent vaccine given simultaneously with the DTwP-HB vaccine.

Author Biographies

Novilia Sjafri Bachtiar, Bio Farma, Bandung, West Java
Surveillance & Clinical Trial Division of Bio Farma. Was graduated from doctoral program in Padjadjaran University in 2016.
Kusnandi Rusmil, Universitas Padjadjaran Medical School, Bandung, West Java
Child Health Department, Universitas Padjadjaran Medical School/Dr. Hasan Sadikin Hospital, Bandung, West Java
Sunarjati Sudigdoadi, Universitas Padjadjaran Medical School, Bandung, West Java
Microbiology Department, Universitas Padjadjaran Medical School, Bandung, West Java
Hadyana Sukandar, Universitas Padjadjaran Medical School, Bandung, West Java
Epidemiology and Biostatistics Department, Universitas Padjadjaran Medical School, Bandung, West Java
Rini Mulia Sari, Universitas Padjadjaran Medical School, Bandung, West Java

Graduate School of Biomedical Sciences Master Program  Universitas Padjadjaran Medical School, Bandung, West Java

Cissy B. Kartasasmita, Department of Child Health, Universitas Padjadjaran Medical School/Dr. Hasan Sadikin Hospital, Bandung, West Java
Child Health Department, Hasan Sadikin Hospital/Faculty of Medicine, Universitas Padjadjaran Bandung

References

1. Chandran A, Watt JP, Santosham M. Haemophilus influenzae vaccines. Vaccine (Plotkin). 5th ed. Pennsylvania: Saunders-Elsevier; 2009. p. 471–520.
2. World Health Organization. WHO position paper on Haemophilus influenzae type b conjugate vaccines. (Replaces WHO position paper on Hib vaccines previously published in the Weekly Epidemiological Record. Wkly Epidemiol Rec. 2006;81:445–52.
3. Broker M. Burden of invasive disease caused by Haemophilus influenzae type b in Asia. Jpn J Infect Dis. 2009;62:87–92.
4. Kementerian Kesehatan RI. Pneumonia pada balita. Bulletin Jendela Epidemiologi. 2010; 3:1–36.
5. Watt JP, Wolfson LJ, O'Brien KL, Henkle E, Deloria-Knoll M, McCall N, et al. Burden of disease caused by Haemophilus influenzae type b in children younger than 5 years: global estimates. Lancet. 2009;374:903–11.
6. Rusmil K, Fadlyana E, Gunadi R, Bachtiar NS, Hadyana H. Haemophilus influenzae type b/polyribosylribitol phosphate-tetanus (Hib/PRP-T) vaccine safety, phase I study. IJIHS. 2015;3:55–9.
7. Rusmil K, Fadlyana E, Bachtiar NS, Hadyana H. Safety and immunogenicity of the DTP/HB/Hib combination vaccine, phase I study. Pediatr Indones. 2013;53:309–14.
8. Mariani M, Luzzi E, Proietti D, Mancianti S, Casini D, Constantino P, et al. A competitive enzyme-linked immunosorbent assay for measuring the levels of serum antibody to Haemophilus influenzae type b. Clin Diag Lab Immunol. 1998;5:667–74.
9. Denoel PA, Goldblatt D, de Vleeschauwer I, Jacquet JM, Pichichero ME, Poolman JT. Quality of the Haemophilus influenza Type b (Hib) antibody response induced by diphtheria-tetanus-acellular pertussis/Hib combination vaccine. Clin Vaccine Immunol. 2007;14:1362–9.
10. Bachtiar NS, Rusmil K, Sudigdoadi S, Sukandar H, Kartasasmita CB, Hadyana. The immunogenicity and safety of the new Indonesian DTwP-HB-Hib vaccine compared to DTwP-HB vaccine given with the Hib vaccine. Paediatr Indones. 2017;57:129–37.
11. Sharma HJ, Patil VD, Lalwani SK, Manglani MV, Ravichandran L, Kapre LV, et al. Assessment of safety and immunogenicity of two different lots of diphtheria, tetanus, pertussis, hepatitis B and Haemophilus influenzae type b vaccine manufactured using small and large scale manufacturing process. Vaccine. 2012;30:510–6.
12. Hla KH, Thein SA, Aye A, Han HH, Bock HL, David MP, et al. Reactogenicity and immunogenicity profiles of a novel pentavalent diphtheria-tetanus-whole cell pertussis-hepatitis B and Haemophilus influenzae type b vaccine: a randomized dose-ranging trial of the Hib tetanus-conjugate content. Pediatr Infect Dis J. 2006;25:706–12.
13. Eregowda A, Lalwani S, Chatterjee S, Vakil H, Ahmed K, Costantini M, et al. A phase III single arm, multicenter, open-label study to assess the immunogenicity and tolerability of a pentavalent DTwP-HepB-Hib vaccine in Indian infants. Hum Vaccin Immunother. 2013;9:1903–09.
14. Tregnaghi M, Lopez P, Rocha C, Rivera L, David MP, Ruttimann R, et al. A new DTPw-HB/Hib combination vaccine for primary and booster vaccination of infants in Latin America. Rev Panam Salud Publica. 2006;19:179–88.
15. Rao R, Dhingra MS, Bavdekar S, Behera N, Daga SR, Dutta AK, et al. A comparison of immunogenicity and safety of indigenously developed liquid (DTwPHB-Hib) pentavalent combination vaccine (Shan 5) with Easyfive (liq) and TritanrixHB + Hiberix (lyo) in Indian infants administered according to the EPI schedule. Hum Vaccin. 2009;5:425–9.
16. Edwards KM. Maternal antibodies and infant immune responses to vaccines. Vaccine. 2015;33:6469–72.
17. Crowe JE. Influence of maternal antibodies on neonatal immunization against respiratory viruses. Clin Infect Dis. 2001;33:1720–7.
18. Siegrist CA. Mechanisms by which maternal antibodies influence infant vaccine responses: review of hypotheses and definition of main determinants. Vaccine. 2003;21:3406–12.
19. Townsend K, Ladhani SN, Findlow H, Borrow R. Evaluation and validation of a serum bactericidal antibody for Haemophilus influenza type b and the threshold of protection. Vaccine. 2014;32:5560–6.
Published
2018-01-05
How to Cite
1.
Bachtiar N, Rusmil K, Sudigdoadi S, Sukandar H, Sari R, Kartasasmita C. The quantity and quality of anti-PRP induced by the new Indonesian DTwP-HB-Hib vaccine compared to the Hib vaccine given with the DTwP-HB vaccine. PI [Internet]. 5Jan.2018 [cited 31Oct.2024];57(5):262-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/1642
Received 2017-09-13
Accepted 2017-10-31
Published 2018-01-05