Asplenic individuals are known to be at increased risk of infection with encapsulated bacteria. Recent United Kingdom recommendations stated that this at-risk group should receive one dose of the meningococcal serogroup C conjugate (MCC) vaccine. However, the immune response of asplenic individuals to MCC vaccine is unknown. The immune response of asplenics (n = 130) to immunization with the MCC vaccine was investigated. Asplenic individuals had a significantly lower geometric mean titer (GMT) (157.8; 95\% confidence interval CI, 94.5 to 263.3) of bactericidal antibody in serum (SBA) than an age-matched control group (n = 48) (1448.2; 95\% CI, 751.1 to 2792.0). However, 80\% of asplenic individuals achieved the proposed protective SBA titer of \textgreater or =8. No differences were observed between the two groups in the serogroup C-specific immunoglobulin G geometric mean concentration. A significant reduction in SBA GMT or the number of responders achieving an SBA titer of \textgreater or =8 was observed if the reason for splenectomy was a medical cause or if MCC vaccination occurred \textless10 years after splenectomy. Individuals (n = 29) who did not achieve an SBA titer of \textgreater or =16 were offered a second dose of MCC vaccine. Analysis of the SBA response revealed that 61\% (14 of 23) of the individuals who received a second dose achieved a protective titer. In total, 93\% of asplenic individuals achieved a titer of \textgreater or =8 following MCC vaccination (one or two doses combined). We recommend that, following vaccination of asplenics, either the level of functional antibody should be determined, with a second dose of MCC vaccine offered to nonresponders, or two doses of MCC vaccine should be routinely offered.
%0 Journal Article
%1 balmer_immune_2004
%A Balmer, Paul
%A Falconer, Michelle
%A McDonald, Paula
%A Andrews, Nick
%A Fuller, Emily
%A Riley, Christine
%A Kaczmarski, Edward
%A Borrow, Raymond
%D 2004
%J Infection and Immunity
%K 80 Activity, Adolescent, Adult, Aged, Antibodies, Bacterial, Bactericidal Blood Female, G, Humans, Immunoglobulin Infections, Male, Meningococcal Middle Neisseria Splenectomy Vaccines, and meningitidis, over,
%N 1
%P 332--337
%T Immune response to meningococcal serogroup C conjugate vaccine in asplenic individuals
%U http://www.ncbi.nlm.nih.gov/pubmed/14688112
%V 72
%X Asplenic individuals are known to be at increased risk of infection with encapsulated bacteria. Recent United Kingdom recommendations stated that this at-risk group should receive one dose of the meningococcal serogroup C conjugate (MCC) vaccine. However, the immune response of asplenic individuals to MCC vaccine is unknown. The immune response of asplenics (n = 130) to immunization with the MCC vaccine was investigated. Asplenic individuals had a significantly lower geometric mean titer (GMT) (157.8; 95\% confidence interval CI, 94.5 to 263.3) of bactericidal antibody in serum (SBA) than an age-matched control group (n = 48) (1448.2; 95\% CI, 751.1 to 2792.0). However, 80\% of asplenic individuals achieved the proposed protective SBA titer of \textgreater or =8. No differences were observed between the two groups in the serogroup C-specific immunoglobulin G geometric mean concentration. A significant reduction in SBA GMT or the number of responders achieving an SBA titer of \textgreater or =8 was observed if the reason for splenectomy was a medical cause or if MCC vaccination occurred \textless10 years after splenectomy. Individuals (n = 29) who did not achieve an SBA titer of \textgreater or =16 were offered a second dose of MCC vaccine. Analysis of the SBA response revealed that 61\% (14 of 23) of the individuals who received a second dose achieved a protective titer. In total, 93\% of asplenic individuals achieved a titer of \textgreater or =8 following MCC vaccination (one or two doses combined). We recommend that, following vaccination of asplenics, either the level of functional antibody should be determined, with a second dose of MCC vaccine offered to nonresponders, or two doses of MCC vaccine should be routinely offered.
@article{balmer_immune_2004,
abstract = {Asplenic individuals are known to be at increased risk of infection with encapsulated bacteria. Recent United Kingdom recommendations stated that this at-risk group should receive one dose of the meningococcal serogroup C conjugate {(MCC)} vaccine. However, the immune response of asplenic individuals to {MCC} vaccine is unknown. The immune response of asplenics (n = 130) to immunization with the {MCC} vaccine was investigated. Asplenic individuals had a significantly lower geometric mean titer {(GMT)} (157.8; 95\% confidence interval {[CI],} 94.5 to 263.3) of bactericidal antibody in serum {(SBA)} than an age-matched control group (n = 48) (1448.2; 95\% {CI,} 751.1 to 2792.0). However, 80\% of asplenic individuals achieved the proposed protective {SBA} titer of {\textgreater} or =8. No differences were observed between the two groups in the serogroup C-specific immunoglobulin G geometric mean concentration. A significant reduction in {SBA} {GMT} or the number of responders achieving an {SBA} titer of {\textgreater} or =8 was observed if the reason for splenectomy was a medical cause or if {MCC} vaccination occurred {\textless}10 years after splenectomy. Individuals (n = 29) who did not achieve an {SBA} titer of {\textgreater} or =16 were offered a second dose of {MCC} vaccine. Analysis of the {SBA} response revealed that 61\% (14 of 23) of the individuals who received a second dose achieved a protective titer. In total, 93\% of asplenic individuals achieved a titer of {\textgreater} or =8 following {MCC} vaccination (one or two doses combined). We recommend that, following vaccination of asplenics, either the level of functional antibody should be determined, with a second dose of {MCC} vaccine offered to nonresponders, or two doses of {MCC} vaccine should be routinely offered.},
added-at = {2011-03-11T10:05:34.000+0100},
author = {Balmer, Paul and Falconer, Michelle and {McDonald}, Paula and Andrews, Nick and Fuller, Emily and Riley, Christine and Kaczmarski, Edward and Borrow, Raymond},
biburl = {https://www.bibsonomy.org/bibtex/257f0ea30f4f506214cfd66d83c9e3e24/jelias},
interhash = {b14374acf4462f365ce36921c3a48141},
intrahash = {57f0ea30f4f506214cfd66d83c9e3e24},
issn = {0019-9567},
journal = {Infection and Immunity},
keywords = {80 Activity, Adolescent, Adult, Aged, Antibodies, Bacterial, Bactericidal Blood Female, G, Humans, Immunoglobulin Infections, Male, Meningococcal Middle Neisseria Splenectomy Vaccines, and meningitidis, over,},
month = jan,
note = {{PMID:} 14688112},
number = 1,
pages = {332--337},
timestamp = {2011-03-11T10:05:47.000+0100},
title = {Immune response to meningococcal serogroup C conjugate vaccine in asplenic individuals},
url = {http://www.ncbi.nlm.nih.gov/pubmed/14688112},
volume = 72,
year = 2004
}