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Cited by 19Bacterial Infections and VaccinesPneumonia and Respiratory InfectionsImmune responses and vaccinations

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Tetanus–diphtheria–pertussis vaccine may suppress the immune response to subsequent immunization with pneumococcal CRM197-conjugate vaccine (coadministered with quadrivalent meningococcal TT-conjugate vaccine): a randomized, controlled trial⋆

Tashani, Mohamed, Heron, Leon, Wong, Melanie, Rashid, Harunor, Booy, Robert·2017·Journal of Travel Medicine
DOI 10.1093/jtm/tax006
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Abstract

BACKGROUND: : Due to their antigenic similarities, there is a potential for immunological interaction between tetanus/diphtheria-containing vaccines and carrier proteins presented on conjugate vaccines. The interaction could, unpredictably, result in either enhancement or suppression of the immune response to conjugate vaccines if they are injected soon after or concurrently with diphtheria or tetanus toxoid. We examined this interaction among adult Australian travellers before attending the Hajj pilgrimage of 2015. METHODS: We randomly assigned each participant to one of three vaccination schedules. Group A received tetanus, diphtheria and acellular pertussis vaccine (Tdap) 3-4 weeks before receiving CRM197-conjugated 13-valent pneumococcal vaccine (PCV13) coadministered with TT-conjugated quadrivalent meningococcal vaccine (MCV4). Group B received all three vaccines concurrently. Group C received PCV13 and MCV4 3-4 weeks before Tdap. Blood samples collected at baseline, at each vaccination visit and 3-4 weeks after vaccination were tested for the pneumococcal opsonophagocytic assay (OPA). RESULTS: A total of 166 participants aged 18-64 (median 42) years were recruited, 159 completed the study. Compared with the other groups, Group A had significantly ( P < 0.05) lower geometric mean titres (GMTs) post-vaccination in seven serotypes of PCV13 (1, 3, 4, 5, 14, 18C and 9V). Additionally, Group A had lower frequency of serorises (≥ 4-fold rise in OPA titres) in serotype5 (79%, p = 0.01) and 18C (73.5%, p = 0.06); whereas Groups B and C had significantly lower frequencies of serorises in Serotype 4 (82%) and 6A (73.5%), respectively. No statistically significant difference was detected across the three groups in frequencies achieving OPA titre ≥ 1:8 post-vaccination. CONCLUSIONS: Tdap vaccination 3-4 weeks before administration of PCV13 and MCV4 significantly reduced the GMTs to seven of the 13 pneumococcal serotypes in adults. If multiple vaccination is required before travel, deferring tetanus/diphtheria until after administering the conjugate vaccine is recommended to avoid immune interference.

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Metadata

Authors
Tashani, M., Heron, L., Wong, M., Rashid, H., & Booy, R.
Affiliations
  • The University of Sydney (AU)
  • Children's Hospital at Westmead (AU)
Corresponding author
Tashani, Mohamed
ORCID
Venue
Journal of Travel Medicine
Publisher
Oxford University Press (OUP)
Published
2017-03-29
Volume
24
Issue
4
ISSN
  • 1195-1982 (ISSN-L)
  • 1708-8305
DOI
10.1093/jtm/tax006
OpenAlex
W2677892160
Cited by
19
References
1
Citations by year
2026: 1 · 2025: 2 · 2024: 2 · 2023: 1 · 2022: 1 · 2021: 2 · 2019: 3 · 2018: 7
FWCI
2.12
Type
journal article
Language
en
Open access
closed
Locations
  • Journal of Travel Medicine (publishedVersion)
  • PubMed (publishedVersion)
Funders
Islamic Development Bank
Topics
  • Life Sciences › Immunology and Microbiology › Microbiology › Bacterial Infections and Vaccines
  • Health Sciences › Medicine › Epidemiology › Pneumonia and Respiratory Infections
  • Life Sciences › Immunology and Microbiology › Immunology › Immune responses and vaccinations
Keywords
PCV13, quadrivalent meningococcal conjugate vaccine, immunosuppression, pneumococcal serotypes, serotype 5, serotype 18C, serotype 4, serotype 6A, Hajj pilgrimage
MeSH terms
Adolescent, Adult, Antibodies, Bacterial, Female, Humans, Immunization Schedule, Male, Middle Aged, Religion, Vaccination, Diphtheria-Tetanus-Pertussis Vaccine, Vaccines, Conjugate, Pneumococcal Vaccines, Meningococcal Vaccines, Young Adult, Travel Medicine

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