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Validation of Serological Correlate of Protection for Meningococcal C Conjugate Vaccine by Using Efficacy Estimates from Postlicensure Surveillance in England
Open accessAbstract
Meningococcal C conjugate (MCC) vaccines were licensed on the basis of serological correlates of protection without efficacy data. The original correlate of protection was established by using a serum bactericidal antibody assay (SBA) with human complement (hSBA), with titers ≥4 predicting protection. However, the antibody data supporting licensure were largely generated by SBA with rabbit complement (rSBA), which gives higher titers than hSBA. While rSBA titers ≥128 reliably predict protection, as measured by hSBA, sera with rSBA titers in the range of 8 to 64 may not have hSBA titers ≥4. For rSBA titers in this equivocal range, a fourfold rise pre- to postvaccination with the MCC vaccine and/or a characteristic booster response to a polysaccharide challenge was proposed as a correlate of protection. To validate this proposed rSBA correlate, age-specific efficacy estimates for MCC vaccines obtained from postlicensure surveillance in England were compared with the efficacy predicted by the percentage of individuals in these age groups with rSBA titers above different cutoffs at 4 weeks and at 7 to 9 months after vaccination with the MCC vaccine. The average time since vaccination in the cohorts in whom efficacy was measured ranged from 8 to 10 months. The rSBA cutoff of ≥128 was shown to significantly underestimate efficacy, with rSBA cutoffs of ≥4 or ≥8 at 4 weeks postvaccination with the MCC vaccine being the most consistent with observed efficacy. When the levels obtained 7 to 9 months postvaccination with the MCC vaccine were used, all rSBA cutoffs significantly underestimated efficacy, suggesting that continuing protection is less dependent on the SBA level at the time of exposure but is more reliant on immunologic memory.
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Cites
HUMAN IMMUNITY TO THE MENINGOCOCCUS
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HUMAN IMMUNITY TO THE MENINGOCOCCUS
Goldschneider, I., Gotschlich, E. C., & Artenstein, M. S. (1969) · The Journal of Experimental Medicine · doi:10.1084/jem.129.6.1327 · Cited by 995
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Self-citationMaslanka, S. E., Gheesling, L. L., Libutti, D. E., Donaldson, K. B., Harakeh, H. S., Dykes, J. K., Arhin, F. F., Devi, S. J., Frasch, C. E., Huang, J. C., et al. (1997) · Clinical Diagnostic Laboratory Immunology · doi:10.1128/cdli.4.2.156-167.1997 · Cited by 420
Efficacy of meningococcal serogroup C conjugate vaccine in teenagers and toddlers in England
Ramsay, M. E., Andrews, N., Kaczmarski, E. B., & Miller, E. (2001) · The Lancet · doi:10.1016/s0140-6736(00)03594-7 · Cited by 338
Self-citationBorrow, R., Andrews, N., Goldblatt, D., & Miller, E. (2001) · Infection and Immunity · doi:10.1128/iai.69.3.1568-1573.2001 · Cited by 316
Self-citationEstimation of Vaccine Effectiveness Using the Screening Method
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Meningococcal Serogroup C Conjugate Vaccine Is Immunogenic in Infancy and Primes for Memory
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Self-citationRichmond, P., Borrow, R., Goldblatt, D., Findlow, J., Martin, S., Morris, R., Cartwright, K., & Miller, E. (2001) · The Journal of Infectious Diseases · doi:10.1086/317646 · Cited by 219
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Cited by
Shankar, G., Devanarayan, V., Amaravadi, L., Barrett, Y. C., Bowsher, R., Finco-Kent, D., Fiscella, M., Gorovits, B., Kirschner, S., Moxness, M., et al. (2008) · Journal of Pharmaceutical and Biomedical Analysis · doi:10.1016/j.jpba.2008.09.020 · Cited by 613
Andrews, N. J., Waight, P. A., Burbidge, P., Pearce, E., Roalfe, L., Zancolli, M., Slack, M., Ladhani, S. N., Miller, E., & Goldblatt, D. (2014) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(14)70822-9 · Cited by 545
Self-citationMaintaining protection against invasive bacteria with protein–polysaccharide conjugate vaccines
Pollard, A. J., Perrett, K. P., & Beverley, P. C. (2009) · Nature Reviews Immunology · doi:10.1038/nri2494 · Cited by 485
Jódar, L., Butler, J., Carlone, G., Dagan, R., Goldblatt, D., Käyhty, H., Klugman, K., Plikaytis, B., Siber, G., Kohberger, R., et al. (2003) · Vaccine · doi:10.1016/s0264-410x(03)00230-5 · Cited by 388
Updates on immunologic correlates of vaccine-induced protection
Plotkin, S. A. (2020) · Vaccine · doi:10.1016/j.vaccine.2019.10.046 · Cited by 165
Metadata
- Authors
- Andrews, N., Borrow, R., & Miller, E.
- Venue
- Clinical and Vaccine Immunology
- Publisher
- American Society for Microbiology
- Published
- 2003-09
- Volume
- 10
- Issue
- 5
- Pages
- 780-786
- ISSN
- 1556-679X (ISSN-L)
- 1556-6811
- OpenAlex
- W2128589740
- Cited by
- 323
- References
- 18
- FWCI
- 13.66
- Type
- journal article
- Language
- en
- Open access
- diamond
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