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Cited by 87Bacterial Infections and VaccinesPneumonia and Respiratory InfectionsImmunodeficiency and Autoimmune Disorders

Immunologic memory in Haemophilus influenzae type b conjugate vaccine failure

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McVernon, J·2003·Archives of Disease in Childhood
DOI 10.1136/adc.88.5.379PMC PMC1719572
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Abstract

AIMS: To compare the convalescent antibody response to invasive Haemophilus influenzae type b (Hib) disease between conjugate vaccine immunised and unimmunised children, to look for evidence of priming for immunologic memory. METHODS: Unmatched case-control study in the UK and Eire 1992-2001 and Victoria, Australia 1988-1990. A total of 93 children were identified as having invasive Hib disease following three doses of conjugate vaccine in infancy through post licensure surveillance throughout the UK and Eire; 92 unvaccinated children admitted to an Australian paediatric hospital with invasive Hib disease were used as historical controls. Convalescent serum was taken for measurement of Hib antibody concentration, and clinical information relating to potential disease risk factors was collected. The geometric mean concentrations of convalescent Hib antibodies were compared between immunised and unimmunised children, using raw and adjusted data. RESULTS: Hib conjugate vaccine immunised children had higher serum Hib antibody responses to disease (geometric mean concentration (GMC) 10.81 microg/ml (95% CI 6.62 to 17.66) than unimmunised children (1.06 microg/ml (0.61 to 1.84)) (p < 0.0001). However, following adjustment for the significant confounding influences of age at presentation and timing of serum collection, a difference persisted only in children presenting with meningitis (vaccinated GMC 3.78 microg/ml (2.78 to 5.15); unvaccinated GMC 1.48 microg/ml (0.90 to 2.21); p = 0.003). CONCLUSIONS: Higher antibody responses to invasive Hib disease in vaccinated children with meningitis reflect priming for immunologic memory by the vaccine. Although a majority of children in the UK are protected from Hib disease by immunisation, the relative roles of immunologic memory and other immune mechanisms in conferring protection remain unclear.

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  • For Haemophilus influenzae type B and capsular group C meningococcal infection, individuals with vaccine-induced immune memory can still develop disease once their antibody levels have waned, despite mounting robust but not rapid enough memory responses.

    “there is evidence in the case of both Haemophilus influenzae type B (Hib) and capsular group C meningococcal infection that individuals with vaccine-induced immune memory can still develop disease once their antibody levels have waned, despite mounting robust, although not rapid enough, memory responses43,44.”

    From A guide to vaccinology: from basic principles to new developments (2021) · cites this paper as [43]

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  1. Schneerson R, Rodrigues LP, Parke JC, et al. Immunity to disease caused by Haemophilus influenzae type b. J Immunol 1971;107:1081-9.

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Authors
McVernon, J.
Affiliations
John Radcliffe Hospital (GB)
Corresponding author
McVernon, J
ORCID
McVernon, J
Venue
Archives of Disease in Childhood
Publisher
BMJ
Published
2003-05-01
Volume
88
Issue
5
Pages
379-383
ISSN
  • 0003-9888 (ISSN-L)
  • 1468-2044
DOI
10.1136/adc.88.5.379
PMC
PMC1719572
OpenAlex
W2124912532
Cited by
87
References
31
Citations by year
2026: 1 · 2024: 1 · 2023: 3 · 2022: 3 · 2021: 3 · 2020: 3 · 2019: 2 · 2018: 1 · 2017: 4 · 2016: 1 · 2015: 1 · 2014: 3 · 2013: 7 · 2012: 6
FWCI
3.93
Type
journal article
Language
en
Open access
Locations
  • Archives of Disease in Childhood (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • HighWire Press Open Archive (submittedVersion)
Funders
University of Oxford
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 › Immunodeficiency and Autoimmune Disorders
Keywords
Haemophilus influenzae type b, conjugate vaccines, vaccine failure, immunological memory, invasive Hib disease, meningitis, vaccine priming, childhood immunization, post-licensure surveillance
MeSH terms
Age Factors, Antibodies, Bacterial, Child, Preschool, Enzyme-Linked Immunosorbent Assay, Epiglottitis, Female, Haemophilus Infections, Humans, Immunologic Memory, Infant, Male, Meningitis, Risk Factors, Case-Control Studies, Treatment Failure, Haemophilus Vaccines, Vaccines, Conjugate, Haemophilus influenzae type b

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