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Pediatrics International
Volume 45 Issue 3 Page 314 - June 2003
doi:10.1046/j.1442-200X.2003.01706.x
Original Article
Effect of
aluminum adjuvants on safety and immunogenicity of Haemophilus
influenzae type b-CRM197 conjugate vaccine
güler Kanra,1
Simonetta Viviani,2
Kadriye Yurdakök,3
Elif Özmert,3
Alessandra Anemona,2
SongüL Yalç n,3
Okan Demiralp,4
Nihan Bilgili,4
Ates Kara,1
Ali BüLent Cengiz ,1
Belgin Mutlu,5
Alexandra Baldini,2
Elisa Marchetti2
and Audino Podda2
Abstract Objective : The
present study was carried out to evaluate the safety and
immunogenicity of the Haemophilus influenzae type b-CRM197
(Hib-CRM197 ) conjugate vaccine in relation to the change
of adjuvant from aluminum hydroxide to aluminum phosphate (AlPO4 ).
Methods : The present study was a clinical phase II,
observer-blind, randomized, multicenter, controlled study. Subjects
were healthy infants aged 6 12 weeks, eligible
for expanded program of immunization (EPI) routine vaccination and
admitted to Hacettepe University Department of Social Pediatrics and
Gülveren Health Center, Ankara. A total of 520 healthy infants were
randomized in a 2:2:1 ratio to receive at either Chiron Hib/AlPO4
vaccine or VaxemHib (aluminum hydroxide adjuvant) vaccine or
HibTiter (no adjuvant). Vaccines were administered simultaneously
with routine diphtheria, tetanus and pertussis (DTaP) and oral polio
vaccine (OPV) vaccines at 2, 4 and 6 months of age. Blood samples
for anti-plain polysaccharide (PRP) antibody measurement were
collected before the first vaccination and 1 month after the last
vaccination. After each vaccination parents filled out a diary for
7 days.
Results : Out of 520 subjects enrolled, 514 received
three doses and were included for safety analysis. Local and
systemic reactions occurred with low and similar frequencies in all
groups. Only erythema was more common in Chiron Hib/AlPO4
vaccine (19, 10, 11% in Chiron Hib/AlPO4 , VaxemHib and
HibTiter, respectively, P < 0.05). Nine serious adverse events
were reported in seven cases of which none were related to vaccines.
A total of 504 subjects were included in the immunogenicity
analysis. The three vaccines were highly immunogenic and equivalent
in terms of percentage of acquisition of long-term protective
levels. The anti-PRP geometric mean titers were 9.9, 8.3 and
5.14 µg/mL, respectively (P < 0.05).
Conclusions : The use of aluminum compounds
adjuvants in Hib-CRM197 conjugate vaccines does not
impact the safety profile, while it does increase the magnitude of
anti-PRP antibody titers.
Affiliations
Departments of 1Paediatric Infectious
Diseases and 3Social Pediatrics Medical Faculty, Hacettepe University, Ankara,
2Clinical Research and Medical Affairs Department, Chiron Vaccines, Siena,
Italy, 4Gülveren Health Center, Ankara and 5Chiron Vaccines, Berk Ilaç Ith,
Ankara, Turkey
Correspondence
Correspondence: Professor Güler
Kanra, Department of Paediatric Infectious Diseases, Medical Faculty, Hacettepe
University, Ihsan Dogramaci Cocuk Hastanesi-Cocuk Enfeksiyon Hastaliklari
Unitesi, Sihhiye 06100, Ankara, Turkey. Email: aleskara@hacettepe.edu.tr
To cite this article
Kanra, güler, Viviani, Simonetta,
Yurdakök, Kadriye, Özmert, Elif, Anemona, Alessandra, Yalçn, SongüL, Demiralp,
Okan, Bilgili, Nihan, Kara, Ates, Cengiz, Ali BüLent, Mutlu, Belgin, Baldini,
Alexandra, Marchetti, Elisa & Podda, Audino (2003)
Effect of aluminum adjuvants on
safety and immunogenicity of Haemophilus influenzae type b-CRM197 conjugate
vaccine.
Pediatrics International 45 (3),
314-318.
doi: 10.1046/
j.1442-200X.2003.01706.x
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