Vicki Krause, Australia

Northern Territory Government Health

Author Of 3 Presentations

HEAD TO HEAD COMPARISONS AT 2, 4, AND 7 MONTHS, FOLLOWING STANDARD AND COMBINED PHID-CV10 AND PCV13 SCHEDULES. (ID 429)

Abstract

Background

Australian Aboriginal children are at high risk of early infection withStreptococcus pneumoniae and non-typeable Haemophilus influenzae (NTHi). We evaluated immunogenicity against 10 shared serotypes of a 4-dose combination schedule of PHiD-CV10 at 1-2-4 months plus PCV13 at 6 months, compared with standard 2-4-6 month schedules.

Methods

Infants were allocated (1:1:1) at 28 to 38 days of age, to 3-dose schedules of PCV13 (P) or PHiD-CV10 (S) at 2-4-6 months (_PPP or _SSS), or a combination schedule at 1-2-4-6 months (SSSP). Immunogenicity was measured at 2, 4, and 7 months.

Results

At 2 months the SSSP combination was superior to pre-vaccination (VTs other than 6B, 19F, or 23F). At 4 months SSSP was superior to _PPP (9 VTs) and _SSS (7 VTs), and _SSS was superior to _PPP (8 VTs). At 7 months, SSSP was superior to _PPP (1, 6B, 9V, 19F and 23F) and _SSS (8 VTs), and _PPP was superior to _SSS (8 VTs). OPA supports the SSSP schedule, particularly against 1, 6B, and 23F.

Conclusions

The 1-2-4-6 month schedule (SSSP) was superior at 2, 4, and 7 months of age compared to _SSS or _PPP, particularly for 1, 6B, and 23F at 7 months. At 4 months, _SSS was superior to _PPP.

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INTERCHANGEABILITY OF PHID-CV10 AND PCV13 IN PRIMARY COURSE SCHEDULES (ID 204)

Abstract

Background

In remote communities of northern Australia, we previously demonstrated that the onset of otitis media (OM) in Aboriginal infants was preceded by acquisition of bacterial pathogens that colonise the nasopharynx (NP) soon after birth. We aimed to determine safety and effectiveness of mixed vaccine schedules against early infection due to non-typeable Haemophilus influenzae and Streptococcus pneumoniae.

Methods

In an open-label controlled trial, we randomised (1:1:1) Aboriginal infants at 28 to 38 days of age, to either Prevenar13™ (P, PCV13) at 2-4-6 months of age (_PPP), Synflorix™ (S, PHiD-CV10) at 2-4-6 months (_SSS), or Synflorix at 1-2-4 months plus Prevenar13 at 6 months (SSSP). Primary outcomes (assessor-blinded) were immunogenicity at 7 months of age against pneumococcal serotypes 3, 6A, and 19A, and protein D (GMCs and proportions of infants with IgG > 0·35 µg/mL or > 100 EL.U/mL, respectively). Secondary immunogenicity outcomes at 2 and 4 months are also reported.

Results

A 4-dose early 1-2-4-6 month combination schedule of Synflorix plus Prevenar13 (SSSP) provided superior overall immune protection against serotypes 3, 6A, 19A, and protein D, compared to standard 3-dose 2-4-6 month schedules (_SSS or _PPP).

Conclusions

These vaccines can be combined safely and effectively within this primary schedule, with no evidence of immune suppression.

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