Combination vaccine produces lower immune response than vaccines administered separately

A combination vaccine developed to reduce the number of vaccines infants receive appears to provide less immunity than the vaccines administered individually, according to a study in the April 13 issue of JAMA.

The development of immunogenic vaccines against major diseases of childhood has dramatically decreased the rates of invasive disease, according to background information in the article. Since the introduction of a monovalent serogroup C meningococcal glycoconjugate vaccine (MenC) into the United Kingdom routine immunization schedule in November 1999, group C meningococcal disease has decreased by 87 percent in the ages targeted for vaccination, with estimated vaccine efficacy of 90 percent. Within 2 years of the introduction of a 7-valent pneumococcal glycoconjugate vaccine into the recommended infant schedule in the United States, there was a 69 percent reduction in culture-positive invasive pneumococcal disease in children younger than 2 years.

The advent of these efficacious and safe vaccines has increased pressure on crowded infant immunization schedules. Infants in the United States receive up to 20 separate vaccine injections over 5 immunization encounters at ages 2, 4, 6, 12, and 18 months to protect against disease due to hepatitis B, diphtheria, tetanus, pertussis, polio, measles, mumps, rubella, varicella, H influenzae type b, and pneumococcus. The inclusion of MenC would add a further 3 to 4 doses to the U.S. regimen. The development of combination vaccines has become a priority. The combining of pneumococcal and meningococcal conjugate vaccines has the potential to spare U.S. infants up to 4 extra injections by age 18 months and to decrease parental and clinician concerns about the number of vaccinations in early childhood.

Jim P. Buttery, F.R.A.C.P., formerly of the University of Oxford, Churchill Hospital, Headington, Oxford, U.K., and colleagues conducted a study to determine the immunogenicity and safety of a combinati

Contact: Jim P. Buttery, F.R.A.C.P.
JAMA and Archives Journals

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