Evaluation of a Hexavalent-Pentavalent-Hexavalent Infant Primary Vaccination Series Followed by a Pentavalent Booster Vaccine in Healthy Infants and Toddlers

Pediatr Infect Dis J. 2019 Mar;38(3):317-322. doi: 10.1097/INF.0000000000002231.

Abstract

Background: This study assessed a pediatric mixed hexavalent diphtheria (D)-tetanus (T)-acellular pertussis (aP)-inactivated poliovirus (IPV)-hepatitis B (HB)-Haemophilus influenzae b [polyribosylribitol phosphate (PRP-T)]-pentavalent (DTaP-IPV//PRP-T)-hexavalent primary series schedule followed by a pentavalent booster.

Methods: Healthy infants (N = 265) who had received a prior HB vaccination received a fully liquid, hexavalent vaccine (DTaP-IPV-HB-PRP-T) at 2 and 6 months of age and a reconstituted pentavalent vaccine (DTaP-IPV//PRP-T) at 4 months of age. Coadministered vaccines were pneumococcal vaccine at 2 and 4 months (and optionally at 6 months of age), rotavirus vaccine at 2, 4, 6 months and meningococcal serogroup C vaccine at 2 months. At 18 months, participants received DTaP-IPV//PRP-T and pneumococcal vaccine boosters. Immunogenicity was assessed using validated assays and safety by parental reports.

Results: For the hexavalent and pentavalent vaccines, the primary series and booster immune responses in terms of seroprotection and vaccine response rates were high for all antigens (generally > 99% and > 95% for the primary series and booster, respectively) and prebooster antibody persistence was good for all antigens (in particular, 92.4% of participants had prebooster anti-HB antibody ≥ 10 mIU/mL). The incidence of solicited reactions was lower after the booster vaccination (56.9%-73.1%) than the primary series (76.6%-97.4%); there were few vaccine-related unsolicited adverse events (1.9% and 1.5% for the primary series and booster, respectively), none led to participant discontinuation and none was serious.

Conclusions: This study provides data that allow recommending authorities to consider the use of a sequential hexavalent-pentavalent-hexavalent primary vaccination series followed by a pentavalent booster in coadministration with other common childhood vaccines.

Publication types

  • Clinical Trial, Phase III
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antibodies, Bacterial / blood
  • Antibodies, Viral / blood
  • Diphtheria-Tetanus-Pertussis Vaccine / administration & dosage*
  • Female
  • Haemophilus Vaccines / administration & dosage*
  • Hepatitis B Antibodies / blood
  • Hepatitis B Vaccines / administration & dosage*
  • Humans
  • Immunization Schedule*
  • Immunization, Secondary*
  • Immunogenicity, Vaccine*
  • Infant
  • Male
  • Poliovirus Vaccine, Inactivated / administration & dosage*
  • Vaccines, Combined / administration & dosage

Substances

  • Antibodies, Bacterial
  • Antibodies, Viral
  • DTaP-IPV-HB-PRP-T vaccine
  • Diphtheria-Tetanus-Pertussis Vaccine
  • Haemophilus Vaccines
  • Hepatitis B Antibodies
  • Hepatitis B Vaccines
  • Poliovirus Vaccine, Inactivated
  • Vaccines, Combined