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Serologic Responses to ACYW135 Polysaccharide Meningococcal Vaccine in Saudi Children under 5 Years of Age

Department of Preventive Medicine, Ministry of Health, Saudi Arabia,¹ Medical Education and Research Center, King Fahad Specialist Hospital, Qassim, Saudi Arabia,² Meningococcal Reference Unit, HPA North West Laboratory, Manchester Royal Infirmary, Manchester M13 9WZ, United Kingdom,³ Statistics Unit, Communicable Disease Surveillance Centre, HPA Centre for Infections, London NW9 5EQ, United Kingdom⁴

Received 7 December 2004/ Returned for modification 5 January 2005/ Accepted 9 January 2005

An immunization campaign with meningococcal ACYW135 polysaccharide vaccine was conducted in 2003 by the Saudi Arabian Ministry of Health and included a study to evaluate the immune responses in children under 5 years of age in the Al Qassim region of Saudi Arabia. Children who were 24 months old were given one dose of tetravalent polysaccharide vaccine, while younger children were given two doses with an interval of 2 to 3 months. Blood samples were collected prevaccination and 1 month after the second dose for children younger than 24 months old and 1 month after the single dose for older children. Serogroup-specific antibody responses were determined by serum bactericidal antibody (SBA) assays and a tetraplex immunoglobulin G (IgG) bead assay. Significant increases in the proportions of individuals who were 24 months old with SBA titers of 8 were observed pre- to postvaccination for all serogroups. Age-dependent increases in the percentage of individuals with SBA titers of 8 1 month postvaccination were observed for each serogroup. Age-dependent increases in postvaccination IgG levels were observed for serogroup A (menA), serogroup W135 (menW), and serogroup Y (menY) but not for serogroup C (menC). Two doses of tetravalent polysaccharide vaccine in individuals who were 18 months old were poorly immunogenic for menC, menW, and menY. However, for menA, 42% of the children who were 18 months old were putatively protected with SBA titers of 8. A high percentage of subjects who were 2 years of age were putatively protected for menA; a similar level was observed for menY for children who were 4 years of age but not for younger children. However, for menC and menW poor levels of putative protection were still evident at 4 years of age.

Editor: D. L. Burns

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