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Infection and Immunity, January 2004, p. 332-337, Vol. 72, No. 1
0019-9567/04/$08.00+0     DOI: 10.1128/IAI.72.1.332-337.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.

Immune Response to Meningococcal Serogroup C Conjugate Vaccine in Asplenic Individuals

Manchester Laboratory, Health Protection Agency North West, Manchester Medical Microbiology Partnership, Manchester M13 9WZ,¹ Cheshire and Merseyside Health Protection Team, Chester Microbiology Laboratory, Chester CH2 1UL,² Immunisation Division, Health Protection Agency, CDSC, London NW9 5EQ, United Kingdom³

Received 30 June 2003/ Returned for modification 3 September 2003/ Accepted 30 September 2003

Asplenic individuals are known to be at increased risk of infection with encapsulated bacteria. Recent United Kingdom recommendations stated that this at-risk group should receive one dose of the meningococcal serogroup C conjugate (MCC) vaccine. However, the immune response of asplenic individuals to MCC vaccine is unknown. The immune response of asplenics (n = 130) to immunization with the MCC vaccine was investigated. Asplenic individuals had a significantly lower geometric mean titer (GMT) (157.8; 95% confidence interval [CI], 94.5 to 263.3) of bactericidal antibody in serum (SBA) than an age-matched control group (n = 48) (1448.2; 95% CI, 751.1 to 2792.0). However, 80% of asplenic individuals achieved the proposed protective SBA titer of 8. No differences were observed between the two groups in the serogroup C-specific immunoglobulin G geometric mean concentration. A significant reduction in SBA GMT or the number of responders achieving an SBA titer of 8 was observed if the reason for splenectomy was a medical cause or if MCC vaccination occurred <10 years after splenectomy. Individuals (n = 29) who did not achieve an SBA titer of 16 were offered a second dose of MCC vaccine. Analysis of the SBA response revealed that 61% (14 of 23) of the individuals who received a second dose achieved a protective titer. In total, 93% of asplenic individuals achieved a titer of 8 following MCC vaccination (one or two doses combined). We recommend that, following vaccination of asplenics, either the level of functional antibody should be determined, with a second dose of MCC vaccine offered to nonresponders, or two doses of MCC vaccine should be routinely offered.

Editor: S. H. E. Kaufmann

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