Comparison of multiple immunization schedules for Haemophilus influenzae type b-conjugate and tetanus toxoid vaccines following bone marrow transplantation

• Published in: Bone marrow transplantation (Basingstoke) Vol. 22; no. 8; pp. 735 - 741
• Main Authors: VANCE, E, GEORGE, S, GUINAN, E. C, WHEELER, C, ANTIN, J. H, AMBROSINO, D. M, MOLRINE, D. C
• Format: Journal Article
• Language: English
• Published: Basingstoke Nature Publishing Group 01-10-1998
• Subjects: Adolescent; Adult; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Antibodies; Biological and medical sciences; Bone marrow; Bone marrow transplantation; Bone Marrow Transplantation - adverse effects; Bone marrow, stem cells transplantation. Graft versus host reaction; Child; Child, Preschool; Conjugates; Female; Haemophilus Infections - etiology; Haemophilus Infections - immunology; Haemophilus Infections - prevention & control; Haemophilus influenzae; Haemophilus influenzae - immunology; Haemophilus Vaccines - administration & dosage; Haemophilus Vaccines - immunology; Humans; Immunization; Immunization Schedule; Immunoglobulin G; Immunosuppression - adverse effects; Male; Medical sciences; Middle Aged; Schedules; Stem cell transplantation; Tetanus; Tetanus - etiology; Tetanus - prevention & control; Tetanus Toxoid - administration & dosage; Tetanus Toxoid - immunology; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Transplantation; Transplantation, Homologous; Transplants & implants; Vaccines; Vaccines, Conjugate - administration & dosage; Vaccines, Conjugate - immunology; Human; Immune response; Toxoid; Homograft; Administration schedule; Vaccine; Haemophilus influenzae; Active immunization; Infection; Pasteurellaceae; Prevention; Immunoprophylaxis; Autograft; Viral disease; Bacteriosis; Bone marrow; Bacteria; Graft; Conjugation; Tetanus; Comparative study; Humoral immunity
• ISSN: 0268-3369; 1476-5365
• DOI: 10.1038/sj.bmt.1701424

Antibody concentrations to vaccine-preventable diseases decline following BMT and an optimal schedule for vaccination after transplant has not been established. We examined antibody responses to tetanus toxoid (TT) and Haemophilus influenzae type b-conjugate (HIB) vaccines of BMT patients immunized at 6, 12 and 24 months (6 month group, n = 21) and compared them to those previously reported for patients immunized at 3, 6, 12 and 24 months (3 month group, n = 74) or at 12 and 24 months (12 month group, n = 17) following transplantation. Geometric mean total anti-HIB and IgG anti-TT concentrations were significantly higher after the 12 month dose in the 3 and 6 month immunization groups compared to the group who received their first dose at 12 months. Although HIB antibody concentrations were higher in the 3 month and 6 month groups 12 to 24 months after BMT, the proportion of patients with protective levels was not significantly different from the proportion protected in the 12 month group. Following the 24 month immunizations, geometric mean antibody concentrations to HIB and TT were similar for all three immunization groups. The proportion of patients in each group with protective levels of HIB antibody after the 24 month dose was > or = 80%. A two dose schedule of HIB and TT vaccines at 12 and 24 months after BMT should afford protection.