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Abstract：
BACKGROUND: Immunization with meningococcal ACWY conjugate vaccine induces protective antibodies against invasive meningococcal disease (IMD) caused by serogroups A, C, W and Y. We studied MenACWY-TT vaccine immunogenicity in adolescents with a heterogenous group of primary and secondary immune deficiency including patients with systemic lupus erythematosus, mixed connective tissue disease, vasculitis, uveitis, 22Q11 syndrome, sickle cell disease, and patients who underwent stem cell transplantation for bone marrow failure.
RESULTS: We enrolled 69 individuals aged 14-18 years diagnosed with a primary or secondary immune deficiency in a prospective observational cohort study. All patients received a single dose of MenACWY-TT vaccine during the catch-up campaign 2018-19 because of the IMD-W outbreak in the Netherlands. Capsular polysaccharide-specific (PS) IgG concentrations against MenACWY were measured before and 3-6, 12, and 24 months after vaccination. Overall, geometric mean concentrations (GMCs) of MenACWY-PS-specific IgG were lower in patients compared to data from healthy, aged-matched controls (n = 75) reaching significance at 12 months postvaccination for serogroup A and W (adjusted GMC ratios 0.26 [95% CI: 0.15-0.47] and 0.22 [95% CI: 0.10-0.49], respectively). No serious adverse events were reported by study participants.
CONCLUSIONS: The MenACWY conjugate vaccine was less immunogenic in adolescent patients with primary or secondary immunodeficiency compared to healthy controls, urging the need for further surveillance of these patients and supporting considerations for booster MenACWY conjugate vaccinations in these patient groups.
RESULTS: We enrolled 69 individuals aged 14-18 years diagnosed with a primary or secondary immune deficiency in a prospective observational cohort study. All patients received a single dose of MenACWY-TT vaccine during the catch-up campaign 2018-19 because of the IMD-W outbreak in the Netherlands. Capsular polysaccharide-specific (PS) IgG concentrations against MenACWY were measured before and 3-6, 12, and 24 months after vaccination. Overall, geometric mean concentrations (GMCs) of MenACWY-PS-specific IgG were lower in patients compared to data from healthy, aged-matched controls (n = 75) reaching significance at 12 months postvaccination for serogroup A and W (adjusted GMC ratios 0.26 [95% CI: 0.15-0.47] and 0.22 [95% CI: 0.10-0.49], respectively). No serious adverse events were reported by study participants.
CONCLUSIONS: The MenACWY conjugate vaccine was less immunogenic in adolescent patients with primary or secondary immunodeficiency compared to healthy controls, urging the need for further surveillance of these patients and supporting considerations for booster MenACWY conjugate vaccinations in these patient groups.
摘要：
背景：用脑膜炎球菌ACWY结合疫苗免疫诱导针对由血清群A引起的侵袭性脑膜炎球菌病（IMD）的保护性抗体，C,W和Y。我们研究了MenACWY-TT疫苗在患有原发性和继发性免疫缺陷的异质性青少年中的免疫原性，包括系统性红斑狼疮患者，混合性结缔组织病,血管炎,葡萄膜炎,22Q11综合征，镰状细胞病,以及因骨髓衰竭而接受干细胞移植的患者。
结果：在一项前瞻性观察性队列研究中，我们招募了69名年龄在14-18岁之间被诊断为原发性或继发性免疫缺陷的个体。由于荷兰的IMD-W爆发，所有患者在2018-19年的追赶运动期间都接受了单剂量的MenACWY-TT疫苗。在接种前和接种后3-6、12和24个月测量针对MenACWY的荚膜多糖特异性（PS）IgG浓度。总的来说,与健康患者的数据相比，MenACWY-PS特异性IgG的几何平均浓度（GMC）较低，年龄匹配的对照（n=75）在疫苗接种后12个月达到显着血清群A和W（调整后的GMC比率0.26[95％CI：0.15-0.47]和0.22[95％CI：0.10-0.49]，分别)。研究参与者未报告严重不良事件。
结论：与健康对照相比，MenACWY结合疫苗在患有原发性或继发性免疫缺陷的青少年患者中的免疫原性较低，敦促需要对这些患者进行进一步监测，并支持在这些患者组中进行加强MenACWY结合疫苗接种的考虑。
结果：在一项前瞻性观察性队列研究中，我们招募了69名年龄在14-18岁之间被诊断为原发性或继发性免疫缺陷的个体。由于荷兰的IMD-W爆发，所有患者在2018-19年的追赶运动期间都接受了单剂量的MenACWY-TT疫苗。在接种前和接种后3-6、12和24个月测量针对MenACWY的荚膜多糖特异性（PS）IgG浓度。总的来说,与健康患者的数据相比，MenACWY-PS特异性IgG的几何平均浓度（GMC）较低，年龄匹配的对照（n=75）在疫苗接种后12个月达到显着血清群A和W（调整后的GMC比率0.26[95％CI：0.15-0.47]和0.22[95％CI：0.10-0.49]，分别)。研究参与者未报告严重不良事件。
结论：与健康对照相比，MenACWY结合疫苗在患有原发性或继发性免疫缺陷的青少年患者中的免疫原性较低，敦促需要对这些患者进行进一步监测，并支持在这些患者组中进行加强MenACWY结合疫苗接种的考虑。
