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April 12, 2000

Can Meningococcal C Conjugate Vaccine Overcome Immune Hyporesponsiveness Induced by Previous Administration of Plain Polysaccharide Vaccine?

Author Affiliations

Phil B.FontanarosaMD, Deputy EditorIndividualAuthorStephen J.LurieMD, PhD, Fishbein FellowIndividualAuthor

JAMA. 2000;283(14):1826-1827. doi:10.1001/jama.283.14.1821

To the Editor: We previously reported a randomized controlled trial to assess the induction of immunologic memory in children (15-23 months) previously given 2 doses of either meningococcal C conjugate vaccine or plain quadrivalent meningococcal polysaccharide vaccine, separated by 2 months.1 The conjugate vaccination primed for a memory IgG antimeningococcal C antibody response to a dose of plain quadrivalent meningococcal vaccine given 1 year later.1 In contrast, the group initially given the plain meningococcal vaccine showed evidence of hyporesponsiveness. While the clinical significance is unknown, theoretically, these children might be at increased risk for invasive serogroup C meningococcal disease if exposed. Therefore, we carried out an open-label extension of the previous study at the 3 original sites to determine if a dose of meningococcal C conjugate vaccine could overcome this hyporesponsive state.

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