Antibody persistence to diphtheria toxoid, tetanus toxoid, Bordetella pertussis antigens, and Haemophilus influenzae type b following primary and first booster with pentavalent versus hexavalent vaccines

Figures & data

Table 1. Comparison of antigen components in each vaccine.

	Hexavalent aP-containing vaccine (DTaP-IPV-HB-Hib) (0.5 mL/dose)	Pentavalent wP-containing vaccine (DTwP-HB-Hib) (0.5 mL/dose)^a	Tdap-IPV (0.5 mL/dose)
Trade name and manufacturer	Infanrix hexa (GSK, Rixensart, Belgium)	Quinvaxem (Crucell-Janssen, Incheon, South Korea)	Boostrix-polio (GSK, Rixensart, Belgium)
Groups that received the vaccine	aP group as the primary series and the first booster	wP and EPI wP groups as the primary series and the first booster	All groups (aP, wP, EPI wP) as the second booster
Pertussis
Pertussis toxin (PT)	25 µg		8 µg
Filamentous hemagglutinin (FHA)	25 µg		8 µg
Pertactin (PRN)	8 µg		2.5 µg
Inactivated B. pertussis		≥4 IU
Diphtheria
Diphtheria toxoid	≥30 IU	≥30 IU	≥2 IU
Hepatitis B
Hepatitis B surface antigen (HBsAg)	10 µg	10 µg	N/A
Tetanus
Tetanus toxoid	≥40 IU	≥60 IU	≥20 IU
Haemophilus influenzae type b (Hib)
Hib polyribosylribitol phosphate (PRP)^a
Hib capsular oligosaccharide^b	10 µg	10 µg	N/A
Poliovirus
Inactivated poliovirus type 1	40 D-antigen unit	N/A	40 D-antigen unit
Inactivated poliovirus type 2	8 D-antigen unit		8 D-antigen unit
Inactivated poliovirus type 3	32 D-antigen unit		32 D-antigen unit

^aConjugated to approximately 25 µg of tetanus toxoid (TT) as carrier protein.

^bConjugated to approximately 25 µg of CRM 17.

^cN/A: not applicable.

Figure 1. The consort flow diagram of this study.

Abbreviations: aP group referred to participants who received acellular pertussis-containing vaccine at 2, 4, 6, 18 months of age; wP group referred to participants who received whole cell pertussis-containing vaccine at 2, 4, 6, 18 months of age; EPI, Expanded Programme on Immunization; EPI wP group referred to participants who received whole cell pertussis-containing vaccine at 2, 4, 6, 18 months of age, but they were born to women who did not receive Tdap vaccine during pregnancy. Vaccine icon denoted Tdap-IPV as a second booster vaccination.

Figure 2. Geometric mean concentrations (GMCs) of anti-DT IgG (a), anti-TT IgG (b) from birth to 6 y, and anti-Hib IgG (c) from birth to 3 y among the aP (red), wP (blue), and EPI wP (green) cohort. Data from birth to month 19 were previously published.¹⁶ Error bars denoted 95% confidence interval.

Table 2. Percentages of children achieving diphtheria, tetanus, and Haemophilus influenzae b seroprotection between 2 and 6 y of age.

	24 months	36 months	48 months (Pre-2^nd booster)	49 months (Post-2^nd booster)	60 months	72 months
Anti-DT IgG
≥0.1 IU/mL
Hexavalent (aP) group	95.9	74.4	84.2	100	95.2	91
Pentavalent (wP) group	84.1	56.3	71.8	100	93.7	88.5
EPI wP group	81.8	68.4	76.8	100	95.8	85.7
Anti-TT IgG
≥0.1 IU/mL
Hexavalent (aP) group	100	98.3	99.2	100	100	100
Pentavalent (wP) group	100	100	100	100	100	100
EPI wP group	100	100	100	100	100	100
Anti-Hib IgG
≥0.15 µg/mL
Hexavalent (aP) group	100	100
Pentavalent(wP) group	100	100
EPI wP group	100	100

Figure 3. Geometric mean concentrations (GMCs) of anti-PT IgG (a), anti-FHA IgG (b), and anti-PRN IgG (c) from birth to 6 y among aP (red), wP (blue) and EPI wP (green) cohort. Data from birth to month 19 were previously published.¹⁴ Error bars denoted 95% confidence interval. Statistical differences between the antibody levels among children from different groups were analyzed using Kruskal–Wallis test followed by Dunn’s test for multiple comparison adjustments. Statistical significance was indicated as follows: ^#adjusted p-value <.05 between aP and wP group, *adjusted p-value <.05 between aP and EPI wP group.

Slack MPE, Cripps AW, Grimwood K, Mackenzie GA, Ulanova M. Invasive Haemophilus influenzae infections after 3 decades of hib protein conjugate vaccine use. Clin Microbiol Rev. 2021;34(3):e0002821. doi:10.1128/CMR.00028-21.

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Data availability statement

Data will be available upon request.