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Evaluation of immune responses to an oral typhoid vaccine, Ty21a, in children from 2 to 5 years of age in Bangladesh

Journal article
Authors Taufiqur Rahman Bhuiyan
F. K. Choudhury
F. Khanam
A. Saha
Md A. Sayeed
U. Salma
Anna Lundgren
D. A. Sack
Ann-Mari Svennerholm
F. Qadri
Published in Vaccine
Volume 32
Issue 9
Pages 1055-1060
ISSN 0264-410X
Publication year 2014
Published at Institute of Biomedicine, Department of Microbiology and Immunology
Pages 1055-1060
Language en
Links dx.doi.org/10.1016/j.vaccine.2014.0...
Keywords Antibodies, Children, Mucosal, Oral, T cells, Typhoid vaccine
Subject categories Microbiology, Immunology in the medical area

Abstract

Young children are very susceptible to typhoid fever, emphasizing the need for vaccination in under five age groups. The parenteral Vi polysaccharide vaccine is not immunogenic in children under 2 years and the oral Ty21a vaccine (Vivotif) available in capsular formulation is only recommended for those over 5 years. We studied immune responses to a liquid formulation of Ty21a in children 2-5 years of age. Since children in developing countries are in general hypo responsive to oral vaccines, the study was designed to determine if anti-helminthic treatment prior to vaccination, improves responses. In a pilot study in 20 children aged 4-5 years, the immune responses in plasma and in antibody in lymphocyte secretions (ALS) to the enteric coated capsule formulation of Ty21a was found to be comparable to a liquid formulation (P > 0.05). Based on this, children (n = 252) aged ≥2-<3 years and ≥3-<5 years were randomized to receive a liquid formulation of Ty21a with and without previous anti-helminthic treatment. The vaccine was well tolerated with only a few mild adverse events recorded in <1% of the children. De-worming did not improve immune responses and both age groups developed 32-71% IgA, IgG, and IgM responses in plasma and 63-86% IgA responses in ALS and stool specimens to a membrane preparation (MP) of Ty21a. An early MP specific proliferative T cell response was also seen. We recommend that safety and efficacy studies with a liquid formulation of the vaccine are carried out in children under five, including those less than two years of age to determine if Ty21a is protective in these age groups and applicable as a public health tool for controlling typhoid fever in high prevalence areas of typhoid fever including Bangladesh. © 2014 Elsevier Ltd. All rights reserved.

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Denna text är utskriven från följande webbsida:
http://www.gu.se/english/research/publication/?publicationId=194615
Utskriftsdatum: 2019-08-26