Economisation of vaccination against Haemophilus influenzae type b : a randomised trial of immunogenicity of fractional-dose and two-dose regimens.
Background The cost of Haemophilus influenzae type b (Hib) conjugate vaccines has limited their use in non-industrialised countries.
To identify more economical vaccination schedules, we carried out a randomised trial of the immunogenicity of alternative regimens to the standard three-dose series.
Methods 627 Chilean infants were randomly allocated to one of four regimens with either Hib polysaccharide-tetanus toxoid conjugate vaccine (PRP-T) or Hib oligosaccharide-diphtheria mutant toxoid conjugate vaccine (PRP-CRM197), for a total of eight groups.
All infants receive diphtheria-tetanus-pertussis (DTP) vaccine at ages 2,4, and 6 months.
The regimens included three full doses, three fractional doses consisting of one half or one third of the full dose, and a regimen of two full doses (at age 4 and 6 months).
The primary outcome was the proportion of infants with serum anti-polyribosylribitol phosphate (PRP, the type b capsular polysaccharide) concentrations of 0.15 mug/mL or more at age 8 months.
Findings 93% (95% Cl 85-98) of infants vaccinated with three full doses of PRP-T or PRP-CRM197 (95% Cl 84-98) achieved anti-PRP concentrations of 0.15 mug/mL or more at age 8 months, compared with 91% (83-96) to 100% (95-100) of infants immunised with any fractional-dose regimen.
Of the infants vaccinated with two doses of PRP-T or PRP-CRM197,99% (93-100) and 87% (77-93) developed anti-PRP concentrations of 0.15 mug/mL or more, respectively. (...)
Mots-clés Pascal : Vaccination, Haemophilus influenzae, Pasteurellaceae, Bactérie, Fréquence, Dose, Analyse coût efficacité, Immunogénicité, Nourrisson, Homme, Epidémiologie, Economie santé, Chili, Amérique du Sud, Amérique, Randomisation, Etude comparative
Mots-clés Pascal anglais : Vaccination, Haemophilus influenzae, Pasteurellaceae, Bacteria, Frequency, Dose, Cost efficiency analysis, Immunogenicity, Infant, Human, Epidemiology, Health economy, Chile, South America, America, Randomization, Comparative study
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0261973
Code Inist : 002B05A02. Création : 11/09/1998.