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Concomitant Vaccine Dosing Safe, Effective


 

PHILADELPHIA — Administering two or more vaccines simultaneously was safe and immunogenic in results from two separate studies reported at the annual meeting of the Infectious Diseases Society of America.

One study assessed the immune response when healthy girls received concomitant vaccination with a human papillomavirus (HPV) vaccine along with a vaccine for tetanus, diphtheria, and pertussis (Tdap), and a third vaccine with a quadrivalent, conjugated meningococcal formulation (MCV4). The second study tested coadministration of the 2007-2008 seasonal influenza vaccine with an investigational, 13-valent, conjugated pneumococcal vaccine in adults aged 50-59 years.

The first study enrolled 1,283 healthy girls aged 11-18 years at 48 U.S. centers. The researchers randomized the participants to one of six different treatment schemes: HPV vaccine only at months 0, 1, and 6; HPV with Tdap at month 0 followed by HPV only at months 1 and 6; HPV with the meningococcal vaccine at month 0 followed by HPV only at months 1 and 6; all three vaccines at month 0 followed by HPV only at months 1 and 6; Tdap only at month 0 followed by HPV only at months 1, 2, and 7; and MCV4 only at month 0 and then HPV only at months 1, 2, and 7, said Cosette M. Wheeler, Ph.D., professor of pathology and obstetrics and gynecology at the University of New Mexico in Albuquerque.

Her study used the Cervarix formulation of HPV vaccine, the Boostrix formulation of Tdap, and the Menactra formulation of meningococcal vaccine. The Cervarix and Boostrix vaccines are marketed by GlaxoSmithKline, which funded the study. Menactra is marketed by Sanofi Pasteur.

The results showed that 1 month after the subjects received any of the concomitant doses, their immune responses all fell within the prespecified criteria for noninferiority, compared with the responses when the vaccines were administered individually. Also, the immune responses to the HPV vaccine 6 months after the final dose, when one dose was given in combination with one or two of the other vaccines, were noninferior to the responses to the HPV vaccine given by itself. The recipients of two or more simultaneous vaccines also had similar incidence rates for adverse events.

The second study examined concomitant administration of an investigational, 13-valent, conjugated pneumococcal vaccine and the trivalent, seasonal influenza vaccine of 2007-2008 in 1,106 healthy adults aged 50-59 years who had no history of previously receiving a pneumococcal vaccine, said Dr. Robert W. Frenck Jr., professor of pediatrics at Cincinnati Children's Hospital Medical Center.

He and his associates randomized subjects to receive either the pneumococcal and flu vaccines together at month 0 followed by placebo at month 1, or the flu vaccine and placebo at month 0 followed by the pneumococcal vaccine at month 1.

One month after vaccination, the immune responses to both vaccines in people who received them simultaneously fell within the prespecified noninferiority limit, compared with the responses in people who received the two vaccines 1 month apart, Dr. Frenck reported. Simultaneous administration also resulted in similar rates of local and systemic reactions compared with giving the vaccines 1 month apart.

Disclosures: Dr. Wheeler has received research support from GlaxoSmithKline, Merck (which markets the HPV vaccine Gardasil), and Roche Molecular Systems. Dr. Frenck's study was funded by Wyeth, which developed the pneumococcal vaccine; he had no other disclosures.

Simultaneous administration of more than one vaccine did not impair immunogenicity.

Source Joyce Frieden/Elsevier Global Medical News

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