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      Immunogenicity and Safety of a Novel 13-Valent Pneumococcal Vaccine in Healthy Chinese Infants and Toddlers

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          Abstract

          Background

          To determine the non-inferiority of the seven common serotypes (4, 6B, 9V, 14, 18C, 19F, and 23F) in the 13-valent pneumococcal conjugate vaccine (PCV13) with each serotype conjugated to a tetanus toxoid carrier protein and adsorbed on aluminum phosphate and the superiority of its six additional serotypes (1, 3, 5, 6A, 7F, and 19A) to the serotypes in the PCV7.

          Methods

          Participants were evenly randomized in a 1:1 ratio into either the PCV13 or PCV7 groups, to receive three doses of the vaccine at the age of 3, 4, and 5 months, respectively, and a booster dose between 12 and 15 months of age. Serotype-specific antibodies were measured using a standardized enzyme-linked immunosorbent assay (ELISA) and opsonophagocytic activity (OPA) microcolony assay method.

          Results

          A total of 1,040 healthy infants were enrolled. All the seven common serotypes in the PCV13 were non-inferior to those in the PCV7 in terms of the serotype-specific IgG production induced; however, non-inferiority was not shown for serotype 6B after the infant series. The proportion of subjects who reached OPA antibody titers ≥ 1:8 in the PCV13 group was 89.25% or higher. Local reactions and systemic events were mild or moderate in severity and similar between the two groups. No new safety signals were observed.

          Conclusion

          The newly developed PCV13 was immunogenic for all serotypes and had a comparable safety profile to the marketed PCV7.

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          Most cited references30

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          Two-sided confidence intervals for the single proportion: comparison of seven methods.

          Simple interval estimate methods for proportions exhibit poor coverage and can produce evidently inappropriate intervals. Criteria appropriate to the evaluation of various proposed methods include: closeness of the achieved coverage probability to its nominal value; whether intervals are located too close to or too distant from the middle of the scale; expected interval width; avoidance of aberrations such as limits outside [0,1] or zero width intervals; and ease of use, whether by tables, software or formulae. Seven methods for the single proportion are evaluated on 96,000 parameter space points. Intervals based on tail areas and the simpler score methods are recommended for use. In each case, methods are available that aim to align either the minimum or the mean coverage with the nominal 1 -alpha.
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            Interval estimation for the difference between independent proportions: comparison of eleven methods

            Several existing unconditional methods for setting confidence intervals for the difference between binomial proportions are evaluated. Computationally simpler methods are prone to a variety of aberrations and poor coverage properties. The closely interrelated methods of Mee and Miettinen and Nurminen perform well but require a computer program. Two new approaches which also avoid aberrations are developed and evaluated. A tail area profile likelihood based method produces the best coverage properties, but is difficult to calculate for large denominators. A method combining Wilson score intervals for the two proportions to be compared also performs well, and is readily implemented irrespective of sample size.
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              The Use of Confidence or Fiducial Limits Illustrated in the Case of the Binomial

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                Author and article information

                Contributors
                Journal
                Front Microbiol
                Front Microbiol
                Front. Microbiol.
                Frontiers in Microbiology
                Frontiers Media S.A.
                1664-302X
                09 May 2022
                2022
                : 13
                : 870973
                Affiliations
                [1] 1Hebei Province Centre for Disease Control and Prevention (Hebei CDC) , Shijiazhuang, China
                [2] 2Shanxi Province Centre for Disease Control and Prevention (Shanxi CDC) , Taiyuan, China
                [3] 3Henan Province Centre for Disease Control and Prevention (Henan CDC) , Zhengzhou, China
                [4] 4National Institutes for Food and Drug Control , Beijing, China
                [5] 5Walvax Biotechnology Co., Ltd. , Kunming, China
                [6] 6Department of Health Statistics of Air Force Military Medical University (DHSAFMU) , Xi’an, China
                [7] 7Beijing Key Tech Statistical Consulting Co., Ltd. , Beijing, China
                [8] 8Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention (Guangxi CDC) , Nanning, China
                Author notes

                Edited by: Silvia Beatriz Boscardin, University of São Paulo, Brazil

                Reviewed by: Maria Da Graca Salomao, Butantan Institute, Brazil; Jarrod Mousa, University of Georgia, United States; Xiawei Jiang, Zhejiang Chinese Medical University, China

                *Correspondence: Jielai Xia, jielaixia@ 123456yahoo.com

                These authors have contributed equally to this work

                This article was submitted to Infectious Agents and Disease, a section of the journal Frontiers in Microbiology

                Article
                10.3389/fmicb.2022.870973
                9125316
                17f8ff5d-7437-4823-a227-1fbd56ce91b8
                Copyright © 2022 Zhao, Li, Xia, Ye, Yuan, Li, Li, Chen, Yang, Jiang, Zhao, Li, Li, Xia and Huang.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 07 February 2022
                : 24 March 2022
                Page count
                Figures: 1, Tables: 6, Equations: 0, References: 30, Pages: 12, Words: 8122
                Categories
                Microbiology
                Original Research

                Microbiology & Virology
                pneumococcal conjugate vaccine,sequential test,non-inferiority,superiority,china

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