Studies on Pneumococcus vaccine alone or mixed with DTP and on Pneumococcus type 6B and Haemophilus influenzae type b capsular polysaccharide-tetanus toxoid conjugates in two- to five-year-old children with sickle cell anemia

Pediatr Infect Dis J. 1990 Mar;9(3):181-6. doi: 10.1097/00006454-199003000-00007.


Pneumococcus vaccine, injected alone or mixed with diphtheria-tetanus toxoid-pertussis, did not elicit significant concentrations of pneumococcus type 6 antibodies in 2- to 5-year-old sickle cell anemia patients (n = 22). Reinjection 5 months later failed to elicit a booster response to pneumococcus type 6. We then injected conjugates of pneumococcus type 6B and of Haemophilus influenzae type b (Hib), each bound to tetanus toxoid (TT), alternatively at monthly intervals into sickle cell anemia patients of the same age group (n = 25); most received 3 injections of each vaccine. Pneumococcus vaccine was administered to 19 patients and Hib to 1 at approximately 1 year of age. Blood samples were taken before each and approximately 6 months after the last injection. Infrequent and minimal local reactions and only 6 episodes of fever (3%) occurred after injection of the conjugates. Pneumococcus type 6B-TT elicited a rise in the geometric mean concentration of pneumococcus type 6 antibodies (Ab) from 104 ng of antibody nitrogen (AbN)/ml in preimmunization sera to 385 ng of AbN/ml after the first injection (P less than 0.01). There were further increases after the 2 subsequent injections; 6 months after the third injection, the mean concentration was 940 ng of AbN/ml and 15 of 16 (94%) had greater than 300 ng of AbN/ml. Hib-TT elicited a 160-fold increase of Hib antibodies to a geometric mean concentration of 39.0 micrograms of Ab/ml after the first injection. These levels rose approximately 2-fold following 2 additional injections to 71.7 micrograms/ml and declined to 10.7 micrograms/ml at the 6-month sampling.(ABSTRACT TRUNCATED AT 250 WORDS)

MeSH terms

  • Anemia, Sickle Cell / immunology*
  • Antibodies, Bacterial / immunology*
  • Bacterial Vaccines / immunology*
  • Child, Preschool
  • Cross Reactions
  • Diphtheria-Tetanus-Pertussis Vaccine / immunology*
  • Female
  • Haemophilus influenzae / immunology*
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Polysaccharides, Bacterial / immunology*
  • Streptococcus pneumoniae / immunology*
  • Tetanus Toxoid / immunology*


  • Antibodies, Bacterial
  • Bacterial Vaccines
  • Diphtheria-Tetanus-Pertussis Vaccine
  • Polysaccharides, Bacterial
  • Tetanus Toxoid