Naturally Acquired and Conjugate Vaccine-Induced Antibody to Haemophilus influenzae Type b (Hib) Polysaccharide in Malian Children: Serological Assessment of the Hib Immunization Program in Mali

Julia Hutter Center for Vaccine Development and the Departments of Pediatrics and Medicine, University of Maryland School of Medicine, Baltimore, Maryland; Centre pour le Développement des Vaccins, Mali, Bamako, Mali

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Marcela F. Pasetti Center for Vaccine Development and the Departments of Pediatrics and Medicine, University of Maryland School of Medicine, Baltimore, Maryland; Centre pour le Développement des Vaccins, Mali, Bamako, Mali

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Doh Sanogo Center for Vaccine Development and the Departments of Pediatrics and Medicine, University of Maryland School of Medicine, Baltimore, Maryland; Centre pour le Développement des Vaccins, Mali, Bamako, Mali

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Milagritos D. Tapia Center for Vaccine Development and the Departments of Pediatrics and Medicine, University of Maryland School of Medicine, Baltimore, Maryland; Centre pour le Développement des Vaccins, Mali, Bamako, Mali

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Samba O. Sow Center for Vaccine Development and the Departments of Pediatrics and Medicine, University of Maryland School of Medicine, Baltimore, Maryland; Centre pour le Développement des Vaccins, Mali, Bamako, Mali

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Myron M. Levine Center for Vaccine Development and the Departments of Pediatrics and Medicine, University of Maryland School of Medicine, Baltimore, Maryland; Centre pour le Développement des Vaccins, Mali, Bamako, Mali

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Haemophilus influenzae type b (Hib) conjugate vaccine for infants (6, 10, and 14 weeks of age) was introduced into the Malian Expanded Program on Immunization in July 2005, to diminish invasive Hib disease in young children. Antibodies to Hib capsular polysaccharide (PRP) were measured in infants and toddlers from an area already served by the Hib immunization program (Bamako) and in unimmunized children of the same age in a district (Kangaba) where Hib immunization had not yet begun. Among vaccinated Bamako children 6–23 months of age, 77–93% exhibited PRP titers ≥ 1.0 μg/mL, indicating long-term protection, versus only 10–23% of Kangaba children of that age. High PRP antibody titers in immunized children persisted through 2 years of age. Moreover, ∼50% of Bamako children exhibited anti-PRP titers ≥ 5.0 μg/mL; a level that impedes Hib upper respiratory carriage, and may thereby diminish the Hib transmission to the unimmunized susceptible population (i.e., providing indirect protection).

Author Notes

*Address correspondence to Julia Hutter, University of Maryland School of Medicine, Center for Vaccine Development, 685 W. Baltimore St., Rm. 480, Baltimore, MD 21201. E-mail: jthutter@gmail.com

Financial Support: Grant from the Bill and Melinda Gates Foundation to Myron M. Levine.

Authors' addresses: Julia Hutter, Marcela F. Pasetti, Milagritos D. Tapia, and Myron M. Levine, University of Maryland School of Medicine, Center for Vaccine Development, Baltimore, MD, E-mails: jthutter@gmail.com, mpasetti@medicine.umaryland.edu, mtapia@medicine.umaryland.edu, and mlevine@medicine.umaryland.edu. Doh Sanogo and Samba O. Sow, Ministry of Health, Centre pour le Développement des Vaccins – Mali, Ex-Institut Marchoux, Bamako, Mali, E-mails: sanogodoh@yahoo.fr and ssow@medicine.umaryland.edu.

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