Persistence of Immunity following 2-Dose Priming with a 10-Valent Pneumococcal Conjugate Vaccine at 6 and 10 Weeks or 6 and 14 Weeks of Age in Nepalese Toddlers

Meeru Gurung, Sanjeev M. Bijukchhe, Parisa Hariri, Merryn Voysey, Rama Kandasamy, Stephen Thorson, Pratistha Maskey, Raju Pandit, Biplav Shrestha, Madhav Chandra Gautam, Mamata Maharjan, Laxmi Lama, Baikuntha Acharya, Ruby Basi, Manisha K.c., Peter O'Reilly, Sonu Shrestha, Imran Ansari, Ganesh P. Shah, Sarah KellyKatherine L. O'Brien, David Goldblatt, Dominic F. Kelly, David R. Murdoch, Andrew J. Pollard, Shrijana Shrestha

Research output: Contribution to journalArticlepeer-review


Background: The pneumococcal conjugate vaccine has had a substantial impact on invasive pneumococcal disease. Previously, we compared immunity following vaccination with the 10-valent pneumococcal conjugate vaccine (PCV10) administered at 2 slightly different schedules: at 6 and 10 weeks of age, and at 6 and 14 weeks of age, both followed by a 9-month booster. In this study, we followed up those participants to evaluate the medium-term persistence of serotype-specific pneumococcal immunity at 2-3 years of age. Method: Children from the previous studies were contacted and after taking informed consent from their parents, blood samples and nasopharyngeal swabs were collected. Serotype-specific IgG antibody concentrations were determined by enzyme-linked immunosorbent assay, for the 10 vaccine serotypes, at a WHO pneumococcal serology reference laboratory. Findings: Two hundred twenty of the 287 children who completed the primary study returned at 2-3 years of age to provide a blood sample and nasopharyngeal swab. The nasopharyngeal carriage rate of PCV10 serotypes in the 6 + 14 group was higher than the 6 + 10 group (13.4% vs. 1.9%). Nevertheless, the proportion of toddlers with serum pneumococcal serotype-specific IgG greater than or equal to 0.35 µg/mL was comparable for all PCV10 serotypes between the 6 + 10 week and 6 + 14 week groups. Similarly, the geometric mean concentrations of serum pneumococcal serotype-specific IgG levels were similar in the 2 groups for all serotypes, except for serotype 19F which was 32% lower in the 6 + 10 group than the 6 + 14 group. Conclusion: Immunization with PCV10 at 6 + 10 weeks or 6 + 14 weeks, with a booster at 9 months in each case, results in similar persistence of serotype-specific antibody at 2-3 years of age. Thus, protection from pneumococcal disease is expected to be similar when either schedule is used.

Original languageEnglish (US)
Pages (from-to)937-943
Number of pages7
JournalPediatric Infectious Disease Journal
StateAccepted/In press - 2021


  • Nepal
  • immunogenicity
  • pneumococcal
  • pneumococcal conjugate vaccine
  • toddlers

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Microbiology (medical)
  • Infectious Diseases


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