Reactivity and immunogenicity of bivalent (AC) and tetravalent (ACW135Y) meningococcal vaccines containing O-acetyl-negative or O-acetyl-positive group C polysaccharide.

The immunogenicity and the reactivity of two bivalent (AC) and two tetravalent (ACW135Y) meningococcal vaccines containing either the O-acetyl-positive or the O-acetyl-negative group C polysaccharide were compared in healthy adolescent and adult volunteers. The vaccines contained high-molecular-weight, purified capsular meningococcal polysaccharides and were administered subcutaneously at a dose of 50 micrograms for each polysaccharide. Reactivity was low for all vaccines, and the tetravalent vaccines were not significantly more reactive than the bivalent vaccines. Immunogenicity was measured by assay of bactericidal antibodies in pre- and postvaccination sera. More than 90% of the vaccines had at least a fourfold increase in the bactericidal antibody titer against each group of meningococcus represented in the vaccines. Addition of polysaccharide W135 and polysaccharide Y to polysaccharides A and C did not alter the immunogenicity of the latter polysaccharides. Thus, there is no evidence of antigenic competition with the tetravalent vaccine. Comparison of the antibody response to the O-acetyl-positive and the O-acetyl-negative variants of group C polysaccharide in the bivalent vaccines, as measured by both bactericidal and enzyme-linked immunosorbent assays, indicates that in adults, the two types of group C polysaccharide are similarly immunogenic.