of adolescent vaccines – quadrivalent meningococcal conjugate vaccine, Tdap and one of the three HPV doses – would be expected to facilitate improved compliance with the vaccination recommendations. In our study, we did not observe increased selleck inhibitor reactogenicity with concomitant or sequential administration of the investigational quadrivalent meningococcal CRM197 conjugate vaccine, MenACWY-CRM, with Tdap and HPV. In addition, immune responses to the antigens contained in MenACWY-CRM were not influenced by concomitant administration with Tdap and HPV. Using an hSBA titre ≥1:8 as an endpoint, predefined measures of non-inferiority for both concomitant and sequential administration of MenACWY-CRM were demonstrated for all serogroups. Using seroresponse as an endpoint, non-inferiority of sequential administration of MenACWY-CRM 1 month after Tdap and HPV was demonstrated for all serogroups except W-135. However, the response to serogroup W-135 was still robust, most importantly among those subjects see more with a seronegative titre at baseline where 90% of subjects achieved an hSBA titre of ≥1:8. Lower GMTs were reported for serogroups W-135 and Y when MenACWY-CRM was administered 1 month after Tdap. Nevertheless, non-inferiority of the immune response was still demonstrated for all serogroups.
The immune responses to the tetanus and diphtheria antigens contained in Tdap remained robust when Rolziracetam given concomitantly or sequentially with MenACWY-CRM, and were non-inferior when compared with those induced by Tdap alone. Concomitant administration of Tdap and MenACWY-CRM augmented the anti-diphtheria response, as has been previously reported when adolescents were concomitantly administered diphtheria-toxoid
quadrivalent meningococcal conjugate and Td vaccine  and . Using the group ratio of GMCs as the endpoint for pertussis antigens, non-inferiority was demonstrated for PT but not for FHA and PRN, when comparing concomitant administration with Tdap alone. The clinical relevance of this finding is not clear, as no correlates of protection for pertussis have been clearly established, and linkages of clinical efficacy to immunogenicity have only been evaluated in infants . Responses to PT , or PT, PRN and FIM2 (fimbriae, an antigen not present in the tested vaccine)  and  have been suggested to be the major factors in protection against pertussis disease. Although the absolute GMCs for pertussis antigens in this study in the concomitant administration group were lower than those when Tdap was administered alone, they are comparable or higher than those shown to provide clinical protection in infants . A robust response to the pertussis component was shown by 7.1–21.7-fold increases in GMCs for the three antigens.