Liquid vaccines for multiple meningococcal serogroups
Conjugated capsular saccharides from meningococcal serogroups C, W135 and Y are safe and immunogenic in humans when combined in a single dose. This effect is retained when a conjugated capsular saccharide from serogroup A is added. These conjugated antigens can be stably combined in a single aqueous dose without the need for lyophilization. Broad protection against serogroup B infection can be achieved by using a small number of defined polypeptide antigens. These polypeptide antigens can be combined with the saccharide antigens without loss of protective efficacy for any of the five serogroups. Efficacy if retained even if a Hib conjugate is added. The efficacy of a serogroup W135 conjugate is enhanced by addition of protein antigens derived from a serogroup B strain. Addition of a Hib conjugate to meningococcal conjugates enhances the overall activity against meningococcus serogroup W135.
1. An aqueous immunogenic composition which, after administration to a subject, is able to induce an immune response that is (a) bactericidal against at least serogroup W135 of N. meningitidis and (b) protective against H. influenzae type b disease, wherein the composition comprises: (i) a conjugated serogroup W135 capsular saccharide antigen; (ii) a conjugated H. influenzae type b capsular saccharide antigen.
2. The composition of claim 1 , further comprising conjugated capsular saccharide antigens from serogroups C and Y and, optionally, A.
3. The composition of claim 1 , further comprising one or more polypeptide antigens from serogroup B of N. meningitidis.
4. The composition of claim 1 , wherein the serogroup W135 saccharide is conjugated to a diphtheria toxoid, a tetanus toxoid or a H. influenzae protein D.
5. The composition of claim 1 , wherein the Hib saccharide is conjugated to a tetanus toxoid.
6. The composition of claim 1 , wherein the composition includes an aluminium phosphate adjuvant.
7. The composition of claim 1 , wherein the serogroup W135 saccharide is conjugated to a CRM197 diphtheria toxin mutant, and the composition comprises <30 μg meningococcal saccharide per dose.
8. The composition of claim 1 , wherein the serogroup W135 saccharide has a degree of polymerisation of less than 30.
9. The composition of claim 5 , wherein the serogroup W135 saccharide is conjugated to a diphtheria toxoid, a tetanus toxoid, or a CRM197 diphtheria toxin mutant.
10. The composition of claim 6 , wherein the serogroup W135 saccharide is conjugated to a diphtheria toxoid, a tetanus toxoid, or a CRM197 diphtheria toxin mutant.
11. The composition of claim 1 , wherein the same carrier protein is used for all serogroups.
12. The composition of claim 1 , wherein the serogroup W135 saccharide has a saccharide:protein ratio (w/w) between 1:5 and 5:1.
13. The composition of claim 4 , wherein the serogroup W135 saccharide is conjugated via a linker.
14. The composition of claim 7 , wherein the serogroup W135 saccharide is conjugated via a linker.
15. The composition of claim 4 , wherein the serogroup W135 saccharide is conjugated directly.
16. The composition of claim 7 , wherein the serogroup W135 saccharide is conjugated directly.
17. The composition of claim 4 , wherein the Hib saccharide is conjugated to a CRM197 diphtheria toxin mutant, a tetanus toxoid or an outer membrane complex of N. meningitidis.
18. The composition of claim 6 , wherein the Hib saccharide is conjugated to a CRM197 diphtheria toxin mutant, a tetanus toxoid or an outer membrane complex of N. meningitidis.
19. The composition of claim 7 , wherein the Hib saccharide is conjugated to a CRM197 diphtheria toxin mutant, a tetanus toxoid or an outer membrane complex of N. meningitidis.
20. The composition of claim 1 , wherein the composition comprises an adjuvant.
21. The composition of claim 1 , wherein the composition does not include an aluminium hydroxide adjuvant.
22. The composition of claim 4 , wherein the composition includes an aluminium phosphate adjuvant.
23. The composition of claim 6 , wherein the Hib antigen is adsorbed to aluminium phosphate.
24. The composition of claim 6 , wherein the Hib antigen is not adsorbed to aluminium phosphate.
25. The composition of claim 1 , wherein the Hib antigen is initially lyophilised.
26. The composition of claim 1 , wherein the conjugates have a saccharide:protein ratio (w/w) of between 1:5 and 5:1.