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Ray Borrow, Elizabeth Miller, Reply, The Journal of Infectious Diseases, Volume 184, Issue 1, 1 July 2001, Pages 116–117, https://doi.org/10.1086/321013
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To the Editor—Froeschle et al. [1] report a significant polyclonal immune response to serogroup C in individuals who had received a booster dose of meningococcal polysaccharide vaccine (MPV; Menomune-A/C/Y/W-135) after 1 or 2 prior doses. They report a significant increase in serogroup C–specific IgG and IgM levels before and 1 month after a booster dose of MPV. However, the relevance of their observation to the phenomenon of hyporesponsiveness is unclear
First, immunologic hyporesponsiveness to repeated doses of vaccine is measured by comparing antibody responses 1 month after a second dose with antibody responses 1 month after a first dose. The study of Froeschle et al. [1] does not make this comparison, and thus it is not possible to determine whether a reduced response occurred after a second dose of MPV. We do not dispute the fact that antibody levels rise from before to 1 month after a second dose of MPV vaccine: in an earlier study, we reported a significant increase (P<.001) in geometric mean titer (GMT), as measured by serum bactericidal assay (SBA), from before to 1 month after a second dose [2]. The key observation demonstrating hyporesponsiveness in our study was that the SBA GMT 1 month after a second dose was significantly lower than that 1 month after a first dose 6 months earlier (P<.001)