{
  "abstract": "Background/Objectives: Maternally transferred antibodies protect infants early in life, but high concentrations can reduce immune responses to primary vaccination. CRM₁₉₇ is a nontoxic mutant of diphtheria toxin that retains antigenic similarity to the native protein. We therefore investigated whether anti-diphtheria antibodies present before vaccination were related to responses against pneumococcal polysaccharides conjugated to CRM₁₉₇. Methods: This post hoc analysis used data from a multicenter, randomized, single-blind phase III trial in which Indian infants received BE-PCV14/PNEUBEVAX 14® at 6–8, 10–12, and 14–16 weeks of age (commonly referred to as 6–10–14 weeks). Baseline anti-diphtheria toxoid IgG concentrations measured at 6–8 weeks were assessed in relation to serotype-specific pneumococcal IgG responses 28 days after dose 3. We evaluated these associations using categorical and continuous analyses with false-discovery-rate correction for serotype-specific comparisons. Results: Baseline and post-primary results were available for 603 of 650 infants in the co-administration cohort. Post-primary pneumococcal IgG concentrations did not differ significantly across the baseline anti-diphtheria IgG categories. Individual fold rises differed nominally among baseline anti-diphtheria IgG categories for serotype 5, but the difference did not remain significant after multiplicity correction. In the adjusted continuous models, geometric mean ratios (GMRs) associated with each 2-fold increase in baseline anti-diphtheria IgG ranged from 0.978 to 1.011, with no statistically significant associations after false-discovery-rate correction. Analyses stratified by baseline pneumococcal IgG similarly showed no consistent evidence of reduced responses. Conclusions: In this cohort, pre-existing anti-diphtheria toxoid IgG measured before vaccination, which was likely maternally derived, was not associated with a consistent reduction in post-primary serotype-specific pneumococcal IgG responses to CRM₁₉₇-conjugated BE-PCV14.",
  "abstract_shown": true,
  "affiliations": [
    "Biological E. Limited, Hyderabad 500033, India",
    "All India Institute of Medical Sciences, Raipur 492099, India",
    "Cheluvamba Hospital, Mysore Medical College & Research Institute, Mysore 570001, India",
    "King George Hospital, Visakhapatnam 530002, India",
    "Karnataka Lingayat Education Society, Dr. Prabhakar Kore Hospital & Medical Research Centre, Belagavi 590010, India",
    "Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak 124001, India",
    "Guru Teg Bahadur Hospital, Delhi 110095, India",
    "Medipoint Hospital, Pune 411007, India"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 15,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Subhash Thuluva"
    },
    {
      "affs": [
        0
      ],
      "name": "Subbareddy Gunneri"
    },
    {
      "affs": [
        0
      ],
      "name": "Siddalingaiah Ningaiah"
    },
    {
      "affs": [
        0
      ],
      "name": "Vijay Yerroju"
    },
    {
      "affs": [
        0
      ],
      "name": "Rammohan Reddy Mogulla"
    },
    {
      "affs": [
        0
      ],
      "name": "Kamal Thammireddy"
    },
    {
      "affs": [
        0
      ],
      "name": "Shivani Desai"
    },
    {
      "affs": [
        0
      ],
      "name": "Venkatalakshmi Gundu"
    },
    {
      "affs": [
        1
      ],
      "name": "Atul Jindal"
    },
    {
      "affs": [
        2
      ],
      "name": "Pradeep Nanjappa"
    },
    {
      "affs": [
        3
      ],
      "name": "Bheemisetty S. Chakravarthy"
    },
    {
      "affs": [
        4
      ],
      "name": "Niranjana S. Mahantashetti"
    },
    {
      "affs": [
        5
      ],
      "name": "Savita Verma"
    },
    {
      "affs": [
        6
      ],
      "name": "Manish Narang"
    },
    {
      "affs": [
        7
      ],
      "name": "Jog Pramod Prabhakar"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/d56j1r0pzc25g.bib",
  "cited_by": 0,
  "doi": "10.3390/vaccines14100854",
  "fulltext_url": "https://www.mdpi.com/2076-393X/14/10/854",
  "id": "d56j1r0pzc25g",
  "issns": [
    "2076-393X"
  ],
  "landing_url": "https://doi.org/10.3390/vaccines14100854",
  "language": "en",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "R"
    ],
    [
      "openalex",
      "2713|Pneumonia and Respiratory Infections"
    ]
  ],
  "openalex": "W7214675562",
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-09-01",
  "publisher": "MDPI AG",
  "ris": "https://research.draconitic.com/paper/d56j1r0pzc25g.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T14:21:37Z",
      "native_id": "10b9f5cf86bb420988be1924d8327706",
      "source": "doaj",
      "url": "https://doi.org/10.3390/vaccines14100854"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2713|Pneumonia and Respiratory Infections",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Association Between Pre-Existing Anti-Diphtheria Toxoid IgG and Immune Responses to a CRM₁₉₇-Conjugated 14-Valent Pneumococcal Conjugate Vaccine in Infants: A Post Hoc Analysis of a Multicenter Phase III Trial",
  "title_text": "Association Between Pre-Existing Anti-Diphtheria Toxoid IgG and Immune Responses to a CRM₁₉₇-Conjugated 14-Valent Pneumococcal Conjugate Vaccine in Infants: A Post Hoc Analysis of a Multicenter Phase III Trial",
  "type": "peer-reviewed",
  "updated_at": "2026-10-31T14:21:37Z",
  "url": "https://research.draconitic.com/paper/d56j1r0pzc25g",
  "venue": "Vaccines",
  "versions": []
}