Induction of Protective Serum Meningococcal Bactericidal and Diphtheria-Neutralizing Antibodies and Mucosal Immunoglobulin A in Volunteers by Nasal Insufflations of theNeisseria meningitidisSerogroup C Polysaccharide-CRM197 Conjugate Vaccine Mixed with Chitosan

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Abstract
Thirty-six healthy volunteers received either a single intramuscular injection ofNeisseria meningitidisserogroup C polysaccharide (MCP)-CRM197 conjugate vaccine in alum or two nasal insufflations 28 days apart of the same vaccine powder, without alum, mixed with chitosan. Nasal immunization was well tolerated, with fewer symptoms reported than after intramuscular injection. The geometric mean concentrations of MCP-specific immunoglobulin G (IgG) after one nasal immunization were 3.25 μg/ml in naïve subjects and 14.4 μg/ml in subjects previously immunized parenterally, compared with 4.30 μg/ml in naïve subjects immunized intramuscularly. The geometric mean titer of serum bactericidal antibody (SBA) rose 24-fold after two nasal immunizations in naïve subjects and was comparable to parenteral immunization (1,080 versus 1,625). All subjects achieved SBA titers associated with protection after two nasal immunizations: even those with titers of N. meningitidisand diphtheria.

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