Immunogenicity of sequential 13-valent conjugated and 23-valent unconjugated pneumococcal vaccines in a population of children with lupus

被引:9
作者
Gorelik, M. [1 ]
Elizalde, A. [1 ]
Williams, K. Wong [2 ]
Gonzalez, E. [1 ]
Cole, J. L. [1 ]
机构
[1] Baylor Coll Med, Childrens Hosp San Antonio, Div Pediat Allergy Immunol & Rheumatol, San Antonio, TX USA
[2] Med Univ South Carolina, Dept Pediat, Charleston, SC 29425 USA
关键词
Pediatric lupus; pneumococcal vaccination; infection; POLYSACCHARIDE VACCINE; RHEUMATOID-ARTHRITIS; DOUBLE-BLIND; ERYTHEMATOSUS; RECOMMENDATIONS; INFECTIONS; RESPONSES; TRIAL;
D O I
10.1177/0961203318808589
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Pneumococcal vaccination is recommended as a quality indicator for management of children with systemic lupus erythematosus. Literature on the immunogenicity of pneumococcal vaccines (PCVs) in children is scant. We sought to prospectively evaluate via an observational study, the immunogenicity to sequential children with lupus. Out of a cohort of 26 patients, approximately 65% achieved > 70% vaccinated serotype antibody levels of > 1.3 mcg/dL following PCV13, and of 22 patients followed through PPSV23 vaccination, 59% achieved the same. Patients with rituximab exposure in the 6 months prior to a vaccination were more likely to not achieve protective serotype levels (p < 0.01 for PCV13, trend p = 0.07 for PPSV23). Three of 22 patients with no apparent risk factors did not achieve protective serotype levels. Non-responders to PCV13 generally did not respond to PPSV23. Retrospective healthy controls achieved 100% protective levels in response to PPSV23 vaccination, with 95% of serotypes being > 1.3 mcg/dL. Thus, sequential 13- and 23-valent pneumococcal vaccines achieve protective status for approximately two thirds of pediatric lupus patients in our population. Lack of response to vaccine may be secondary to induced or inherent functional impairments in the patient.
引用
收藏
页码:2228 / 2235
页数:8
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