Immunogenicity of the 13-Valent Pneumococcal Conjugate Vaccine (PCV13) Followed by the 23-Valent Pneumococcal Polysaccharide Vaccine (PPSV23) in Adults with and without Immunosuppressive Therapy

被引:11
作者
Garcia Garrido, Hannah M. [1 ]
Vollaard, Albert [2 ]
D'Haens, Geert R. [3 ]
Spuls, Phyllis I. [4 ]
Bemelman, Frederike J. [5 ]
Tanck, Michael W. [6 ]
de Bree, Godelieve J. [1 ]
Meek, Bob [7 ]
Grobusch, Martin P. [1 ]
Goorhuis, Abraham [1 ]
机构
[1] Univ Amsterdam, Amsterdam UMC, Ctr Trop Med & Travel Med, Amsterdam Inst Infect & Immun,Dept Infect Dis, NL-1105 AZ Amsterdam, Netherlands
[2] Natl Inst Publ Hlth & Environm, Ctr Infect Dis Control Netherlands, NL-3721 MA Bilthoven, Netherlands
[3] Univ Amsterdam, Amsterdam UMC, Dept Gastroenterol, NL-1105 AZ Amsterdam, Netherlands
[4] Univ Amsterdam, Amsterdam UMC, Dept Dermatol, NL-1105 AZ Amsterdam, Netherlands
[5] Univ Amsterdam, Dept Nephrol, Amsterdam UMC, NL-1105 AZ Amsterdam, Netherlands
[6] Univ Amsterdam, Dept Epidemiol & Data Sci, Amsterdam UMC, NL-1105 AZ Amsterdam, Netherlands
[7] St Antonius Hosp, Dept Med Microbiol & Immunol, NL-3435 CM Nieuwegein, Netherlands
关键词
pneumococcal vaccination; immunocompromised host; transplant recipient; autoimmune disease; vaccine immunogenicity; INFLAMMATORY-BOWEL-DISEASE; RHEUMATOID-ARTHRITIS; TRANSPLANT RECIPIENTS; CONTROLLED-TRIAL; DOUBLE-BLIND; METHOTREXATE; INFECTIONS; SAFETY; RISK;
D O I
10.3390/vaccines10050795
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Immunosuppressive therapy increases the risk of pneumococcal disease. This risk can be mitigated by pneumococcal vaccination. The objective of this study was to investigate the immunogenicity of the 13-valent pneumococcal conjugate vaccine (PCV13), followed by the 23-valent pneumococcal polysaccharide vaccine (PPSV23), in adults with and without immunosuppressive therapy. We performed a prospective cohort study among adults using conventional immunomodulators (cIM), biological immunomodulators (bIM), combination therapy, and controls during 12 months. The primary outcome was seroprotection, defined as the proportion of patients with a postimmunization IgG concentration of >= 1.3 mu g/mL for at least 70% (17/24) of the serotypes of PCV13 + PPSV23. We included 214 participants. For all 24 vaccine serotypes, IgG levels increased significantly in both treatment subgroups and controls, with peak seroprotection rates of 44% (combination therapy), 58% (cIM), 57% (bIM), and 82% (controls). By month 12, seroprotection had decreased to 24%, 48%, 39%, and 63%, respectively. Although pneumococcal vaccination with PCV13 + PPSV23 was immunogenic in all treatment groups, impaired vaccination responses were observed in patients using immunosuppressive medication. Apart from the obvious recommendation to administer vaccines before such medication is started, alternative vaccination strategies, such as additional PCV13 doses or higher-valent pneumococcal vaccines, should be investigated.
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页数:17
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