TY - JOUR
T1 - 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
AU - Garcia Garrido, Hannah M.
AU - Vollaard, Albert
AU - D’haens, Geert R.
AU - Spuls, Phyllis I.
AU - Bemelman, Frederike J.
AU - Tanck, Michael W.
AU - de Bree, Godelieve J.
AU - Meek, Bob
AU - Grobusch, Martin P.
AU - Goorhuis, Abraham
AU - D'Haens, Geert R
N1 - Funding Information: This work was supported by a public research grant of The Netherlands Organisation for Health Research and Development (ZonMw), grant number 522004005. The funder of the study had no role in the study design, data collection, data analysis, data interpretation, or writing of the report. The corresponding author had full access to all the data in the study and had final responsibility for the decision to submit for publication. Acknowledgments: The authors would like to thank the analysts Erik Beij, Ben de Jong, and Anne Reiners from the Department of Immunology at the St. Antonius Hospital Nieuwegein for the assistance with the laboratory assessments. In addition, the authors thank the nurses working at the Center for Tropical Medicine and Travel Medicine for the administration of vaccines to the study population. Funding Information: Funding: This work was supported by a public research grant of The Netherlands Organisation for Health Research and Development (ZonMw), grant number 522004005. The funder of the study had no role in the study design, data collection, data analysis, data interpretation, or writing of the report. The corresponding author had full access to all the data in the study and had final responsibility for the decision to submit for publication. Publisher Copyright: © 2022 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2022/5/1
Y1 - 2022/5/1
N2 - 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 im-munogenicity of the 13-valent pneumococcal conjugate vaccine (PCV13), followed by the 23-valent pneumococcal polysaccharide vaccine (PPSV23), in adults with and without immunosuppressive ther-apy. 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 µg/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 im-munogenic 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.
AB - 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 im-munogenicity of the 13-valent pneumococcal conjugate vaccine (PCV13), followed by the 23-valent pneumococcal polysaccharide vaccine (PPSV23), in adults with and without immunosuppressive ther-apy. 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 µg/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 im-munogenic 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.
KW - autoimmune disease
KW - immunocompromised host
KW - pneumococcal vaccination
KW - transplant recipient
KW - vaccine immunogenicity
UR - http://www.scopus.com/inward/record.url?scp=85130988584&partnerID=8YFLogxK
U2 - https://doi.org/10.3390/vaccines10050795
DO - https://doi.org/10.3390/vaccines10050795
M3 - Article
C2 - 35632551
SN - 2076-393X
VL - 10
JO - Vaccines
JF - Vaccines
IS - 5
M1 - 795
ER -