Immunogenicity of 13-valent pneumococcal conjugate vaccine among children with underlying medical conditions |
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| Institution: | 1. Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, University of the Witwatersrand, Johannesburg, South Africa;2. Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand, Johannesburg, South Africa;3. National Institute for Communicable Diseases: A Division of National Health Laboratory Service, Centre for Vaccines and Immunology, Johannesburg, South Africa;4. Department of Paediatrics and Child Health, Chris Hani Baragwanath Academic Hospital and Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa;5. Perinatal HIV Research Unit, Faculty of Health Sciences, University of the Witwatersrand, South Africa;1. Discipline of General Practice, Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia;2. Adelaide Rural Clinical School, The University of Adelaide, Adelaide, SA, Australia;3. The Australian Sentinel Practices Research Network (ASPREN), The University of Adelaide, Adelaide, SA, Australia;4. Australian Partnership for Preparedness Research on Infectious Disease Emergencies (APPRISE) Centre of Research Excellence, NHMRC, Australia;1. The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel;2. The Pediatric Infectious Disease Unit, Soroka University Medical Center, Beer-Sheva, Israel;3. Neonatal department Soroka University Medical Center, Beer-Sheva, Israel;1. Division of Otorhinolaryngology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel;2. Division of Pediatrics, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel;3. Pediatric Infectious Disease Unit, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel;1. Marmara University, Faculty of Medicine, Division of Pediatric Infectious Diseases, Istanbul, Turkey;2. Marmara University, Faculty of Medicine, Department of Pediatrics, Istanbul, Turkey;3. Marmara University, Faculty of Medicine, Department of Microbiology, Istanbul, Turkey;1. The Pediatric Infectious Disease Unit, Soroka University Medical Center, Ben-Gurion University, Beer-Sheva, Israel;2. Shaare Zedek Medical Center, Jerusalem, Israel;3. Wolfson Medical Center, Holon, Israel;4. The Barzilai Medical Center, Ashkelon, Israel;5. The Pediatric Infectious Disease Service, HaEmek Medical Center, Afula, Israel;1. Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa;2. Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, University of the Witwatersrand, Johannesburg, South Africa;3. National Institute for Communicable Diseases: A Division of National Health Laboratory Service, Centre for Vaccines and Immunology, Johannesburg, South Africa |
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| Abstract: | BackgroundStreptococcus pneumoniae is a leading cause of vaccine-preventable disease in children under 5 years. Immunocompromised children and those with underlying diseases are at increased risk of severe complications from vaccine-preventable infections. We studied the humoral immune response to the 13-valent pneumococcal conjugate vaccine (PCV13) in children with HIV-infection, kidney or lung disease and compared this to the response in healthy control children.MethodsChildren aged 12–71 months with underlying conditions including HIV-infection and those with kidney and lung diseases (at-risk children), and a healthy control group were vaccinated with PCV13. The at-risk children received two doses of PCV13 and the controls received one dose. Serotype-specific antibodies for all PCV13 serotypes were measured by a luminex-based enzyme immunoassay at baseline and post-vaccination.ResultsAfter the first PCV13 dose, the fold-increase in serotype-specific antibody geometric mean concentrations (GMCs) from baseline and the percentage of participants with ≥4-fold-increase in antibody concentrations was similar between the control and at-risk children. GMCs were, however, lower for three of the 13 serotypes in HIV-infected children, higher for serotype 6B in children with kidney disease and higher for serotypes 6B and 14 in children with lung disease. After second vaccine dose HIV-infected children had an increase in GMCs from post-first dose for nine serotypes but the percentage of participants with ≥4-fold-increase from baseline was similar post-second dose compared to post-first dose except for serotypes 6A and 19F. In children with kidney or lung diseases the immune responses after second vaccine dose were similar to post-first dose. Attenuated responses were observed for serotypes 3 and 19A in all study-groups, which was especially pronounced in the at-risk groups.ConclusionAll study-groups mounted an immune response to PCV13, with the at-risk groups having responses that were mostly similar to the control children. |
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| Keywords: | Pneumococcal conjugate vaccine PCV13 HIV Kidney Lung |
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