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Humoral response to a 13-valent pneumococcal conjugate vaccine in kidney transplant recipients |
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| Institution: | 1. Department of Infectious Diseases, University Hospital Essen, University Duisburg-Essen, Essen, Germany;2. Department of Nephrology, University Hospital Essen, University Duisburg-Essen, Essen, Germany;3. Institute for Transfusion Medicine, University Hospital Essen, University Duisburg-Essen, Essen, Germany;4. University College London, Institute of Child Health, London, United Kingdom;5. World Health Organisation, Pneumococcal Serology Reference Laboratory, London, United Kingdom;1. Laboratory of Molecular Microbiology of Human Pathogens, Instituto de Tecnologia Química e Biológica António Xavier, Universidade Nova de Lisboa, Oeiras, Portugal;2. Institute for Infection and Immunity, St. George’s, University of London, London, UK;3. BUGS Bioscience, London Bioscience Innovation Centre, London, UK;4. BioISI – Biosystems & Integrative Sciences Institute, Faculdade de Ciências da Universidade de Lisboa, Lisbon, Portugal;5. Laboratory of Molecular Genetics, Instituto de Tecnologia Química e Biológica António Xavier, Universidade Nova de Lisboa, Oeiras, Portugal;6. Laboratory of Microbiology and Infectious Diseases, The Rockefeller University, New York, NY, USA;1. Northern California Kaiser Permanente Vaccine Study Center, Oakland, CA, USA;2. Pfizer Vaccines, 500 Arcola Road, Collegeville, PA, USA;1. Department of Pediatrics and Center for Vaccine Evaluation and Study, Medical Research Institute, Ewha Womans University School of Medicine, Seoul, Republic of Korea;2. Division of Infectious Diseases, Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Republic of Korea;3. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Republic of Korea;1. Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya;2. Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA;3. Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK;4. Kenya Ministry of Health, Kilifi, Kenya;5. Kenya Ministry of Health, Nairobi, Kenya;6. London School of Hygiene & Tropical Medicine, London, UK;1. Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada;2. Division of Vaccine Preventable Diseases, Public Health Agency of Canada, Ottawa, ON, Canada;3. Department of Pediatrics, Division of Infectious Diseases, The Montreal Children''s Hospital, McGill University, Montreal, QC, Canada;4. Quebec Institute of Public Health, Montreal, QC, Canada;5. McGill University Health Centre, Vaccine Study Centre, Research Institute of the MUHC, Montreal, QC, Canada;1. Center for Vaccinology and Neonatal Immunology, Department of Pediatrics and Pathology-Immunology, Medical Faculty and University Hospitals of Geneva, Switzerland;2. Department of Woman, Child and Adolescent Medicine, Unit of Immunology and Vaccinology, University Hospitals of Geneva and Faculty of Medicine, Geneva, Switzerland;3. Transplant Infectious Diseases Unit, University Hospitals of Geneva and Faculty of Medicine, Geneva, Switzerland;4. Laboratory of Vaccinology, University Hospitals of Geneva, Switzerland;5. Departments of Gastroenterology and Hepatology, University Hospitals of Geneva and Faculty of Medicine, Geneva, Switzerland;6. Division of Nephrology, University Hospitals of Geneva and Faculty of Medicine, Geneva, Switzerland;7. Division of Cardiology, University Hospitals of Geneva and Faculty of Medicine, Geneva, Switzerland;8. Division of Pneumology, University Hospitals of Geneva and Faculty of Medicine, Geneva, Switzerland;9. Division of Transplantation, University Hospitals of Geneva and Faculty of Medicine, Geneva, Switzerland |
| Abstract: | BackgroundVaccination against S. pneumoniae is recommended by national guidelines. Moderate immunogenicity of the 13-valent pneumococcal conjugate vaccine (PCV13) has been reported in adult kidney transplant recipients (KTR). This study further defines the immunogenicity of PCV13 in this cohort.Methods49 KTR were immunized with PCV13. A validated opsonophagocytic killing assay (OPA), a global anti-pneumococcal capsular polysaccharide (anti-PCP) IgG, IgG2, IgM and IgA ELISA, and - for selected patients - a serotype specific anti-PCP WHO reference ELISA were performed pre-vaccination and at month 1 and 12 post-vaccination.ResultsGeometric mean OPA titers increased significantly for 13/13 serotypes at month 1 and for 10/13 serotypes at month 12 post-vaccination. Vaccine response defined as an OPA titer ≥1:8 was reached in 9/13 serotypes (median). 53% reached the vaccine response criteria at month 1 and 45% at month 12. At month 1 after vaccination, the median OPA titer in an age-group matched healthy reference population was 5- to 10-fold higher than in KTR. OPA titers correlated strongly with results to the global and serotype specific anti-PCP IgG ELISA. Lower OPA titers significantly (p < 0.05) correlated with albuminuria, an interval between vaccination and transplantation <12 months, age and treatment with mycophenolate mofetil. Global IgG, IgG2, IgM and IgA, as well as serotype specific anti-PCP antibody concentrations (12/13 serotypes) increased significantly at month 1 and 12 post-vaccination.ConclusionsKidney transplant recipients show a significant humoral response after vaccination with PCV13. Functional antibody response exists, but is not as vigorous as in healthy adults. |
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