Persistence of immunity to conjugate and polysaccharide pneumococcal vaccines in frail, hospitalised older adults in long-term follow up
Copyright © 2019 Elsevier Ltd. All rights reserved..
BACKGROUND: Data on long-term antibody responses to pneumococcal vaccines in the elderly, especially the frail elderly at greatest risk of severe disease, are limited. We followed up participants in a randomised trial of the immunogenicity of 23-valent polysaccharide vaccine (23vPPV) and 7 valent pneumococcal conjugate vaccines (PCV7) in hospitalised older adults.
METHODS: We measured antibody to vaccine serotypes by standardised enzyme-linked immunosorbent assay (ELISA) and opsonophagocytic (OPA) assays. A follow up study was conducted six years after vaccination with 23vPPV alone or with PCV7 followed by 23vPPV six months later.
RESULTS: Of 215 surviving trial participants, 136 (63%) completed follow up; 62 received 23vPPV and 74 received PCV7 + 23vPPV. There was no significant difference in death and readmission between arms. Antibody levels by ELISA and OPA did not differ significantly between the two study arms at 72 months post-vaccination. ELISA and OPA antibody remained higher than baseline except for OPA antibody to 4, 6A, 6B, 9v, 19F and 23F, including in subjects with undetectable immunity at baseline.
DISCUSSION: While ELISA responses in both study arms remained high 6 years post-vaccination, considerable waning was observed by OPA in both study arms, which should be considered given the current single-dose recommendation in Australia. Further research is needed to inform pneumococcal vaccine recommendations in people over the age of 65.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2019 |
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| Erschienen: |
2019 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:37 |
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| Enthalten in: |
Vaccine - 37(2019), 35 vom: 14. Aug., Seite 5016-5024 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
MacIntyre, C Raina [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 06.10.2020 Date Revised 06.10.2020 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.vaccine.2019.07.005 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM299133753 |
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| 520 | |a Copyright © 2019 Elsevier Ltd. All rights reserved. | ||
| 520 | |a BACKGROUND: Data on long-term antibody responses to pneumococcal vaccines in the elderly, especially the frail elderly at greatest risk of severe disease, are limited. We followed up participants in a randomised trial of the immunogenicity of 23-valent polysaccharide vaccine (23vPPV) and 7 valent pneumococcal conjugate vaccines (PCV7) in hospitalised older adults | ||
| 520 | |a METHODS: We measured antibody to vaccine serotypes by standardised enzyme-linked immunosorbent assay (ELISA) and opsonophagocytic (OPA) assays. A follow up study was conducted six years after vaccination with 23vPPV alone or with PCV7 followed by 23vPPV six months later | ||
| 520 | |a RESULTS: Of 215 surviving trial participants, 136 (63%) completed follow up; 62 received 23vPPV and 74 received PCV7 + 23vPPV. There was no significant difference in death and readmission between arms. Antibody levels by ELISA and OPA did not differ significantly between the two study arms at 72 months post-vaccination. ELISA and OPA antibody remained higher than baseline except for OPA antibody to 4, 6A, 6B, 9v, 19F and 23F, including in subjects with undetectable immunity at baseline | ||
| 520 | |a DISCUSSION: While ELISA responses in both study arms remained high 6 years post-vaccination, considerable waning was observed by OPA in both study arms, which should be considered given the current single-dose recommendation in Australia. Further research is needed to inform pneumococcal vaccine recommendations in people over the age of 65 | ||
| 650 | 4 | |a Comparative Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Randomized Controlled Trial | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Adult vaccination | |
| 650 | 4 | |a Elderly | |
| 650 | 4 | |a Frailty | |
| 650 | 4 | |a Immunology | |
| 650 | 4 | |a Pneumococcal conjugate vaccines | |
| 650 | 4 | |a Pneumococcal polysaccharide vaccines | |
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| 650 | 7 | |a Antibodies, Bacterial |2 NLM | |
| 650 | 7 | |a Heptavalent Pneumococcal Conjugate Vaccine |2 NLM | |
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| 650 | 7 | |a Pneumococcal Vaccines |2 NLM | |
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| 700 | 1 | |a McIntyre, Peter |e verfasserin |4 aut | |
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