The trend in the formation of postvaccinal antibodies (Ab) to a mixture of S. pneumoniae polysaccharides (PS) was studied in 100 Pneumo 23-vaccinated children and adolescents with type 1 diabetic (T1D) (Group 1, n = 72) and its combination with the subunit vaccine Grippol (Group 2, n = 28). Following 1-1.5 months, the protective level of Ab l 40 conventional units (CU/ml) was revealed in 95.1 and 85.2% of Groups 1 and 2, respectively; and after 1 year, this was in 55.1 and 37%, respectively (p > 0.05). The level of formation of IgG Ab to a PS mixture did not depend on the age of patients, the duration of T1D, the presence of late diabetic complications. A relationship was found between the formation of postvaccinal Ab and their baseline level: in patients with very low (< 10 CU/ml) and low (10-20 CU/ml) levels of Ab after administration of pneumococcal vaccine, the level of IgG Ab to a S. pneumoniae PS mixture increased by 8.8-4.1 times in the early periods and exceeded the baseline levels by 4.8-2.8 times, respectively. The putative protective level of IgG AB to a S. pneumoniae PS mixture is proposed to be l 20 CU/ml.

The effect of a Pneumo 23 vaccine against pneumococcal infection (n = 72; Subgroup 1) in combination with a Grippol vaccine against influenza infection (n = 28; Subgroup 2) was studied in children and adolescents with type 1 diabetes on insulin therapy. A control group consisted of 30 unvaccinated children. Unlike monovaccination, combined vaccination was ascertained to cause a significant reduction in the glycated hemoglobin following a year. The daily dose of insulin and the levels of high-density lipoprotein cholesterol, triglycerides, and b-lipoproteins were unchanged in all the groups. The level of albumins increased, by approximating to the normal values. The blood content of urea and creatinine remained to be in the normal range at all stages of the study. In Subgroup 2 children microalbuminuria was significantly decreased. Within a year after vaccination, all the children and adolescents with T1D also showed a reduction in the number of disease decompensation episodes, which being significant in Subgroup 2, resulting from the reductions in the incidence and severity of acute respiratory infections. In the vaccinated children, the number of late vascular diabetic complications remained unchanged. Vaccination against pneumococcal infection in 13 children before hospital discharge in the subcompensation phase was followed by the same changes in the biochemical parameters and the clinical course of T1D parameters as in the patients vaccinated in the phase of compensation of the disease. The dynamic abdominal ultrasonographic pattern was found to become worse in the unvaccinated patients than that in Subgroup 1 patients. Analysis of clinical, laboratory, and instrumental results indicated the stability of the course of T1D in the children and adolescents vaccinated against pneumococcal and influenza infections.