Comparison of Pneumococcal Conjugate Polysaccharide and Free Polysaccharide Vaccines in Elderly Adults: Conjugate Vaccine Elicits Improved Antibacterial Immune Responses and Immunological Memory

Abstract

In adults, an initial dose of 7vPnC is likely to elicit higher and potentially more effective levels of antipneumococcal antibodies than is PPV. In contrast with PPV, for which the induction of hyporesponsiveness was observed when used as a priming dose, 7vPnC elicits an immunological state that permits subsequent administration of 7vPnC or PPV to maintain functional antipolysaccharide antibody levels.

Superior Immune Response to Protein-Conjugate versus Free Pneumococcal Polysaccharide Vaccine in Chronic Obstructive Pulmonary Disease

“…We have demonstrated that patients with COPD are able to mount immune responses comparable to those previously reported in healthy elderly patients (14,15). We showed that PCV7, when given at twice the dose recommended for children, induces a superior immune response to PPSV23 in COPD.…”

“…Bolded items represent a significant difference in absolute postvaccination IgG levels between vaccine groups and underlined items represent a significant difference in 1 month to baseline IgG ratio. levels in previously vaccinated healthy patients older than 70 years of age using the 1.0-ml PCV7 dose and by de Roux and coworkers who demonstrated the same results using the traditional pediatric dose (0.5 ml) in a vaccine-naive elderly population (14,15). Taken together, these studies suggest that although protein-conjugate vaccines may induce superior immune responses to the free polysaccharide vaccine, the optimal dose is uncertain and higher doses may be needed in those previously vaccinated with PPSV23.…”

“…The 7-valent diphtheria-conjugated pneumococcal polysaccharide vaccine (PCV7) (Prevnar; Wyeth, Pearl River, NY) induces a potent immune response in children and reduces the nasopharyngeal carriage of vaccine serotypes, episodes of otitis, and the frequency of invasive disease (13). Although this vaccine is not currently licensed for use in adults, preliminary studies in healthy patients older than age 70 years have shown that PCV7 induces greater functional antibody activity at 1 month post vaccination than does PPSV23, although this response is reduced in those who have been previously vaccinated (14,15). Jackson and colleagues demonstrated that in these healthy patients the 1.0-ml dose of PCV7 induced a greater immune response than the pediatric 0.5-ml dose.…”

Effect of Methotrexate, Anti–Tumor Necrosis Factor α, and Rituximab on the Immune Response to Influenza and Pneumococcal Vaccines in Patients With Rheumatoid Arthritis: A Systematic Review and Meta‐Analysis

“…In a study of patients with human immunodeficiency virus, the immune response was better for patients vaccinated according to this strategy than in those vaccinated with only a dose of PPV (40). Similar results were found in a population of elderly adults (41). Studies evaluating this prime-boost strategy in RA patients are needed.…”

A review of economic evaluations of 13-valent pneumococcal conjugate vaccine (PCV13) in adults and the elderly

“…9 Some immunological studies 10 have suggested improved immunogenicity of PCV7 over PPV23 in adults and/or the elderly. [11][12][13][14][15] while others have reported no significant differences. 10,[16][17][18][19] In 2014 the first large clinical trial of PCV13 in the adults aged >65 y (CAPiTA trial -Community Acquired Pneumonia Immunization Trial in Adults 20 ) was completed.…”