Comparison of the immunogenicity and safety of polysaccharide and protein-conjugated pneumococcal vaccines among the elderly aged 80 years or older in Japan: An open-labeled randomized study

Namkoong, Ho; Funatsu, Yohei; Oishi, Kazunori; Akeda, Yukihiro; Hiraoka, Rika; Takeshita, Kei; Asami, Takahiro; Yagi, Kazuma; Kimizuka, Yoshifumi; Ishii, Makoto; Tasaka, Sadatomo; Suzuki, Yukio; Iwata, Satoshi; Betsuyaku, Tomoko; Hasegawa, Naoki

doi:10.1016/j.vaccine.2014.11.023

Cited by 13 publications

(6 citation statements)

References 19 publications

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“…The reason for the discrepant results of these two studies remains unclear. A randomized study of nursing home residents Ն80 years old found that both PPV23 and PCV7 were immunogenic in this population, with the conjugate vaccine resulting in higher IgG levels and opsonic activity for some serotypes and both vaccines equally immunogenic for others (80). The effects of single-dose versus boosted vaccination, in various combinations, have been assessed in a number of studies but with conflicting results (reviewed in reference 81).…”

Section: Pneumococcal Vaccines Are Immunogenic In Older Peoplementioning

confidence: 99%

Pneumococcal Capsular Polysaccharide Immunity in the Elderly

Adler

Ferreira

Gordon

et al. 2017

Clin Vaccine Immunol

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Immunity to pneumococcal infections is impaired in older people, and current vaccines are poorly protective against pneumococcal disease in this population. Naturally acquired immunity to pneumococcal capsular polysaccharides develops during childhood and is robust in young adults but deteriorates with advanced age. In particular, antibody levels and function are reduced in older people. Pneumococcal vaccines are recommended for people Ͼ65 years old. However, the benefits of polysaccharide and protein-conjugated vaccines in this population are small, because of both serotype replacement and incomplete protection against vaccine serotype pneumococcal disease. In this review, we overview the immune mechanisms by which naturally acquired and vaccine-induced pneumococcal capsular polysaccharide immunity declines with age, including altered colonization dynamics, reduced opsonic activity of antibodies (particularly IgM), and impaired mucosal immunity.

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Section: Pneumococcal Vaccines Are Immunogenic In Older Peoplementioning

confidence: 99%

Pneumococcal Capsular Polysaccharide Immunity in the Elderly

Adler

Ferreira

Gordon

et al. 2017

Clin Vaccine Immunol

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“…Finally, a study in subjects 80 years of age in Japan showed that PCV7 serotypes 4, 6B, 9V, 14, 18C, 19F, and 23F elicited higher functional antibody responses in PCV7 compared with PPSV23 recipients; these differences were significantly higher for serotypes 4, 9V, 18C, and 23F. 43 It is particularly reassuring that elderly Japanese subjects 80 years of age are able to mount higher functional antibody responses after PCV7 compared with PPSV23, despite reports of immunosenescence in the elderly. 44 As in other studies with PCV13, 12,19,45 in the current study, PCV13 was shown to have an acceptable safety and reactogenicity profile.…”

Section: Discussionmentioning

confidence: 95%

Immunogenicity and safety of the 13-valent pneumococcal conjugate vaccine compared to the 23-valent pneumococcal polysaccharide vaccine in elderly Japanese adults

Shiramoto¹,

Hanada

Juergens

et al. 2015

Human Vaccines & Immunotherapeutics

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sive pneumococcal disease; LLOQ, lower limit of quantitation; OPA, opsonophagocytic activity; PCV13, 13-valent pneumococcal conjugate vaccine; PPSV23, 23-valent pneumococcal polysaccharide vaccineStreptococcus pneumoniae is a major cause of severe disease worldwide, particularly in the elderly population. Due to increasing life expectancy in Japan and elsewhere, an effective vaccine which offers the possibility of prolonged protection is required. Protein conjugated pneumococcal vaccines, which have the ability to boost immunity (immunologic memory) on natural exposure or revaccination, may meet these requirements. An unconjugated 23-valent pneumococcal polysaccharide vaccine (PPSV23) has been available for decades; however data on protection against pneumonia are inconsistent. For the first time, a randomized, modified double-blind trial comparing the 13-valent pneumococcal conjugate vaccine (PCV13) with PPSV23 was conducted in PPSV23-naive adults 65 years of age in Japan. This study showed that statistically significantly greater functional antibody responses as measured by opsonophagocytic assays 1 month after vaccination were elicited in the PCV13 group (n D 366) compared with the PPSV23 group (n D 367) for 9 of the 12 serotypes in common with both vaccines and for serotype 6A, unique to PCV13. Local reactions collected within 14 days of vaccination were more frequent in the PCV13 (57.5%, 211/367) than PPSV23 (44.9%, 166/370) group, although severity was generally mild to moderate; systemic and adverse events were similar across groups. There were no treatment-related serious adverse events. Consistent with global studies comparing PCV13 with PPSV23, PCV13 use in Japanese subjects was safe and well-tolerated and elicited greater functional immune responses than PPSV23 for the majority of PCV13-serotypes. PCV13 has the potential to protect against pneumococcal disease in Japanese elderly adults.

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“…In our evaluation of serotype-specific IgG antibodies and serotype-specific OIs between PPV23 and PCV7 for pneumococcus vaccine-naïve elderly people (≥80 years of age), 90 both PPV23 and PCV7 elicited increases in IgG and OI. Meanwhile, PCV7 was more potent than PPV23 in terms of its immunogenicity against 4 serotypes out of the 7 included in PCV7 (serotypes 4, 9V, 18C, and 23F).…”

Section: Serotype Of Streptococcus Pneumoniaementioning

confidence: 93%

Theory and strategy for Pneumococcal vaccines in the elderly

Namkoong

Ishii

Funatsu

et al. 2015

Human Vaccines & Immunotherapeutics

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Pneumonia is the fourth-leading cause of death globally, and Streptococcus pneumoniae is the most important causative pathogen. Because the incidence of pneumococcal diseases is likely to increase with the aging society, we should determine an optimal strategy for pneumococcal vaccination. While consensus indicates that 23-valent pneumococcal polysaccharide vaccine prevents invasive pneumococcal diseases (IPD), its effects on community-acquired pneumonia (CAP) remain controversial. Recently, a 13-valent pneumococcal conjugate vaccine (PCV13) was released. The latest clinical study (CAPiTA study) showed that PCV13 reduced vaccine-type CAP and IPD. Based on these results, the Advisory Committee on Immunization Practices recommended initial vaccination with PCV13 for the elderly. Scientific evidence regarding immunosenescence is needed to determine a more ideal vaccination strategy for the elderly with impaired innate and adaptive immunity. Continuing research on the cost effectiveness of new vaccine strategies considering constantly changing epidemiology is also warranted.

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Comparison of the immunogenicity and safety of polysaccharide and protein-conjugated pneumococcal vaccines among the elderly aged 80 years or older in Japan: An open-labeled randomized study

Cited by 13 publications

References 19 publications

Pneumococcal Capsular Polysaccharide Immunity in the Elderly

Pneumococcal Capsular Polysaccharide Immunity in the Elderly

Immunogenicity and safety of the 13-valent pneumococcal conjugate vaccine compared to the 23-valent pneumococcal polysaccharide vaccine in elderly Japanese adults

Theory and strategy for Pneumococcal vaccines in the elderly

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