Influence of initial vaccination with 13-valent pneumococcal conjugate vaccine or 23-valent pneumococcal polysaccharide vaccine on anti-pneumococcal responses following subsequent pneumococcal vaccination in adults 50 years and older

Abstract

In adults 50 to 64 years of age, initial vaccination with PCV13 establishes an immune state that results in recall anti-pneumococcal responses upon subsequent vaccination with either conjugated or free polysaccharide vaccine. In contrast, initial vaccination with PPSV23 results in an immune state in which subsequent PPSV23 administration yields generally lower responses compared with the initial responses.

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

“…For serotypes 3 and 14, the differences in responses between vaccines post vaccination were consistent with those observed in the current study. 12,13,27,41 As discussed above, a US study clearly demonstrated the ability to revaccinate PCV13 recipients with PCV13. 27 PCV13 was also shown to enhance responses to PPSV23.…”

“…Some studies have observed that immune responses of some PPSV23 serotypes are significantly reduced upon revaccination at a 6-month to 4-year interval, which raises the question of hyporesponsiveness. [25][26][27][28][29] Other studies in the United States 30,31 and in Japan 32 demonstrated that when subjects were revaccinated with PPSV23 after an interval longer than 5 years, the serotypes studied were immunogenic when compared with prevaccination levels. Antibody responses on revaccination, although lower, were generally sustained when compared with those after the initial vaccination.…”

“…One US study showed that when PCV13 recipients received a second dose of PCV13 after approximately 4 years, immune responses were generally sustained compared to responses after the initial PCV13 vaccination, with many of the PCV13 serotypes showing statistically significantly higher responses. 27 Although the duration of protection provided by PCV13 is not known, the CAPiTA study recently demonstrated a reduction of vaccine-type CAP cases in PCV13 vaccinated individuals that lasted at least 4 years. 20,21 However, if protection from initial vaccination should wane, the US study on the impact of PCV13 on subsequent vaccination 27 clearly demonstrates the ability to revaccinate with PCV13 after an appropriate interval, thereby maintaining or increasing antibody levels; this may optimize protection.…”

“…27 Although the duration of protection provided by PCV13 is not known, the CAPiTA study recently demonstrated a reduction of vaccine-type CAP cases in PCV13 vaccinated individuals that lasted at least 4 years. 20,21 However, if protection from initial vaccination should wane, the US study on the impact of PCV13 on subsequent vaccination 27 clearly demonstrates the ability to revaccinate with PCV13 after an appropriate interval, thereby maintaining or increasing antibody levels; this may optimize protection. Surveillance data from many countries will continue to monitor IPD incidence to assess the need for revaccination.…”

“…27 PCV13 was also shown to enhance responses to PPSV23. 12,27 This allows for PPSV23 to be given after PCV13 if broader serotype coverage is required. In the United States, for example, the Advisory Committee for Immunization Practices currently recommends that adults aged 65 years who are naive to pneumococcal vaccines receive a dose of PPSV23 by 6¡12 months after PCV13 to cover the 11 additional serotypes not included in PCV13.…”