Opsonophagocytic activity against Streptococcus pneumoniae in Indigenous and non-Indigenous patients with severe chronic kidney disease immunized with 13-valent pneumococcal conjugate vaccine

Ulanova, Marina; Huska, Brenda; Dubois, Sacha; McCready, William

doi:10.1016/j.vaccine.2022.06.042

Cited by 1 publication

(1 citation statement)

References 23 publications

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“…While we might observe this finding by chance, one hypothesis is that US patients with reduced eGFR have a higher prevalence of vaccine-matched strains due to differences in demographics, time since vaccination [ 47 ], antibiotic resistance patterns [ 48 ] and national vaccination programs [ 46 , 49 ], but our observation requires further investigation. Regardless, our findings provide reassuring evidence on the clinical benefit of pneumococcal vaccination in individuals with reduced eGFR despite diminished immune response to vaccination [ 43 , 50 ].…”

Section: Discussionmentioning

confidence: 70%

Pneumococcal vaccination effectiveness (PCV13 and PPSV23) in individuals with and without reduced kidney function: a test-negative design study

Le,

Chang,

Grams

et al. 2024

Clinical Kidney Journal

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Background Streptococcal Pneumoniae vaccination effectiveness (VE) in individuals with reduced kidney function is unknown. We estimated pneumococcal conjugate vaccine (PCV13), pneumococcal polysaccharide vaccine (PPSV23), and combined PCV13 & PPSV23 effectiveness against pneumococcal disease in individuals with and without reduced estimated glomerular filtration rate (eGFR). Methods All eligible individuals (case and controls) were adults (aged ≥18) hospitalized within Geisinger Health System and required to have S. Pneumoniae urinary antigen testing (ie. test negative design). Vaccination records were obtained from the electronic health record and statewide vaccination registry. After controlling for the probability of receiving a pneumococcal vaccine, we used multivariable logistic regression models to estimate the odds ratios (ORs) of vaccination between those who did and did not meet the S. Pneumoniae case definition. VE was calculated as (1 – OR) * 100%. Results There were 180 cases and 3,889 controls (mean age 69 years, female 48%, White 97%, mean eGFR 71). The adjusted population PCV13 VE was 40% (95% CI 13 – 58%), and combination PCV13 & PPSV23 was 40% (95% CI 13 - 59%). PPSV23 VE was -4.1% (95% CI -58 – 31%). Stratified by eGFR, adjusted PCV13 VE was consistent in eGFR ≥60 (VE 38% [95% CI 3.2 - 61%]) and 30-59 (VE 61% [95% CI 25 – 80%]) without significant interaction. VE was not calculable for eGFR <30 due to small sample size. Conclusion PCV13 vaccination was associated with reduced risk of S. Pneumoniae hospitalization in individuals with a reduced eGFR (30 – 59 mL/min/1.73m2).

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