Serologic response to pneumococcal vaccination in children experiencing recurrent invasive pneumococcal disease

Abstract

BackgroundSome children are prone to recurrent invasive pneumococcal disease (rIPD) and of these, some respond insufficiently to standard pneumococcal vaccination. Little is known about how to handle these children and if they benefit from additional vaccination. Here, we present results from a nationwide study of pediatric rIPD including data on serotype-specific vaccination response to pneumococcal polysaccharide vaccination (PPV23) and pneumococcal conjugate vaccination (PCV7/13).MethodsA retrospective, population-based study was conducted using The National Streptococcus pneumoniae Registry, which contains laboratory-confirmed data from all cases of IPD in Denmark. From January 1980–June 2013 all children aged 0–15 years with rIPD were identified. Clinical data and data on serotype-specific pneumococcal antibody response were collected. Over the years quantification of pneumococcal antibodies varied from being presented in arbitrary units (ELISA), in μg/ml (WHO ELISA) and lately in μg/ml based on Luminex technology.Results2482 children were diagnosed with IPD and 75 episodes of rIPD were documented in 59 children. An underlying disease was documented in 45 (76%) children. Vaccination data were available for 26 children; 11 were vaccinated solely with PPV23, 8 with a combination of PPV23 + PCV7, 5 with PCV7 and 2 with PCV13. In total, nine responded to PPV23 vaccination and ten were PPV23 non-responders. Of the 15 PCV vaccinated children, two children responded subnormal to PCV7. Among PPV23 non-responders, five responded to subsequent PCV vaccination.ConclusionsIn our population-based study of children with rIPD 53% of the children responded insufficiently to PPV23 vaccination. PPV23 non-responders benefitted from PCV vaccination.Electronic supplementary materialThe online version of this article (10.1186/s12879-018-3267-6) contains supplementary material, which is available to authorized users.

Factors influencing PCV13 specific antibody response in Danish children starting in day care

“…This may be due to a memory response elicited by the serotype that caused IPD 23 or because the children may have been carrying pneumococcal serotypes beforehand. A study by Ingels et al also showed the importance of evaluating pneumococcal antibody response on an individual level in children at higher risk of IPD 24 . The reason why we did not see a difference in PCV13 antibody response between carriers and non-carriers in our study may have several causes.…”

Bacterial Vaccinations in Patients with Chronic Obstructive Pulmonary Disease

“…In addition, the vaccine is not suitable to trigger long-term immunological memory in children, as PPSV23 requires T-cell independent immunity. Therefore, children show a lower response to this vaccine [ 31 , 32 ]. In the case of adults, PCVs induced a more favourable, superior functional antibody response, compared to PPSV23 [ 33 ].…”

Maternal immunization with pneumococcal surface protein A provides the immune memories of offspring against pneumococcal infection

“…In children under 2 years of age, however, PCV provides insufficient immune induction because of the inability to generate T cell-dependent immune responses to B cells ( Selman et al., 2000 ). Because of a heterogeneity of immune maturity, there are a few infants who show impaired response to vaccines called as ‘non-responder’ ( Ingels et al., 2018 ). Another concern regarding the current vaccines is selection of non-vaccine strains, serotype replacement; the most commonly-known example being the 13-valent pneumococcal conjugate vaccine in Europe ( Reinert, 2004 ).…”