title: Immunogenicity and safety of a 23-valent pneumococcal polysaccharide vaccine in healthy children and in children at increased risk of pneumococcal infection.
abstract: Splenectomized children as well as those suffering from nephrotic syndrome or recurrent asthmatic bronchitis have an increased susceptibility to systemic pneumococcal infections compared to healthy children. To determine the immunogenicity and safety of a 23-valent pneumococcal polysaccharide vaccine (PPV), 119 children (21 healthy, 26 splenectomized children, 48 with nephrotic syndrome and 24 with recurrent asthmatic bronchitis), aged 2-18 years, received one subcutaneous injection of a 23-valent PPV. Anti-capsular antibodies (Ab) to types 6B, 9V, 14, 18C, 19F and 23F were measured by ELISA before and 4 weeks after immunization. In all cases the adverse reactions were mild and transient, consisting of local pain and/or erythema or swelling in 41% and fever above 38.5 degrees C in 2% of the children. The healthy children responded well to vaccination with a mean fold increase (FI) of 2.6 in postvaccination Ab titers compared to prevaccination titers. The combined geometric mean Ab concentrations in the high-risk children were significantly lower than those of healthy children both before and after vaccination. However, the combined geometric mean FI were not significantly different between high-risk and healthy children. These results indicate that PPV is immunogenic and safe in high-risk as well as in healthy Korean children.
authors.affiliation: Department of Pediatrics, Seoul National University Children's Hospital, Korea.
authors.forename: H J
authors.initials: HJ
authors.lastname: Lee
authors.forename: J H
authors.initials: JH
authors.lastname: Kang
authors.forename: J
authors.initials: J
authors.lastname: Henrichsen
authors.forename: H B
authors.initials: HB
authors.lastname: Konradsen
authors.forename: S H
authors.initials: SH
authors.lastname: Jang
authors.forename: H Y
authors.initials: HY
authors.lastname: Shin
authors.forename: H S
authors.initials: HS
authors.lastname: Ahn
authors.forename: Y
authors.initials: Y
authors.lastname: Choi
authors.forename: L
authors.initials: L
authors.lastname: Hessel
authors.forename: S W
authors.initials: SW
authors.lastname: Nam
mesh_terms: D000293:Adolescent; D000907:Antibodies, Bacterial / Q000096:biosynthesis / Q000097:blood; D001249:Asthma / Q000150:complications / Q000276:immunology; D001428:Bacterial Vaccines / Q000009:adverse effects / Q000276:immunology* / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007129:Immunoglobulin Gm Allotypes / Q000096:biosynthesis / Q000097:blood; D007223:Infant; D009404:Nephrotic Syndrome / Q000139:chemically induced / Q000276:immunology; D011008:Pneumococcal Infections / Q000276:immunology / Q000517:prevention & control*; D022242:Pneumococcal Vaccines; D012307:Risk Factors; D013156:Splenectomy
chemical_list: D000907:Antibodies, Bacterial; D001428:Bacterial Vaccines; D007129:Immunoglobulin Gm Allotypes; D022242:Pneumococcal Vaccines