title: Immunogenicity of pneumococcal vaccine in persons with spinal cord injury.
abstract: OBJECTIVE
  To determine immunogenicity and optimum timing for administering the 23-valent pneumococcal vaccine after spinal cord injury (SCI).
  
  
  METHODS
  Double-blind, randomized, placebo control study.
  
  
  METHODS
  SCI unit in a tertiary care medical center and community.
  
  
  METHODS
  Eighty-seven persons with recent SCI.
  
  
  METHODS
  Participants were randomized to receive either placebo or pneumococcal vaccine at 16 to 18 days versus 4 to 6 months postinjury.
  
  
  METHODS
  Antibody concentrations were measured prior to intervention and 1, 2, and 12 months afterward to evaluate the immune response to five serotypes of Streptococcus pneumoniae. Effects of demographic and injury-related variables on immune response were also evaluated.
  
  
  RESULTS
  Timing of vaccination did not influence mean antibody concentrations for any serotype (p > .05). Ninety-five percent of vaccinated persons had twofold or greater increases in antibody concentration for at least one serotype when measured 1 month after vaccination versus 35% of placebo groups (p < .01). After 12 months, 93% of vaccinated persons in both groups maintained antibody concentrations twofold or greater than baseline values.
  
  
  CONCLUSIONS
  Most participants developed an immune response to at least one serotype that was maintained for at least 12 months. Immune response varied according to serotype. Given the favorable immune response and no effect of timing, persons with SCI should receive pneumococcal vaccine during initial hospitalization.
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, 35233-7331, USA.
authors.forename: K B
authors.initials: KB
authors.lastname: Waites
authors.forename: K C
authors.initials: KC
authors.lastname: Canupp
authors.forename: K
authors.initials: K
authors.lastname: Edwards
authors.forename: P
authors.initials: P
authors.lastname: Palmer
authors.forename: B M
authors.initials: BM
authors.lastname: Gray
authors.forename: M J
authors.initials: MJ
authors.lastname: DeVivo
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D000907:Antibodies, Bacterial / Q000097:blood*; D001428:Bacterial Vaccines / Q000276:immunology*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D022242:Pneumococcal Vaccines; D012703:Serotyping; D013119:Spinal Cord Injuries / Q000097:blood / Q000276:immunology*; D013296:Streptococcus pneumoniae / Q000145:classification / Q000276:immunology*; D013997:Time Factors
chemical_list: D000907:Antibodies, Bacterial; D001428:Bacterial Vaccines; D022242:Pneumococcal Vaccines