Randomized, double-blind, controlled trial of pneumococcal vaccination in renal transplant recipients.
Renal transplant recipients are at increased risk for developing invasive pneumococcal disease but may have a poor response to pneumococcal polysaccharide vaccine (PPV23). For them, pneumococcal conjugate vaccine (PCV7) may be more immunogenic. Patients were given a single dose of PPV23 or PCV7 in our randomized, controlled, double-blind trial. Immunogenicity was assessed 8 weeks after vaccination by serotype-specific enzyme-linked immunosorbent assay (ELISA) and opsonophagocytic assay (OPA). Baseline demographics, renal function, time since transplantation, and immunosuppression were comparable. In the PCV7 group, the vaccine response rate was improved for serotypes 23F (P=.046) and 6B (P=.067), and mean fold increases in antibody titer were higher for serotypes 23F (P=.046) and 9V (P=.09). The response rate and mean fold increase in OPA titers were not significantly different between groups. There was a trend toward enhanced immunogenicity for PCV7 by ELISA. However, functional antibody responses were not different.
The Immunocompromised Host Infection Service, Division of Multi-Organ Transplant and Infectious Diseases, University of Toronto, Toronto, Canada. dkumar@mtsinai.on.ca
Deepali
D
Kumar
Coleman
C
Rotstein
Genevieve
G
Miyata
Dianne
D
Arlen
Atul
A
Humar
D000328:Adult; D000368:Aged; D000907:Antibodies, Bacterial / Q000097:blood / Q000276:immunology; D004311:Double-Blind Method; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D022242:Pneumococcal Vaccines / Q000009:adverse effects / Q000276:immunology*; D013296:Streptococcus pneumoniae / Q000145:classification / Q000276:immunology
D000907:Antibodies, Bacterial; D022242:Pneumococcal Vaccines