Vaccination with polysaccharide-conjugate-vaccines in adult patients with specific antibody deficiency.
We report on a cohort of seven adult patients with specific antibody deficiency, defined by failure to respond to 23-valent Streptococcus pneumoniae vaccine while being able to respond to tetanus toxoid. Antibodies to Hemophilus influenzae (HiB) polysaccharides either pre-existed or were readily induced by a single vaccination with the HiB-tetanus toxoid conjugate. By contrast a single vaccination with the S. pneumoniae-diphtheria conjugate failed to induce a response to any of the seven serotypes in any of the seven patients. After a second vaccination in six patients, two patients continued to show no response but four showed a 3- to 45-fold response with development of >1 microg/ml of IgG to 2-4 of the serotypes, respectively. The data show that conjugate vaccines can enforce a response in adult patients with selective antibody deficiency but, dependent on the type of polysaccharide-conjugate, repeated immunisation and monitoring of the response is required.
Shrimpton
Anna
A
Department of Immunology, Leicester Royal Infirmary, University Hospitals of Leicester NHS Trust, Leicester LE1 5WW, UK.
Duddridge
Michael
M
Ziegler-Heitbrock
Loems
L
D000328:Adult; D000368:Aged; D000907:Antibodies, Bacterial / Q000097:blood; D016667:Bacterial Capsules; D005260:Female; D018073:Haemophilus Vaccines / Q000276:immunology*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007153:Immunologic Deficiency Syndromes / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D022242:Pneumococcal Vaccines / Q000276:immunology*; D011135:Polysaccharides, Bacterial / Q000276:immunology*; D014611:Vaccination; D018074:Vaccines, Conjugate / Q000276:immunology
C414006:23-valent pneumococcal capsular polysaccharide vaccine; D000907:Antibodies, Bacterial; D018073:Haemophilus Vaccines; C044237:Haemophilus influenzae type b polysaccharide vaccine; D007074:Immunoglobulin G; D022242:Pneumococcal Vaccines; D011135:Polysaccharides, Bacterial; D018074:Vaccines, Conjugate