title: Evaluation of antibody response to the heptavalent pneumococcal conjugate vaccine in pediatric chronic kidney disease.
abstract: Pneumococcal vaccination has been recommended for immunocompromised children, including patients with chronic kidney disease. We determined pneumococcal immunoglobulin (Ig)G antibodies to serotypes 4, 6B, 9V, 14, 18C, 19F, and 23F before and after 48 pediatric patients with chronic renal failure were administered heptavalent conjugated pneumococcal vaccine. The patients were between 1 and 9 years of age and were separated into a conservative treatment group (Group 1) and a dialysis group (Group 2). The antibody response to the vaccinal serotypes was evaluated by measuring antibody concentrations before the first dose and 60 days after the second one. Pre-vaccinal IgG concentrations > or = 0.35 microg/ml were detected for all serotypes in at least 50% of the patients in both groups. Patients from both groups showed a statistically indistinguishable behavior in terms of the medians of post-vaccination IgG levels. An "adequate" vaccine response was defined as a post-immunization level of specific pneumococcal serotype antibody > or = 0.35 microg/ml, based on the World Health Organization's (WHO) protective antibody concentration definition for pneumococcal conjugate vaccines, or on a fourfold increase over baseline for at least five of the seven antigens of the vaccine. An "adequate" vaccinal response was obtained in 100% of the patients of both groups using WHO's definition, or in 45.8% of Group 1 patients and 37.5% of Group 2 patients when the criterion was a fourfold antibody increase over baseline antibody concentrations.
authors.affiliation: Pediatric Nephrology Unit, Instituto da Criança do Hospital das Clinicas da Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
authors.forename: Simone
authors.initials: S
authors.lastname: Vieira
authors.forename: Evandro Roberto
authors.initials: ER
authors.lastname: Baldacci
authors.forename: Magda
authors.initials: M
authors.lastname: Carneiro-Sampaio
authors.forename: Ulysses
authors.initials: U
authors.lastname: Doria Filho
authors.forename: Vera Hermina
authors.initials: VH
authors.lastname: Koch
mesh_terms: D000907:Antibodies, Bacterial / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D016867:Immunocompromised Host; D007074:Immunoglobulin G / Q000097:blood; D007223:Infant; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000276:immunology* / Q000503:physiopathology; D011008:Pneumococcal Infections / Q000517:prevention & control*; D022242:Pneumococcal Vaccines / Q000276:immunology*; D011446:Prospective Studies; D012703:Serotyping; D013296:Streptococcus pneumoniae / Q000145:classification / Q000276:immunology*; D018074:Vaccines, Conjugate / Q000276:immunology*
chemical_list: D000907:Antibodies, Bacterial; D007074:Immunoglobulin G; D022242:Pneumococcal Vaccines; D018074:Vaccines, Conjugate
references.citation: J Lab Clin Med. 1980 Aug;96(2):363-70
references.pmid: 7400669
references.citation: Curr Opin Immunol. 1999 Apr;11(2):180-5
references.pmid: 10322154
references.citation: Nephrol Dial Transplant. 1989;4(3):216-21
references.pmid: 2498780
references.citation: Microb Drug Resist. 1997 Summer;3(2):141-6
references.pmid: 9185141
references.citation: Pediatrics. 2008 Jul;122(1):e26-32
references.pmid: 18595971
references.citation: Pediatr Infect Dis J. 2000 Mar;19(3):187-95
references.pmid: 10749457
references.citation: Lancet. 2005 Mar 26-Apr 1;365(9465):1139-46
references.pmid: 15794968
references.citation: Semin Nephrol. 1998 May;18(3):256-63
references.pmid: 9613866
references.citation: Pediatr Nephrol. 1992 Mar;6(2):179-81
references.pmid: 1571217
references.citation: N Engl J Med. 2003 Oct 2;349(14):1341-8
references.pmid: 14523142
references.citation: Pediatr Nephrol. 2004 Dec;19(12):1334-9
references.pmid: 15503181
references.citation: Nephrol Dial Transplant. 1996 Mar;11(3):468-73
references.pmid: 8671817
references.citation: Pediatr Infect Dis J. 2002 Feb;21(2):141-7
references.pmid: 11840082
references.citation: Kidney Int Suppl. 2001 Feb;78:S206-11
references.pmid: 11169012
references.citation: Vaccine. 2007 Mar 8;25(12):2194-212
references.pmid: 17267077
references.citation: Clin Microbiol Infect. 2006 Jan;12(1):50-5
references.pmid: 16460546
references.citation: Pediatr Infect Dis J. 2003 Feb;22(2):141-9
references.pmid: 12586978
references.citation: Vaccine. 2007 May 10;25(19):3816-26
references.pmid: 17368878
references.citation: Pediatr Infect Dis J. 1987 Jun;6(6):519-26
references.pmid: 3615065
references.citation: Braz J Infect Dis. 1998 Apr;2(2):90-96
references.pmid: 11101916
references.citation: Clin Diagn Lab Immunol. 1999 Jan;6(1):50-4
references.pmid: 9874663
references.citation: Dtsch Med Wochenschr. 2008 Feb;133(8):358-62
references.pmid: 18270917
references.citation: Lancet. 2003 Aug 2;362(9381):355-61
references.pmid: 12907008
references.citation: Pediatr Pulmonol. 1996 Sep;22(3):167-73
references.pmid: 8893255
references.citation: J Infect Dis. 2002 Apr 1;185(7):927-36
references.pmid: 11920317
references.citation: J Pediatr. 1996 May;128(5 Pt 1):649-53
references.pmid: 8627437
references.citation: Nephron. 1975;14(2):195-208
references.pmid: 1079332
references.citation: J Allergy Clin Immunol. 1998 Aug;102(2):215-21
references.pmid: 9723664
references.citation: Clin Nephrol. 1983 Jun;19(6):288-94
references.pmid: 6603319
references.citation: Pediatr Clin North Am. 1987 Jun;34(3):571-90
references.pmid: 3588043
references.citation: J Infect Dis. 2003 Apr 15;187(8):1206-12
references.pmid: 12695999