title: Can the response to 23-valent pneumococcal vaccine in splenectomised patients be predicted?
abstract: The 23-valent pneumococcal vaccine has unequal effectiveness in splenectomised patients. We performed a longitudinal study (2005-2008) whose main objective was to characterize the profile of non-responders among splenectomised patients treated at our institution and identify potential predictive indicators of the response to the vaccine. The immune response was evaluated in 96 subjects. The proportion of responders was 70% (95% CI: 60-78%). Immunosuppression (OR=3.19, 95% CI 1.04-9.73) and the reason for splenectomy (hematologic neoplasia versus non-malignant hematologic diseases, OR=7.37, 95% CI 1.71-31.7) were independent predictors of non-response to vaccination. However, the positive predictive value of the model and the likelihood ratio for a positive result were low (PPV=76.6%, 95% CI 66.2-84.4%, LR(+)=1.41, 95% CI 1.08-1.86). We recommend determining the response to pneumococcal vaccine in these patients when possible.
authors.affiliation: Preventive Medicine and Epidemiology Department, Hospital Clínic de Barcelona, Villarroel 170, 08036 Barcelona, Catalonia, Spain. allupia@clinic.ub.es
authors.forename: Anna
authors.initials: A
authors.lastname: Llupià
authors.forename: Anna
authors.initials: A
authors.lastname: Vilella
authors.forename: Laura
authors.initials: L
authors.lastname: Costas
authors.forename: Consolación
authors.initials: C
authors.lastname: Díez
authors.forename: Ferran
authors.initials: F
authors.lastname: Torres
authors.forename: Jordi
authors.initials: J
authors.lastname: Yagüe
authors.forename: Montserrat
authors.initials: M
authors.lastname: Massó
authors.forename: Ana
authors.initials: A
authors.lastname: Muñoz
authors.forename: Josep
authors.initials: J
authors.lastname: Mensa
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000907:Antibodies, Bacterial / Q000097:blood; D002648:Child; D002675:Child, Preschool; D005260:Female; D006402:Hematologic Diseases / Q000601:surgery; D006801:Humans; D007165:Immunosuppression Therapy; D007223:Infant; D007231:Infant, Newborn; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D011008:Pneumococcal Infections / Q000276:immunology / Q000517:prevention & control*; D022242:Pneumococcal Vaccines / Q000008:administration & dosage / Q000276:immunology*; D011237:Predictive Value of Tests; D013156:Splenectomy; D013296:Streptococcus pneumoniae / Q000276:immunology*; D016896:Treatment Outcome; D014611:Vaccination; D055815:Young Adult
chemical_list: C414006:23-valent pneumococcal capsular polysaccharide vaccine; D000907:Antibodies, Bacterial; D022242:Pneumococcal Vaccines