Optimizing seroprotection against pneumococcus in children with nephrotic syndrome using the 13-valent pneumococcal conjugate vaccine. Issue 41 (22nd September 2016)

• Record Type: Journal Article
• Authors: Pittet, Laure F.; Posfay-Barbe, Klara M.; Chehade, Hassib; Rudin, Christoph; Wilhelm-Bals, Alexandra; Rodriguez, Maria; Siegrist, Claire-Anne; Parvex, Paloma
• Is Part Of: Vaccine. Volume 34:Issue 41(2016)
• Page Start: 4948
• Page End: 4954
• Publication Date: 2016-09-22
• Subjects: Idiopathic nephrotic syndrome (NS) -- Immunization -- Streptococcus pneumoniae -- 13-valent pneumococcal conjugate vaccine (PCV13) -- Vaccine -- Enzyme-linked immunosorbent assay (ELISA); AIM alternative immunosuppressive medication -- CI confidence interval -- ELISA enzyme-linked immunosorbent assay -- FSGS focal segmental glomerulosclerosis -- IgG immunoglobulin G -- IPD invasive pneumococcal disease -- IQR interquartile range -- M month -- MC minimal change disease -- NS nephrotic syndrome -- OPA opsonophagocytosis assay -- OR odds ratio -- PCV pneumococcal conjugate vaccine -- PCV7 7-valent pneumococcal conjugate vaccine -- PCV13 13-valent pneumococcal conjugate vaccine -- PPSV23 23-valent pneumococcal polysaccharide vaccine -- SD standard deviation; Vaccines -- Periodicals; 615.372
• DOI: 10.1016/j.vaccine.2016.08.049
• Languages: English
• ISSNs: 0264-410X

Abstract

Abstract: Background: Infections are among the main life-threatening complications in patients with nephrotic syndrome (NS), in particular with Streptococcus pneumoniae, the first cause of bacterial peritonitis and sepsis in these patients. This study aims to evaluate the baseline seroprotection of NS patients against S. pneumoniae, and immunize them with the 13-valent pneumococcal conjugate vaccine (PCV13) regardless of disease activity and previous immunization history, in order to evaluate the immunogenicity, safety profile, and effect of NS treatment on vaccine responses. Methods: This multicentre prospective interventional study enrolled 42 children with NS at disease onset or during a regular follow-up appointment. PCV13 was administered at inclusion. Serotype-specific S. pneumoniae IgG titer were assessed at baseline, after immunization, and at 1 year follow-up. Vaccine safety was evaluated clinically and by urinary tests. Results: PCV13 induced high serotype-specific IgG titers that were maintained at high levels one year after vaccination, even in children previously immunized. No serious adverse event occurred and relapse frequency was unchanged. Conclusion: Given that high IgG titers were achieved and maintained after PCV13 vaccination, and considering the high morbidity related to S. pneumoniae, we propose PCV13 (re-)vaccination for all NS patients, irrespective of their previous immunization history, treatment and disease activity.