Pneumococcal polysaccharide vaccination in adults undergoing immunosuppressive treatment for inflammatory diseases–a longitudinal study
Open accessAbstract
Introduction: Patients undergoing immunosuppressive therapy are at increased risk of infection. Community-acquired pneumonia and invasive pneumococcal disease account for substantial morbidity and mortality in this population and may be prevented by vaccination. Ideally, immunization to pneumococcal antigens should take place before the start of immunosuppressive treatment. Often, however, the treatment cannot be delayed. Little is known about the efficacy of pneumococcal vaccines during immunosuppressive treatment. The objectives of this study were to determine the percentage of vaccine-naïve, immunosuppressed adults with inflammatory diseases seroprotected against Streptococcus pneumoniae and to assess factors associated with the immunogenicity, clinical impact and safety of 23-valent pneumococcal polysaccharide vaccine (PPV) in seronegative subjects. Methods: This observational study included patients 18 years of age and older who were receiving prednisone ≥20 mg/day or other immunosuppressive drugs. Exclusion criteria were PPV administration in the previous 5 years, intravenous immunoglobulins and pregnancy. Serum immunoglobulin G (IgG) antibody levels against six pneumococcal serotypes were measured. Seropositivity was defined as IgG of 0.5 μg/ml or greater for at least four of six serotypes. Seronegative patients received PPV, and seropositive patients were included as a comparison group. Vaccine response and tolerance were assessed after 4–8 weeks. Disease activity was evaluated on the basis of the Physician Global Assessment scores. Serology was repeated after 1 year, and information on any kind of infection needing medical attention was collected. Outcomes were the proportion of seropositivity and infections between vaccinated and unvaccinated patients. Results: Of 201 included patients, 35 received high-dose corticosteroids and 181 were given immunosuppressive drugs. Baseline seronegativity in 60 (30 %) patients was associated with corticotherapy and lower total IgG. After PPV, disease activity remained unchanged or decreased in 81 % of patients, and 87 % became seropositive. After 1 year, 67 % of vaccinated compared with 90 % of observed patients were seropositive (p < 0.001), whereas the rate of infections did not differ between groups. Those still taking prednisone ≥10 mg/day tended to have poorer serological responses and had significantly more infections. Conclusions: PPV was safe and moderately effective based on serological response. Seropositivity to pneumococcal antigens significantly reduced the risk of infections. Sustained high-dose corticosteroids were associated with poor vaccine response and more infections.
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A prednisone dose of at least 10 mg/day was associated with reduced humoral response to pneumococcal vaccine in patients with inflammatory diseases.
“A dose of ≥10 mg/day was associated with a reduced vaccine-induced humoral response to pneumococcal vaccine in patients with various inflammatory diseases.16”
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Badak, S. Ö. (2022) · Archives of Rheumatology · doi:10.46497/archrheumatol.2022.9303 · Cited by 2 · see citing works
Баранова, М. М., Muravyevа, N. V., Belov, B. S., & Verizhnikova, Z. G. (2024) · Medical alphabet · doi:10.33667/2078-5631-2023-31-15-20 · Cited by 2 · see citing works
COVID-19 infection after mRNA 1273 vaccine: review of the most frequently asked questions
Vanaparthy, R., Malayala, S. V., Rehman, H., Guttha, S., Mohan, G., Vasireddy, D., & Atluri, P. (2021) · Infezioni in Medicina · doi:10.53854/liim-2903-1 · Cited by 2 · see citing works
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Modern Ideas about Vaccination of Patients with Rheumatic Diseases: the View of ACR Experts
Belov, B. S., & Muravyevа, N. V. (2023) · Antibiot Khimioter = Antibiotics and Chemotherapy · doi:10.37489/0235-2990-2023-68-5-6-77-84 · Cited by 1 · see citing works
Immunogenicity of Covishield vaccine in patients with autoimmune rheumatic diseases
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Immunosuppressants, immunomodulators and COVID-19 vaccines: anticipating patient concerns
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How immunosuppressive therapy impaires on COVID-19 mRNA-vaccine response in rheumatic diseases
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Duration and tension of postvaccinal pneumococcal immunity in HIV-positive patients
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COVID-19 Vaccines and Anesthesia
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Anti-inflammatory drugs and immunogenicity of vaccines in patients with rheumatic diseases
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Preventative Care in Scleroderma
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Coronaimpfung unter Immunsuppression
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COVID-19 vaccines: A comprehensive review of safety and efficacy
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- Authors
- Fischer, L., Gerstel, P. F., Poncet, A., Siegrist, C.-A., Laffitte, E., Gabay, C., Seebach, J. D., & Ribi, C.
- Affiliations
- University Hospital of Geneva (CH)
- Centre Hospitalier Universitaire Vaudois (CH)
- Corresponding author
- Ribi, Camillo
- Venue
- Arthritis Research & Therapy
- Published
- 2015-06-06
- Volume
- 17
- Issue
- 1
- Pages
- 151-151
- ISSN
- 1478-6354 (ISSN-L)
- PMC
- PMC4481118
- OpenAlex
- W1832177968
- Cited by
- 73
- References
- 39
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 4 · 2023: 7 · 2022: 11 · 2021: 31 · 2020: 1 · 2019: 3 · 2018: 4 · 2017: 2 · 2016: 4
- FWCI
- 2.61
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Arthritis Research & Therapy (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- SERVAL (Université de Lausanne) (publishedVersion, other-oa)
- Archive ouverte UNIGE (University of Geneva) (publishedVersion, other-oa)
- IRIS (submittedVersion)
- Archive ouverte UNIGE (University of Geneva) (submittedVersion, cc-by)
- Topics
- Health Sciences › Medicine › Epidemiology › Pneumonia and Respiratory Infections
- Life Sciences › Immunology and Microbiology › Microbiology › Bacterial Infections and Vaccines
- Life Sciences › Immunology and Microbiology › Immunology › Immunodeficiency and Autoimmune Disorders
- Keywords
- pneumococcal polysaccharide vaccine, Streptococcus pneumoniae, immunosuppression, inflammatory diseases, vaccine immunogenicity, seroprotection, prednisone, corticosteroids, pneumococcal serotypes, invasive pneumococcal disease, community-acquired pneumonia, vaccine safety, disease activity, total IgG, vaccine response predictors
- MeSH terms
- Adult, Aged, Antibodies, Bacterial, Enzyme-Linked Immunosorbent Assay, Female, Humans, Immunoglobulin A, Immunoglobulin G, Immunoglobulin M, Immunosuppressive Agents, Longitudinal Studies, Male, Middle Aged, Immunocompromised Host, Pneumococcal Vaccines
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