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Humoral response to a 13-valent pneumococcal conjugate vaccine in kidney transplant recipients

Oesterreich, S; Lindemann, M; Goldblatt, D; Horn, PA; Wilde, B; Witzke, O; (2020) Humoral response to a 13-valent pneumococcal conjugate vaccine in kidney transplant recipients. Vaccine , 38 (17) pp. 3339-3350. 10.1016/j.vaccine.2020.02.088. Green open access

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Abstract

Background: Vaccination against S. pneumoniae is recommended by national guidelines. Moderate immunogenicity of the 13-valent pneumococcal conjugate vaccine (PCV13) has been reported in adult kidney transplant recipients (KTR). This study further defines the immunogenicity of PCV13 in this cohort. Methods: 49 KTR were immunized with PCV13. A validated opsonophagocytic killing assay (OPA), a global anti-pneumococcal capsular polysaccharide (anti-PCP) IgG, IgG2, IgM and IgA ELISA, and - for selected patients - a serotype specific anti-PCP WHO reference ELISA were performed pre-vaccination and at month 1 and 12 post-vaccination. Results: Geometric mean OPA titers increased significantly for 13/13 serotypes at month 1 and for 10/13 serotypes at month 12 post-vaccination. Vaccine response defined as an OPA titer ≥1:8 was reached in 9/13 serotypes (median). 53% reached the vaccine response criteria at month 1 and 45% at month 12. At month 1 after vaccination, the median OPA titer in an age-group matched healthy reference population was 5- to 10-fold higher than in KTR. OPA titers correlated strongly with results to the global and serotype specific anti-PCP IgG ELISA. Lower OPA titers significantly (p < 0.05) correlated with albuminuria, an interval between vaccination and transplantation <12 months, age and treatment with mycophenolate mofetil. Global IgG, IgG2, IgM and IgA, as well as serotype specific anti-PCP antibody concentrations (12/13 serotypes) increased significantly at month 1 and 12 post-vaccination. Conclusions: Kidney transplant recipients show a significant humoral response after vaccination with PCV13. Functional antibody response exists, but is not as vigorous as in healthy adults.

Type: Article
Title: Humoral response to a 13-valent pneumococcal conjugate vaccine in kidney transplant recipients
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.vaccine.2020.02.088
Publisher version: http://dx.doi.org/10.1016/j.vaccine.2020.02.088
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Pneumococcal conjugate vaccine, Opsonophagocytic assay, Kidney transplant recipients, Serotype specific, Pneumococcal antibody global serum assays, Pneumococcal vaccination in immunocompromised individuals, STREPTOCOCCUS-PNEUMONIAE, CAPSULAR POLYSACCHARIDES, HAEMOPHILUS-INFLUENZAE, HEALTHY-CHILDREN, DOUBLE-BLIND, ANTIBODIES, ADULTS, IMMUNOGENICITY, IMMUNITY, SEROTYPE
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Infection, Immunity and Inflammation Dept
URI: https://discovery-pp.ucl.ac.uk/id/eprint/10097304
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