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Infection and Immunity, November 1999, p. 5979-5984, Vol. 67, No. 11
0019-9567/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.

Determination of Antibody Responses of Elderly Adults to All 23 Capsular Polysaccharides after Pneumococcal Vaccination

Jeffrey B. Rubins,1,2,* Michael Alter,1,2 Joyce Loch,1 and Edward N. Janoff2,3

Pulmonary Diseases1 and Infectious Diseases,3 Veterans Affairs Medical Center, and Department of Medicine, University of Minnesota School of Medicine,2 Minneapolis, Minnesota 55417

Received 7 May 1999/Returned for modification 15 July 1999/Accepted 25 August 1999

The 23-valent pneumococcal polysaccharide vaccine was formulated to prevent invasive infection in the elderly and other high-risk populations from the most prevalent Streptococcus pneumoniae serotypes. However, the immunogenicity of all 23 vaccine polysaccharides has not been fully characterized in elderly adults. We previously reported that whereas the majority of elderly subjects had vigorous immune responses to selected pneumococcal vaccine polysaccharides, a subset of elderly individuals responded to fewer than two of seven vaccine serotypes after immunization. To determine whether these elderly low responders have a general inability to respond to pneumococcal vaccine and to determine whether elderly low responders might be identified by their responses to a few polysaccharides, we measured antibody responses of elderly adults to all 23 vaccine polysaccharides after pneumococcal immunization. As a group, elderly subjects showed a significant rise after immunization in geometric mean antibody levels to all 23 vaccine serotypes. However, when individual rather than group immune responses were assessed, the 23-valent vaccine did not appear to be uniformly immunogenic in these elderly subjects. Eleven elderly subjects (20%) had twofold increases in specific antibody after vaccination to only 5 or fewer of the 23 vaccine polysaccharides, and they did not respond to the most prevalent serotypes causing invasive disease. Antibody responses to serotype 9N were found to reliably distinguish low vaccine responders from other elderly subjects. However, no particular group of vaccine polysaccharides could be used as a marker for adequate immune responses if only postvaccination sera were analyzed.

* Corresponding author. Mailing address: Pulmonary (111N), VA Medical Center, One Veterans Dr., Minneapolis, MN 55417. Phone: (612) 725-2000, ext. 4400. Fax: (612) 727-5634. E-mail: rubin004{at}tc.umn.edu.

Infection and Immunity, November 1999, p. 5979-5984, Vol. 67, No. 11
0019-9567/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.


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