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Infection and Immunity, March 2000, p. 1435-1440, Vol. 68, No. 3
Zentrum der Kinderheilkunde, Klinikum der
Rheinischen Friedrich-Wilhelms-Universität, 53113 Bonn, Germany
Received 26 July 1999/Returned for modification 30 September
1999/Accepted 3 December 1999
There is still a lack of effective vaccination strategies for
patients with a deficient antibody response to bacterial polysaccharide antigens. In an open trial, we evaluated the immunogenicity and tolerance of a new 7-valent pneumococcal conjugate vaccine in 22 infection-prone nonresponders to pneumococcal polysaccharide vaccine
and 21 controls. In the patient group, nonresponsiveness was confirmed
by repeated vaccination with a 23-valent pneumococcal polysaccharide
vaccine. The study protocol provided two doses of the pneumococcal
conjugate vaccine, given 4 to 6 weeks apart, for both groups. The
antibody response was determined before each vaccination and on
follow-up by an enzyme-linked immunosorbent assay and compared to the
response in a functional opsonophagocytosis assay. Patients showed a
significantly lower postvaccination immune response for all serotypes
than did controls. The postvaccination response was serotype dependent.
A median titer of >1 µg/ml in patients was recorded only for
serotypes 4, 9V, 14, and 19F, which are known to be more immunogenic
than serotypes 6B, 18C, and 23F. In the patient group, 70% responded
to serotype 19F (Pnc 19F), 65% responded to Pnc 14 and 4, 60%
responded to Pnc 9V, 55% responded to Pnc 18C, 50% responded to Pnc
23F, and 25% responded to Pnc 6B. In the control group >95% of
individuals showed a titer of >1 µg/ml to every serotype. The
vaccine was tolerated well, and no major side effects have been
reported. The new pneumococcal conjugate vaccine is clearly more
immunogenic in previous nonresponders than is the 23-valent
pneumococcal vaccine. Immunization with a pneumococcal conjugate
vaccine should be considered as a strategy to protect high-risk patients.
0019-9567/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.
Immunogenicity and Tolerance of a 7-Valent Pneumococcal Conjugate
Vaccine in Nonresponders to the 23-Valent Pneumococcal
Vaccine
*
Corresponding author. Mailing address: Zentrum
der Kinderheilkunde, Klinikum der Rheinischen
Friedrich-Wilhelms-Universität, 53113 Bonn, Germany. Phone:
0049/228-2873214. Fax: 0049/228-2873446. E-mail:
zielen{at}mailer.meb.uni-bonn.de.
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