Table 4.
Antibody responses to 23 pneumococcal serotypes.
| Serotype | SARS-CoV-2 + IIV4/PPV23 group | SARS-CoV-2 + PPV23/IIV4 group | SARS-CoV-2/IIV4+PPV23 group | P value | 95% CI | Non-inferiority* | ||||
|---|---|---|---|---|---|---|---|---|---|---|
| Group 1 | Group 2 | Group 3 | Group 2&1 | Group 3&1 | Group 2&1 | Group 3&1 | Group 2&1 | Group 3&1 | ||
| 1 | Seroconversion [n (%)] | 92.05 | 90.10 | 90.54 | 0.590 | 0.694 | -1.95(-7.69,3.79) | -1.5(-7.69,4.68) | Yes | Yes |
| GMC | 10.21 | 9.47 | 8.16 | 0.614 | 0.025 | 0.93(0.7,1.23) | 0.8(0.61,1.05) | Yes | Yes | |
| 2 | Seroconversion [n (%)] | 91.19 | 93.60 | 89.30 | 0.448 | 0.605 | 2.4(-2.82,7.63) | -1.89(-7.85,4.08) | Yes | Yes |
| GMC | 14.75 | 15.76 | 12.67 | 0.472 | 0.275 | 1.07(0.82,1.4) | 0.86(0.66,1.12) | Yes | Yes | |
| 3 | Seroconversion [n (%)] | 61.50 | 65.52 | 58.96 | 0.461 | 0.667 | 4.02(-5.54,13.58) | -2.54(-12.66,7.58) | Yes | No |
| GMC | 0.97 | 1.55 | 0.95 | <0.001 | 0.858 | 1.6(1.29,1.99) | 0.98(0.79,1.21) | Yes | Yes | |
| 4 | Seroconversion [n (%)] | 86.54 | 83.59 | 80.61 | 0.461 | 0.667 | -2.95(-10.41,4.52) | -5.93(-14,2.14) | No | No |
| GMC | 3.08 | 3.47 | 2.35 | 0.045 | 0.163 | 1.13(0.87,1.46) | 0.76(0.6,0.98) | Yes | Yes | |
| 5 | Seroconversion [n (%)] | 84.97 | 81.28 | 83.96 | 0.350 | 0.887 | -3.69(-11.06,3.67) | -1.02(-8.3,6.27) | No | Yes |
| GMC | 4.71 | 5.03 | 4.75 | 0.201 | 0.521 | 1.07(0.83,1.38) | 1.01(0.79,1.3) | Yes | Yes | |
| 6B | Seroconversion [n (%)] | 80.00 | 74.36 | 71.43 | 0.222 | 0.068 | -5.64(-14.05,2.77) | -8.57(-17.31,0.16) | No | No |
| GMC | 7.42 | 6.87 | 6.99 | 0.766 | 0.435 | 0.93(0.73,1.17) | 0.94(0.74,1.2) | Yes | Yes | |
| 7 | Seroconversion [n (%)] | 84.30 | 95.57 | 88.77 | <0.001 | 0.219 | 11.26(5.13,17.39) | 4.47(-2.61,11.54) | Yes | Yes |
| GMC | 9.99 | 12.31 | 9.49 | 0.268 | 0.287 | 1.23(0.97,1.57) | 0.95(0.75,1.21) | Yes | Yes | |
| 8 | Seroconversion [n (%)] | 86.63 | 86.87 | 81.29 | 1.000 | 0.194 | 0.24(-6.54,7.01) | -5.34(-12.96,2.27) | Yes | No |
| GMC | 14.12 | 16.04 | 13.06 | 0.012 | 0.626 | 1.14(0.93,1.38) | 0.92(0.77,1.11) | Yes | Yes | |
| 9N | Seroconversion [n (%)] | 91.19 | 94.09 | 89.84 | 0.335 | 0.727 | 2.9(-2.25,8.05) | -1.35(-7.25,4.54) | Yes | Yes |
| GMC | 15.52 | 16.96 | 13.21 | 0.845 | 0.140 | 1.09(0.87,1.37) | 0.85(0.67,1.08) | Yes | Yes | |
| 9V | Seroconversion [n (%)] | 85.49 | 82.76 | 82.12 | 0.494 | 0.400 | -2.73(-9.92,4.46) | -3.37(-10.87,4.13) | Yes | No |
| GMC | 9.29 | 9.37 | 8.64 | 0.343 | 0.282 | 1.01(0.81,1.25) | 0.93(0.75,1.15) | Yes | Yes | |
| 10A | Seroconversion [n (%)] | 88.46 | 86.73 | 89.39 | 0.746 | 0.862 | -1.73(-8.63,5.18) | 0.92(-5.82,7.67) | Yes | Yes |
| GMC | 15.04 | 13.57 | 12.92 | 0.545 | 0.252 | 0.9(0.67,1.21) | 0.86(0.64,1.16) | Yes | Yes | |
| 11A | Seroconversion [n (%)] | 79.27 | 81.28 | 75.00 | 0.705 | 0.369 | 2.01(-5.84,9.85) | -4.27(-13.16,4.61) | Yes | No |
| GMC | 8.43 | 9.96 | 7.60 | 0.037 | 0.105 | 1.18(0.95,1.47) | 0.9(0.73,1.12) | Yes | Yes | |
| 12F | Seroconversion [n (%)] | 72.04 | 71.43 | 71.12 | 0.911 | 0.909 | -0.61(-9.57,8.34) | -0.92(-10.07,8.23) | Yes | No |
| GMC | 3.07 | 3.81 | 3.13 | 0.204 | 0.193 | 1.24(0.99,1.55) | 1.02(0.82,1.26) | Yes | Yes | |
| 14 | Seroconversion [n (%)] | 75.98 | 77.11 | 74.33 | 0.809 | 0.719 | 1.14(-7.4,9.67) | -1.65(-10.5,7.21) | Yes | No |
| GMC | 14.44 | 16.36 | 14.34 | 0.669 | 0.325 | 1.13(0.84,1.53) | 1.04(0.77,1.42) | Yes | Yes | |
| 15B | Seroconversion [n (%)] | 86.02 | 83.08 | 87.70 | 0.480 | 0.649 | -2.94(-10.19,4.3) | 1.68(-5.18,8.53) | No | Yes |
| GMC | 22.93 | 19.06 | 19.29 | <0.001 | 0.034 | 0.83(0.65,1.06) | 0.84(0.67,1.05) | Yes | Yes | |
| 17F | Seroconversion [n (%)] | 87.01 | 90.61 | 88.77 | 0.316 | 0.632 | 3.6(-2.92,10.13) | 1.76(-4.95,8.47) | Yes | Yes |
| GMC | 8.19 | 10.90 | 8.12 | 0.873 | 0.225 | 1.33(1.02,1.73) | 0.99(0.76,1.3) | Yes | Yes | |
| 18C | Seroconversion [n (%)] | 83.33 | 90.91 | 84.97 | 0.031 | 0.773 | 7.58(0.82,14.33) | 1.64(-5.91,9.19) | Yes | Yes |
| GMC | 9.63 | 9.43 | 9.22 | 0.790 | 0.571 | 0.98(0.78,1.22) | 0.96(0.78,1.18) | Yes | Yes | |
| 19A | Seroconversion [n (%)] | 79.89 | 85.20 | 75.94 | 0.178 | 0.383 | 5.31(-2.32,12.94) | -3.96(-12.39,4.48) | Yes | No |
| GMC | 8.02 | 9.29 | 6.69 | 0.123 | 0.512 | 1.16(0.83,1.61) | 0.83(0.6,1.15) | Yes | Yes | |
| 19F | Seroconversion [n (%)] | 79.33 | 76.29 | 74.33 | 0.534 | 0.268 | -3.04(-11.47,5.39) | -5.00(-13.62,3.63) | No | No |
| GMC | 9.50 | 9.76 | 7.93 | 0.539 | 0.022 | 1.03(0.81,1.3) | 0.83(0.67,1.04) | Yes | Yes | |
| 20A | Seroconversion [n (%)] | 69.02 | 64.29 | 62.01 | 0.384 | 0.185 | -4.74(-14.2,4.73) | -7.01(-16.77,2.75) | No | No |
| GMC | 11.22 | 9.07 | 8.99 | 0.258 | 0.020 | 0.81(0.63,1.04) | 0.8(0.63,1.02) | Yes | Yes | |
| 22F | Seroconversion [n (%)] | 79.88 | 86.90 | 81.62 | 0.104 | 0.770 | 7.03(-0.95,15.01) | 1.74(-7.21,10.69) | Yes | Yes |
| GMC | 4.51 | 6.23 | 5.34 | 0.215 | 0.895 | 1.38(1.05,1.81) | 1.18(0.9,1.55) | Yes | Yes | |
| 23F | Seroconversion [n (%)] | 80.54 | 76.29 | 80.75 | 0.322 | 1.000 | -4.25(-12.52,4.02) | 0.21(-7.82,8.24) | No | Yes |
| GMC | 5.58 | 5.38 | 4.66 | 0.773 | 0.109 | 0.96(0.74,1.26) | 0.84(0.65,1.08) | Yes | Yes | |
| 33F | Seroconversion [n (%)] | 91.85 | 93.58 | 91.44 | 0.554 | 1.000 | 1.74(-3.55,7.02) | -0.4(-6.03,5.23) | Yes | Yes |
| GMC | 26.94 | 28.18 | 23.46 | 0.897 | 0.077 | 1.05(0.83,1.32) | 0.87(0.69,1.1) | Yes | Yes | |
*Non-inferiority for the GMT ratio is considered to be fulfilled when the lower boundary of 95% CI is 0.5 or higher. Non-inferiority for the seroconversion rate would be considered as achieved if the lower bound of the two-sided 95% CI of the difference was > -10%. Blood samples were collected at 28 days after each group received the PPV23. IgG antibody seroconversion of 23 serotypes of S pneumoniae was defined as a minimum two-fold increase in the post-vaccination IgG antibody concentration compared with baseline.