Abstract
Many countries recommend that adults with chronic disease be vaccinated with pneumococcal polysaccharide vaccine (PPSV23) because of their increased risk for pneumococcal disease. To explore the immunogenicity of PPSV23 in these patients we examined antibody responses in adults age 70–89 with chronic disease after primary vaccination and revaccination compared to healthy adults in this same age group
We measured serotype-specific IgG geometric mean concentrations (GMC, 14 serotypes) and opsonophagocytic activity titers (OPA, 6 serotypes) 4 weeks after vaccination in a community-based cohort vaccinated >= 5 years earlier (N=161) or never vaccinated (N=81) with PPSV23.
For each serotype the GMC and OPA titers did not differ significantly between each of the groups with co-morbid conditions and the group without any of those conditions, with the exception of significantly higher GMC titers against serotype 7F in the revaccination groups with lung disease and heart disease, and serotype 3 in the revaccination group with heart disease. The GMC also were not significantly different between those with 0, 1 and 2–3 of these conditions.
GMC and OPA responses to PPSV23 vaccination and revaccination in older patients with heart disease, lung disease or diabetes mellitus were not significantly different from older patients without these conditions, even if they had more than one of these condition or if they had been previously vaccinated. These results support the recommendation to vaccinate these patients at increased risk with PPSV23.