The Antibody Response and Opsonophagocytosis Activity after Vaccination with 13-Valent Pneumococcal Conjugate Vaccine in Persons with and without Chronic Renal Failure

Pneumonia was a leading cause of deaths in the young children, the elderly and persons with chronic diseases. It was highly recommended that those susceptible persons should receive pneumococcal vaccination to reduce the risk of pneumococcal infection and the associated mortality. The Advice Committee of Immunization Program (ACIP) recommended those aged less than 2 years and greater than 65 years to be vaccinated with pneumococcal vaccines. Vaccination with pneumococcal polysaccharide vaccines to those aged between 2 and 65 years with specific disorders including patients with chronic renal failure are also recommended. Pneumococcal polysaccharide vaccine (PPV) has less immunogenicity and elicits relatively lower antibodies response after vaccination. Pneumococcal conjugate vaccine (PCV) added protein component to the polysaccharides and induced a higher and prolonged antibodies response than the PPV does. PCV was not approved to be immunized in adults until the end of 2011, when US and European FDA approved a 13-valent PCV to be vaccinated in adults aged greater than 50 years. In our previous study, we had evaluated the antibodies response after PPV vaccination in patients with chronic renal failure undergoing maintenance hemodialysis. The antibodies concentrations of 4 common pneumococcal serotypes at one month after PPV vaccination were significantly lower than control group. The antibodies concentration at one year after vaccination declined in both CRF and control groups and the antibodies concentrations were even lower in the CRF patients. We concluded the immune response after PPV vaccination in patients with CRF was lower than those without CRF and declined more rapidly than normal. Due to the stronger immunogenicity of PCV than the PPV in immunocompetent adults, we hypothesize that PCV vaccination in patients with CRF will induced a higher and more persistent antibodies response. The antibodies response will be evaluated with seral type-specific IgG concentration and opsonophagocytosis activity (OPA) one month, one, two and three year after PCV vaccination in adult persons with and without CRF aged greater than 50 years. Those were previous vaccinated with PPV more than 3 years ago will be vaccinated with PCV13 to evaluate the immune response o of re-vaccination (PPV23 followed by PCV13). Study purposes: 1. Measuring opsonophagocytosis activity (OPA) and seral type-specific antibodies concentrations to evaluate the immune response after PCV13 immunization in patients with chronic renal failure. 2. Measuring OPA and seral type-specific antibodies concentrations after PCV13 immunization in previously PPV23 vaccinated chronic renal failure patients to evaluate if there is hypo-responsiveness after PCV13 booster vaccination.

Project ID:PC10210-0034
External Project ID:NSC102-2314-B182-065