Advertisement

Annals of Hematology

, Volume 98, Issue 3, pp 775–779 | Cite as

Antibody persistence 5 years after a 13-valent pneumococcal conjugate vaccine in asplenic patients with β-thalassemia: assessing the need for booster

  • Ioanna Papadatou
  • Theano LagousiEmail author
  • Antonis Kattamis
  • Vana Spoulou
Original Article
  • 129 Downloads

Abstract

Streptococcus pnemoniae is a major cause of morbidity and mortality among splenectomised patients with β-thalassemia major. We have previously shown that a 13-valent pneumococcal conjugate vaccine (PCV13) induces robust early immune responses in such patients, while history of repeated immunisations with the 23-valent polysaccharide pneumococcal vaccine (PPSV23) results in attenuation of the response to PCV13. However, the duration of vaccine-induced protection in splenectomised thalassemic patients and the associated need for booster immunisation remains unclear. In the current study, we enumerate antibody persistence 5 years post-PCV13 and investigate any correlation with early immune response and immunisation history. Pneumococcal serotype (PS)-specific antibodies against 5 vaccine antigens were measured 5 years post-PCV13 in 34 asplenic adults with β-thalassemia. PS-specific antibodies against 5 vaccine serotypes had declined significantly at 5 years post-PCV13 (year 5).Year 5 antibody titres remained above baseline for PS9V, 19A and19F, returned to baseline for PS23F, and dropped below baseline for PS3 (p < 0.001).Year 5 antibodies were positively correlated with day 28 antibody titres, while no correlation was found with early memory B cell response. Previous PPSV23 history was correlated with impaired antibody persistence against serotype 19A. Antibody levels dropped significantly but remained at protective levels 5 years post-PCV13.We propose that asplenic patients with β-thalassemia may benefit from measurement of antipneumococcal antibodies after 5 years post-PCV13 as they may eventually be in need for booster pneumococcal vaccination. Clinical Trials Registration ID: www.clinicaltrials.gov NCT01846923.

Keywords

β-thalassemia major Pneumococcal vaccine Antibody persistence Immunological memory 

Notes

Author contribution

All authors have contributed to this work and approved the submission.

Funding

This work has been supported by the Hellenic Department of Health (Grant ID no. 51657).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

References

  1. 1.
    Ram S, Lewis LA, Rice PA (2010) Infections of people with complement deficiencies and patients who have undergone splenectomy. Clin Microbiol Rev 23:740–780CrossRefPubMedCentralGoogle Scholar
  2. 2.
    Ladis V, Chouliaras G, Berdoukas V, Chatziliami A, Fragodimitri C, Karabatsos F, Youssef J, Kattamis A, Karagiorga-Lagana M (2011) Survival in a large cohort of Greek patients with transfusion-dependent beta thalassaemia and mortality ratios compared to the general population. Eur J Haematol 86:332–338CrossRefGoogle Scholar
  3. 3.
    CDC (2012) Use of 13-valent pneumococcal conjugate vaccine and 23- valent pneumococcal polysaccharide vaccine for adults with immunocompromising conditions: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep 61:816–819Google Scholar
  4. 4.
    Wasserstrom H, Bussel J, Lim LC-L, Cunningham-Rundles C (2008) Memory B cells and pneumococcal antibody after splenectomy. J Immunol 181:3684–3689CrossRefPubMedCentralGoogle Scholar
  5. 5.
    Papadatou I, Piperi C, Alexandraki K, Kattamis A, Theodoridou M, Spoulou V (2014) Antigen-specific B-cell response to 13-valent pneumococcal conjugate vaccine in asplenic individuals with β-thalassemia previously immunized with 23- valent pneumococcal polysaccharide vaccine. Clin Infect Dis 59:862–865CrossRefGoogle Scholar
  6. 6.
    Papadatou I, Orthopoulos G, Theodoridou M, Spoulou V (2015) Long-lasting hyporesponsivenss induced by the 23-valent pneumococcal polysaccharide vaccine (PPSV23) in asplenic patients with β-thalassemia major. Vaccine 33(32):3779–3783CrossRefGoogle Scholar
  7. 7.
    Auckland C, Gray S, Borrow R, Andrews N, Goldblatt D, Ramsay M, Miller E (2006) Clinical and immunologic risk factors for meningococcal C conjugate vaccine failure in the United Kingdom. J Infect Dis 194:1745–1752CrossRefGoogle Scholar
  8. 8.
    Bisharat N, Omari H, Lavi I, Raz R (2001) Risk of infection and death among post-splenectomy patients. J Inf Secur 43:182–186Google Scholar
  9. 9.
    Poolman J, Kriz P, Feron C, Di-Paolo E, Henckaerts I et al (2009) Pneumococcal serotype 3 otitis media, limited effect of polysaccharide conjugate immunisation and strain characteristics. Vaccine 27:3213–3222CrossRefGoogle Scholar
  10. 10.
    Madhi SA, Adrian P, Kuwanda L, Jassat W, Jones S, Little T, Soininen A, Cutland C, Klugman KP (2007) Long-term immunogenicity and efficacy of a 9-valent conjugate pneumococcal vaccine in human immunodeficient virus infected and non-infected children in the absence of a booster dose of vaccine. Vaccine 25:2451–2457CrossRefGoogle Scholar
  11. 11.
    Blanchard Rohner G, Snape MD, Kelly DF, John T, Morant A, Yu LM, Borkowski A, Ceddia F, Borrow R, Siegrist CA, Pollard AJ (2008) The magnitude of the antibody and memory B cell responses during priming with a protein-polysaccharide conjugate vaccine in human infants is associated with the persistence of antibody and the intensity of booster response. J Immunol 180:2165–2173CrossRefGoogle Scholar
  12. 12.
    Liakou CD, Askiti V, Mitsioni A, Stefanidis CJ, Theodoridou MC, Spoulou VI (2014) Safety and immunogenicity of booster immunization with 7-valent pneumococcal conjugate vaccine in children with idiopathic nephrotic syndrome. Vaccine 32(12):1394–1397CrossRefGoogle Scholar
  13. 13.
    Amanna IJ, Slifka MK (2011) Contributions of humoral and cellular immunity to vaccine-induced protection in humans. Virology 411:206–215CrossRefPubMedCentralGoogle Scholar
  14. 14.
    Trück J, Mitchell R, Jawad S, Clutterbuck EA, Snape MD, Kelly DF, Voysey M, Pollard AJ (2017) Divergent memory B-cell responses in a mixed infant pneumococcal conjugate vaccine schedule. Pediatr Infect Dis J 36(5):e130–e135CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Infectious Diseases Unit, 1st Department of Paediatrics, Aghia Sofia Children’s HospitalNational and Kapodistrian University of AthensAthensGreece
  2. 2.Thalassemia Unit, Aghia Sofia Children’s HospitalUniversity of AthensAthensGreece

Personalised recommendations