Journal Article

The Immunogenicity of 7-Valent Pneumococcal Conjugate Vaccine versus 23-Valent Polysaccharide Vaccine in Adults Aged 50–80 Years

David Goldblatt, Jo Southern, Nick Andrews, Lindsey Ashton, Polly Burbidge, Sarah Woodgate, Richard Pebody and Elizabeth Miller

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 49, issue 9, pages 1318-1325
Published in print November 2009 | ISSN: 1058-4838
Published online November 2009 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/606046
The Immunogenicity of 7-Valent Pneumococcal Conjugate Vaccine versus 23-Valent Polysaccharide Vaccine in Adults Aged 50–80 Years

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Background.Infections with pneumococci are a major cause of morbidity and mortality in the elderly population. Although 23-valent pneumococcal polysaccharide vaccine (PPV) is recommended for elderly persons, the potential benefits of conjugate vaccine use in this age group remain unclear.

Methods.We performed an open-label, randomized study that compared 7-valent pneumococcal conjugate vaccine (7vPnC) with PPV in 599 adults aged 50–80 years. Vaccinees received either 1 dose of 7vPnC or PPV or 1 dose of 7vPnC followed by a dose of 7vPnC or PPV 6 months later. Groups were stratified so they contained similar numbers of individuals aged 50–59, 60–69, and 70–80 years. Concentrations of immunoglobulin G specific for the serotypes in 7vPnC were measured before and 4–6 weeks after each vaccination and 1 year after enrollment.

Results.Although baseline antibody levels were slightly lower in the older age groups, responses (fold rises) to either vaccine did not depend on age. Single-dose 7vPnC was superior for only 3 serotypes. Administration of a second dose of PPV or 7vPnC was similarly immunogenic in adults primed with 7vPnC, and titers after a second dose were similar to the first.

Conclusions.Pneumococcal vaccines retain their immunogenicity when administered into the eighth decade of life, but a second dose, when assessed by antibody titers alone, has little utility. 7vPnC vaccines do not lead to subsequent hyporesponsiveness.

Clinical trials registration. http://www.clinicaltrials.gov/NCT00197821.

Journal Article.  4385 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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