Title |
Randomized, Single Blind, Controlled Trial to Evaluate the Prime-Boost Strategy for Pneumococcal Vaccination in Renal Transplant Recipients
|
---|---|
Published in |
PLOS ONE, September 2012
|
DOI | 10.1371/journal.pone.0046133 |
Pubmed ID | |
Authors |
Selma Tobudic, Veronika Plunger, Gere Sunder-Plassmann, Markus Riegersperger, Heinz Burgmann |
Abstract |
Renal transplant recipients are at increased risk of developing invasive pneumococcal diseases but may have poor response to the 23-valent pneumococcal polysaccharide vaccine (PPV). It may be possible to enhance immunogenicity by priming with 7-valent pneumococcal conjugate vaccine (7vPnC) and boosting with PPV 1 year later. In a randomized single-blind, controlled study, adult recipients of renal transplants received either 7nPVC or PPV followed by PPV 1 year later. The vaccine response was defined as 2-fold increase in antibody concentration from baseline and an absolute post-vaccination values ≥1 µg/ml. The primary endpoint was vaccine response of the primed group (7vPnC/PPV) compared with single PPV vaccination. Antibody concentrations for 10 serotypes were measured at baseline, 8 weeks after first vaccination, before second vaccination, and 8 weeks after second vaccination. Of 320 screened patients, 80 patients were randomized and 62 completed the study. Revaccination with PPV achieved no significant increase of immune response in the 7vPnC/PPV group compared with the single PPV recipients A response to at least 1 serotype was seen in 77.1% of patients who received 7vPnC and 93.1% of patients who received PPV (P = 0.046). After second vaccination response to at least 1 serotype was seen in 87.5% patients of 7vPnC/PPV group and 87.1% patients of PPV group (non significant p). The median number of serotypes eliciting a response was 3.5 (95% CI 2.5-4.5) in the 7vPnC/PPV group versus 5 (95% CI 3.9-6.1) in the PPV group (non-significant p). Immunogenicity of pneumococcal vaccination was not enhanced by the prime-boost strategy compared with vaccination with PPV alone. Administration of a single dose of PPV should continue to be the standard of care for adult recipients of renal transplants. |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Brazil | 1 | 3% |
Unknown | 32 | 97% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Bachelor | 7 | 21% |
Student > Ph. D. Student | 5 | 15% |
Researcher | 3 | 9% |
Student > Master | 3 | 9% |
Student > Doctoral Student | 2 | 6% |
Other | 3 | 9% |
Unknown | 10 | 30% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 10 | 30% |
Agricultural and Biological Sciences | 2 | 6% |
Nursing and Health Professions | 2 | 6% |
Mathematics | 2 | 6% |
Biochemistry, Genetics and Molecular Biology | 1 | 3% |
Other | 5 | 15% |
Unknown | 11 | 33% |