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Pediatr Infect Dis J. 2009 Aug;28(8):688-92. doi: 10.1097/INF.0b013e31819d97be.

Seven-valent pneumococcal conjugate vaccine in pediatric solid organ transplant recipients: a prospective study of safety and immunogenicity.

Author information

1
Division of Infectious Diseases, Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, Ontario.

Abstract

OBJECTIVES:

To determine the safety and immunogenicity of the conjugate pneumococcal vaccine (PCV7) in pediatric solid organ transplant recipients.

PATIENTS AND METHODS:

Pediatric solid organ transplant recipients were prospectively enrolled at > or =4 months following transplantation. Eligible pneumococcal vaccine-naive subjects received 3 doses of PCV7 at 8 week intervals, followed 8 weeks later by a dose of the 23-valent vaccine (PV23). Serology was done at baseline, 8 weeks following doses 2 and 3 of PCV7 and 8-12 weeks after PV23. Repeated measures analyses were done using SAS 9.

RESULTS:

Eighty-one recipients commenced immunization at a median age of 7.8 (0.6-17.5) years and a median time from transplantation to immunization of 1.3 (0.3-6.0) years. There were 31 heart, 18 liver, 5 lung, and 27 kidney recipients. Reported adverse events following vaccine doses included local reactions (PCV7: PV23 = 19%:16%) and fever (PCV7: PV23 = 3.8%:4.9%) and there were no serious reactions. Two doses of PCV7 induced > or =2 fold increases in geometric mean concentrations (GMCs) in all organ groups. Cardiac and lung recipients demonstrated additional benefit from a third dose of PCV7. The cardiac recipients showed most benefit from boosting with PV23 with significant increases in GMC's (P < or = 0.008). The time of initiation of the vaccine strategy posttransplantation predicted seroprotection.

CONCLUSION:

PCV7 was safe and immunogenic in solid organ recipients. Three doses of this vaccine appear beneficial for selected organ groups. PV23 when administered at >/=1 year posttransplantation was useful in boosting antibody responses in patient groups demonstrating lower rates of responsiveness.

PMID:
19633514
DOI:
10.1097/INF.0b013e31819d97be
[Indexed for MEDLINE]

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