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Clin Infect Dis. 2009 Nov 1;49(9):1318-25. doi: 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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Institute of Child Health, University College London, UK.



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.


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.


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.


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.


[Indexed for MEDLINE]

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