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Int J Epidemiol. 1997 Apr;26(2):420-7.

Effect of age, sex and smoking habits on pneumococcal antibodies in an elderly population.

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National Public Health Institute, Department in Oulu, Finland.



Pneumococcal infections are a common cause of morbidity and mortality among elderly people. Protection against pneumococcal infections is mediated by serotype-specific antibodies to capsular polysaccharides. To obtain an estimate of anti-pneumococcal immunity, prevalence and levels of pneumococcal antibodies were studied in an unvaccinated elderly population.


IgG antibodies to pneumococcal serotypes 3, 6A, and B and to cell wall polysaccharide (C-PS, a common antigen to all pneumococci) were measured by enzyme immuno-assay in 480 subjects aged 64-97 years (206 men, 274 women) who were a random sample (41%) of elderly inhabitants in a semirural community in Finland.


An average of 10% of the elderly lacked antibodies to serotypes 3, 6A, and 8, and 62% of the elderly had them in low titres only. Anti-C-PS antibodies were found in 99% of the elderly, and in significantly higher titres than anti-capsular antibodies. Antibody titres to C-PS and to type 6A decreased with age. Elderly women had significantly lower antibody levels than men. Among the men, current smokers had higher antibody titres than non-smokers; in the women, this analysis was not possible because of infrequent history of smoking. The effect of smoking on antibody titres was reversible after cessation of smoking.


A considerable proportion of the elderly lacked protective antibodies to commonly infecting pneumococcal serotypes 3, 6A, and 8. Smoking increased the prevalence and levels of pneumococcal antibodies probably as a consequence of numerous respiratory infections. These observations emphasize the importance of administration of the pneumococcal vaccine among the elderly.

[Indexed for MEDLINE]

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