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Clinical and Vaccine Immunology, February 2007, p. 139-145, Vol. 14, No. 2
1071-412X/07/$08.00+0     doi:10.1128/CVI.00336-06
Copyright © 2007, American Society for Microbiology. All Rights Reserved.

Comparative Immune Responses of Patients with Chronic Pulmonary Diseases during the 2-Year Period after Pneumococcal Vaccination

Department of Internal Medicine, Institute of Tropical Medicine, Nagasaki University,¹ Department of Respiratory Medicine, Nagasaki Medical Center of Neurology,² Department of Medicine, Tagami Hospital, Nagasaki,³ First Department of Internal Medicine, Kurume University School of Medicine, Kurume,⁴ Department of Respiratory Medicine, National Fukuoka-Higashi Medical Center, Fukuoka,⁵ Department of Special Pathogens, International Research Center for Infectious Diseases, Research Institute for Microbial Diseases, Osaka University, Suita, Japan⁶

Received 14 September 2006/ Returned for modification 20 November 2006/ Accepted 4 December 2006

Antibody responses to a 23-valent pneumococcal vaccine for Streptococcus pneumoniae serotypes 6B, 14, 19F, and 23F in 84 patients with chronic pulmonary diseases over a 2-year period after vaccination were examined by using a third-generation enzyme-linked immunosorbent assay. Of these patients, 28 (31%) were low responders who had developed increases of at least twofold in the levels of serotype-specific immunoglobulin G (IgG) in sera for none of the four serotypes at 1 month after vaccination. Although no specific clinical features of low responders were evident, their prevaccination levels of IgG for all serotypes were higher than those of responders. In responders, the levels of IgG specific for serotypes 14 and 23F in sera were greatly increased 1 month after vaccination and those specific for serotypes 6B and 19F were moderately increased. In contrast, no significant increases in the levels of IgG specific for serotypes 6B, 19F, and 23F in the low responders during the same period were found, but the levels of IgG specific for serotype 14 did increase. Although a rapid decline in the levels of IgG for all serotypes in responders between 1 month and 6 months after vaccination was found, the levels of IgG specific for serotypes 14 and 23F in sera remained higher than the prevaccination levels for at least 2 years after vaccination. These data suggest the need for the revaccination of responders but not low responders among patients with chronic pulmonary diseases. Revaccination as early as 3 years postvaccination is recommended for responders to increase the reduced levels of IgG in sera, especially those specific for the weak vaccine antigens.

Published ahead of print on 13 December 2006.