Immunogenicity of sequential 13-valent conjugated and 23-valent unconjugated pneumococcal vaccines in a population of children with lupus

Gorelik, Mark; Elizalde, Araceli; Williams, Kelli W.; Gonzalez, Erica; Cole, Journey

doi:10.1177/0961203318808589

Cited by 14 publications

(18 citation statements)

References 24 publications

(41 reference statements)

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“…155 This is further supported by a recent study showing decreased efficacy of influenza vaccination in patients treated with adalimumab but not ustekinumab. 156 In patients exposed to rituximab, most studies found a reduced humoral response to pneumococcal, 101,112,115,[126][127][128]135,157 hepatitis B, 136 and influenza vaccination. 73,108,111,116,122,130,142,144 Rituximab exposure did not significantly affect humoral response to seasonal influenza vaccination in patients with autoimmune blistering disease.…”

Section: Vaccines and Biologicsmentioning

confidence: 99%

An evidence-based guide to SARS-CoV-2 vaccination of patients on immunotherapies in dermatology

Gresham

Marzario

Dutz

et al. 2021

Journal of the American Academy of Dermatology

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Immune-mediated diseases and immunotherapeutics can negatively affect normal immune functioning and, consequently, vaccine safety and response. The COVID-19 pandemic has incited research aimed at developing a novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine. As SARS-CoV-2 vaccines are developed and made available, the assessment of anticipated safety and efficacy in patients with immune-mediated dermatologic diseases and requiring immunosuppressive and/or immunomodulatory therapy is particularly important. A review of the literature was conducted by a multidisciplinary committee to provide guidance on the safety and efficacy of SARS-CoV-2 vaccination for dermatologists and other clinicians when prescribing immunotherapeutics. The vaccine platforms being used to develop SARS-CoV-2 vaccines are expected to be safe and potentially effective for dermatology patients on immunotherapeutics. Current guidelines for the vaccination of an immunocompromised host remain appropriate when considering future administration of SARS-CoV-2 vaccines.

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Section: Vaccines and Biologicsmentioning

confidence: 99%

An evidence-based guide to SARS-CoV-2 vaccination of patients on immunotherapies in dermatology

Gresham

Marzario

Dutz

et al. 2021

Journal of the American Academy of Dermatology

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“…19,20 Studies have revealed that vaccines are generally safe in this patient population and do not result in a disease flare. 10,13,14,21,22 Except for live vaccines, which are contraindicated in patients receiving immunosuppression, recommended inactivated childhood vaccines should be administered to patients with c-SLE. 15 In this quality improvement (QI) study, we evaluated our baseline compliance with pneumococcal vaccination recommendations in patients with c-SLE and identified barriers to vaccination and opportunities to increase pneumococcal vaccination in the rheumatology clinic through multiple plan-do-study-act cycles.…”

mentioning

confidence: 99%

Previsit Planning Improves Pneumococcal Vaccination Rates in Childhood-Onset SLE

et al. 2020

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BACKGROUND: Childhood-onset systemic lupus erythematosus (c-SLE) is a complex autoimmune disease that requires systemic immunosuppressive therapy. Infections are the second leading cause of death in these patients, with invasive pneumococcal infections being a major preventable cause of morbidity and mortality. Pneumococcal vaccination is recommended in this population; however, vaccination rates remain low. METHODS:The plan-do-study-act method of quality improvement was applied. We calculated baseline vaccination rates for pneumococcal conjugate and pneumococcal polysaccharide vaccines in patients with c-SLE in the rheumatology clinic from January 2015 to August 2016. We developed an age-based algorithm to simplify the vaccination guidelines. The clinical pharmacist and nurses performed weekly previsit planning to update vaccine records, make targeted recommendations, and ensure vaccine availability. The primary outcome measure was the percentage patients with of c-SLE seen per month who had received age-appropriate pneumococcal vaccination. RESULTS:The percentage of children receiving at least 1 pneumococcal vaccine increased from 24.9% to 92.7% by 12 months. By 18 months, the compliance rate with both pneumococcal vaccines increased from 2.5% to 87.3%, with sustained results. No serious adverse events or disease flares were reported.CONCLUSIONS: By identifying the major barriers to pneumococcal vaccination in our population with c-SLE, we significantly improved vaccination rates while decreasing time burden on providers. We attribute our success to a teambased quality improvement approach and plan to implement alerts in the electronic health record to streamline the process.

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“…An increase in antibodies was also seen after immunization with PPV23 except for one serotype, but the increase was not significant. Although the evaluation of the vaccine response was performed differently, this is in line with recent studies of paediatric lupus patients 11 and adults with rheumatoid arthritis. 20 Both studies showed a response to pneumococcal immunization but also a higher response after PCV13 than PPV23.…”

Section: Discussionmentioning

confidence: 65%

“…10 The knowledge about response to pneumococcal immunization in children with rheumatic disease and compromised immune system is sparse. Previous studies of children with systemic lupus 11 and JIA 12,13 have shown a response to immunization although it may be dampened in patients treated with TNF-alpha inhibitors. 12 It is difficult to compare the serologic response to pneumococcal immunization between studies due to different vaccine regimens and definitions of response.…”

Section: Introductionmentioning

confidence: 97%

“…Some studies investigated the response to the pneumococcal conjugate vaccine exclusively, 12 others the response to the pneumococcal polysaccharide vaccine, 13 and some a combination of both. 11 A recent meta-analysis of response to pneumococcal immunization in adults treated with immunosuppressive agents showed an impaired initial antibody response compared with controls. 14 It is likely that the same holds true for children but the evidence supporting this notion is sparse.…”

Section: Introductionmentioning

confidence: 99%

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Response to pneumococcal conjugate and polysaccharide vaccination in children with rheumatic disease

et al. 2021

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Children with rheumatic disease and compromised immune system have an increased risk of infection. Streptococcus pneumoniae is a frequent pathogen, and immunization is recommended. In this study, we investigated whether immunocompromised children with rheumatic disease do respond to pneumococcal immunization with 13-valent pneumococcal conjugate vaccine followed by 23-valent pneumococcal polysaccharide vaccine. The study was conducted at two tertiary referral hospitals in Denmark from 2015 to 2018. Patients with rheumatic disease and compromised immune system aged 2-19 years were eligible. Patients were vaccinated with 13-valent pneumococcal conjugate vaccine followed by 23-valent pneumococcal polysaccharide vaccine. A blood sample was collected before vaccination and after each vaccination. IgG antibodies were quantified for twelve serotypes. Seroprotection for each serotype was defined as IgG ≥0.35 µg/mL. A total of 27 patients were enrolled. After the conjugate vaccine, an increase in antibody titres compared with pre-vaccination was found for all serotypes and 9/12 were significant. After the polysaccharide vaccine, the antibody titres for all serotypes but one was seen to increase but none reached significance. The proportion of patients protected before immunization ranged from 20.8% to 100% for the individual serotypes. Odds ratio for achieving seroprotection after the conjugate vaccine was >1 for 10/12 serotypes but only significant for three serotypes. After the polysaccharide vaccine, the odds ratio was >1 for 9/12 serotypes but none reached significance. In conclusion, children with rheumatic disease and compromised immune system respond to pneumococcal immunization with 13-valent pneumococcal conjugate vaccine and maintain antibody levels upon subsequent immunization with 23-valent pneumococcal polysaccharide vaccine. How to cite this article: Jensen L, Christensen AE, Nielsen S, et al. Response to pneumococcal conjugate and polysaccharide vaccination in children with rheumatic disease.

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Immunogenicity of sequential 13-valent conjugated and 23-valent unconjugated pneumococcal vaccines in a population of children with lupus

Cited by 14 publications

References 24 publications

An evidence-based guide to SARS-CoV-2 vaccination of patients on immunotherapies in dermatology

An evidence-based guide to SARS-CoV-2 vaccination of patients on immunotherapies in dermatology

Previsit Planning Improves Pneumococcal Vaccination Rates in Childhood-Onset SLE

Response to pneumococcal conjugate and polysaccharide vaccination in children with rheumatic disease

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