Response to Pneumococcal Vaccine in Renal Transplant and Hemodialysis Patients

Travel risk assessment, advice and vaccinations in immunocompromised travellers (HIV, solid organ transplant and haematopoeitic stem cell transplant recipients): A review

“…Responses to pure polysaccharide vaccines are also poor in allo-HSCT patients compared with conjugate vaccines [12]. On the other hand, for patients who are on prednisolone, responses to both polysaccharide and conjugate pneumococcal vaccines may be impaired [64,65] but with CNIs, a good antibody response may be achieved with a polysaccharide vaccine [66,67]. However, this response may be influenced by the type of solid organ transplanted [68].…”

Evaluation of antibody levels over 3years after 23-valent pneumococcal polysaccharide vaccination in patients with pulmonary diseases receiving steroids and immunosuppressive agents

“…There was no difference in the increase of IgG antibody levels between the groups treated with and without steroids. However, Linnemann et al reported that patients receiving immunosuppressive agents and steroids responded poorly to a pneumococcal vaccine [22]. When antibodies to polysaccharides were measured in renal transplant patients receiving azathioprine and prednisolone, the antibody levels were lower than those in the normal population.…”

Immunizations for renal transplant candidates and recipients

“…13 Whenever possible, vaccines should be administered before transplantation and, in the case of kidney transplantation, prior to initiation of dialysis, as vaccines are more effective before the onset of end-stage renal disease (ESRD). [14][15][16][17][18][19][20][21] In general, live virus vaccines are not considered to have an acceptable risk profile in immunocompromised patients, and thus are contraindicated in the renal transplant recipient. 22 Many experts suggest that vaccines should be administered no less than 6 months after solid organ transplantation, to permit sufficient time for the doses of immunosuppressants to stabilize and for the immunologic system to recover from cytolytic induction therapies.…”

“…42 Although postvaccination antibody titers in renal transplant recipients are lower than in healthy controls, most patients develop protective titers to at least one pneumococcal serotype. 19,43,44 In one study, the opsonophagocytic assay-a functional measure of vaccine response-revealed that 83% and 80% of patients developed protective titers to any serotype after receiving PPV23 and PCV7, respectively. 45 Although reports in healthy children under 2 years of age suggest that PCV7 is more immunogenic than PPV23, 2 PCV7 has not been shown to have significantly greater efficacy than PPV23 in adult transplant recipients.…”