Serum Bactericidal Antibody Response 1 Year after Meningococcal Polysaccharide Vaccination of Patients with Common Variable Immunodeficiency

Abstract

Some patients with common variable immunodeficiency (CVID) can generate an antibody response following vaccination with Neisseria meningitidis polysaccharide, but the duration of this protection is unknown. In this study, serum bactericidal antibody (SBA) responses to serogroup C N. meningitidis of 23 patients with CVID and 23 sex-and age-matched controls were measured 1 year after vaccination with the plain A/C meningococcal polysaccharide vaccine. The fold rise in serum bactericidal antibody geometric mean titers of the control group from prevaccination to 1 year postvaccination was significantly higher than that of the patient group (5.41-versus 2.96-fold, P ‫؍‬ 0.009). Of 23 CVID patients, 8 had a poor response to vaccine (<4-fold rise) 3 weeks after vaccination, and low titers remained when measured 1 year later. Of the 15 CVID patients who had a normal response to vaccine (>4-fold rise) 3 weeks after vaccination, 6 cases failed to maintain protective SBA titers, whereas the remaining 9 had protective titers 1 year after vaccination. Only one of the 23 controls, who developed protective SBA titers after 3 weeks, lost the protective titers after 1 year. Among the patients, the presence of bronchiectasis and/or splenomegaly at enrollment was associated with poor SBA response to vaccine at 3 weeks and/or failure to maintain protective levels at 1 year. The results of this study demonstrate that a number of CVID patients can produce protective antibody titers that can persist for 1 year after vaccination, which lends strong support to the inclusion of polysaccharide vaccine in the immunization program for CVID patients.

Meningococcal C conjugate age-dependant long-term loss of effectiveness

“…Maturation of the immune system is suggested to be the most likely explanation of antibody sustainment [17] and the explanation of age dependant loss of protection. Additionally, some immune deficiency diseases and/or disorders have been reported in vaccine failure cases as additional risk factors [29,30]. Borrow et al studied the kinetics of antibody persistence and observed that antibody concentrations start to decline 1 month after the last dose and decrease exponentially as a function of time in infants [31].…”

New diagnostic criteria for common variable immune deficiency (CVID), which may assist with decisions to treat with intravenous or subcutaneous immunoglobulin

“…In one study, 64% of CVID patients responded to the meningococcal vaccine [49]. Testing responses to other neoantigens such as the rabies virus may be logical, but there are currently few data in immunedeficient patients [50].…”

Updating Information About the Burden of Meningococcal Disease Hospitalisations in Spain

“…Due to the severity of the disease we expected main diagnoses related to acute symptoms while meningococcal disease is confirmed. Additionally, relationship of meningococcal disease with concomitant infections [23][24][25] and immunodeficiency [26,27] has been described previously.…”