Journal of Clinical Immunology

, Volume 38, Issue 2, pp 149–152 | Cite as

Impact of Using Different Response Criteria for Pneumococcal Polysaccharide Vaccination for Assessment of Humoral Immune Status

  • Thijs W. Hoffman
  • Diana A. van Kessel
  • Ger T. RijkersEmail author
Letter to Editor

To the editor:

Polysaccharide vaccination can be used to assess the functional status of the humoral immune system. An impaired response to vaccination supports the diagnosis of an antibody deficiency. Current diagnostic criteria for common variable immunodeficiency and specific antibody deficiency include documentation of an impaired response to polysaccharide vaccination [1].

The criteria for interpreting pneumococcal polysaccharide antibody responses, using pre- and post-vaccination antibody levels, have changed over the years [1, 2]. Because few studies have evaluated these criteria in healthy adults, they are mostly based on expert opinion. Interpretation of the changes in antibody levels can be based on a combination of the following: (1) the increase in specific antibody levels over pre-immunization concentrations, (2) the final concentration of antibodies after immunization, and (3) the percentage of serotypes to which the patient responded. For each of these three criteria, a...



We thank Prof. Xavier Bossuyt for providing the raw data on vaccination responses in the Belgian cohorts.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflicts of interest.

Supplementary material

10875_2017_470_MOESM1_ESM.docx (98 kb)
ESM 1 (DOCX 97 kb)


  1. 1.
    Bonilla FA, Khan DA, Ballas ZK, Chinen J, Frank MM, Hsu JT, et al. Practice parameter for the diagnosis and management of primary immunodeficiency. J Allergy Clin Immunol. 2015;136(5):1186–205.e1-78. Scholar
  2. 2.
    Bonilla FA, Bernstein IL, Khan DA, Ballas ZK, Chinen J, Frank MM, et al. Practice parameter for the diagnosis and management of primary immunodeficiency. Ann Allergy Asthma Immunol. 2005;94(5 Suppl 1):S1–63. Scholar
  3. 3.
    Goldblatt D, Southern J, Andrews N, Ashton L, Burbidge P, Woodgate S, et al. The immunogenicity of 7-valent pneumococcal conjugate vaccine versus 23-valent polysaccharide vaccine in adults aged 50-80 years. Clin Infect Dis. 2009;49(9):1318–25. Scholar
  4. 4.
    Orange JS, Ballow M, Stiehm ER, Ballas ZK, Chinen J, de la Morena M, et al. Use and interpretation of diagnostic vaccination in primary immunodeficiency: a working group report of the basic and clinical immunology interest section of the American Academy of Allergy, Asthma & Immunology. J Allergy Clin Immunol. 2012;130(3 Suppl):S1–24. Scholar
  5. 5.
    Schaballie H, Bosch B, Schrijvers R, Proesmans M, de Boeck K, Boon MN, et al. Fifth percentile cutoff values for antipneumococcal polysaccharide and anti-salmonella typhi vi IgG describe a normal polysaccharide response. Front Immunol. 2017;8:546. Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2017

Authors and Affiliations

  • Thijs W. Hoffman
    • 1
  • Diana A. van Kessel
    • 1
    • 2
  • Ger T. Rijkers
    • 3
    • 4
    Email author
  1. 1.Department of PulmonologySt. Antonius HospitalNieuwegeinNetherlands
  2. 2.Division of Heart and LungsUniversity Medical Center UtrechtUtrechtNetherlands
  3. 3.Department of Medical Microbiology and ImmunologySt. Antonius HospitalNieuwegeinNetherlands
  4. 4.Science DepartmentUniversity College RooseveltMiddelburgNetherlands

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