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Evaluation of antibody response to the heptavalent pneumococcal conjugate vaccine in pediatric chronic kidney disease

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Abstract

Pneumococcal vaccination has been recommended for immunocompromised children, including patients with chronic kidney disease. We determined pneumococcal immunoglobulin (Ig)G antibodies to serotypes 4, 6B, 9V, 14, 18C, 19F, and 23F before and after 48 pediatric patients with chronic renal failure were administered heptavalent conjugated pneumococcal vaccine. The patients were between 1 and 9 years of age and were separated into a conservative treatment group (Group 1) and a dialysis group (Group 2). The antibody response to the vaccinal serotypes was evaluated by measuring antibody concentrations before the first dose and 60 days after the second one. Pre-vaccinal IgG concentrations ≥0.35 μg/ml were detected for all serotypes in at least 50% of the patients in both groups. Patients from both groups showed a statistically indistinguishable behavior in terms of the medians of post-vaccination IgG levels. An “adequate” vaccine response was defined as a post-immunization level of specific pneumococcal serotype antibody ≥0.35 μg/ml, based on the World Health Organization’s (WHO) protective antibody concentration definition for pneumococcal conjugate vaccines, or on a fourfold increase over baseline for at least five of the seven antigens of the vaccine. An “adequate” vaccinal response was obtained in 100% of the patients of both groups using WHO’s definition, or in 45.8% of Group 1 patients and 37.5% of Group 2 patients when the criterion was a fourfold antibody increase over baseline antibody concentrations.

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Authors and Affiliations

  1. Pediatric Nephrology Unit, Instituto da Criança do Hospital das Clinicas da Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil

    Simone Vieira

  2. Pediatric Infectious Diseases Unit, Instituto da Criança do Hospital das Clinicas da Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil

    Evandro Roberto Baldacci

  3. Laboratório de Imunologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, Brazil

    Magda Carneiro-Sampaio

  4. Biostatistics Unit, Instituto da Criança do Hospital das Clinicas da Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil

    Ulysses Doria Filho

  5. Pediatric Nephrology Unit, Instituto da Criança do Hospital das Clínicas da Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil

    Vera Hermina Koch

  6. Rua das Mangabeiras 91/81, 01233–010, São Paulo, Brazil

    Vera Hermina Koch

Authors
  1. Simone Vieira
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  2. Evandro Roberto Baldacci
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  3. Magda Carneiro-Sampaio
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  4. Ulysses Doria Filho
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  5. Vera Hermina Koch
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Correspondence to Vera Hermina Koch.

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Vieira, S., Baldacci, E.R., Carneiro-Sampaio, M. et al. Evaluation of antibody response to the heptavalent pneumococcal conjugate vaccine in pediatric chronic kidney disease. Pediatr Nephrol 24, 83–89 (2009). https://doi.org/10.1007/s00467-008-0989-5

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  • DOI: https://doi.org/10.1007/s00467-008-0989-5

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