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Comparison of pneumococcal vaccination response in children with sickle cell disease: HbSS and HbSC.
Allergol Immunopathol (Madr). 2019 Nov - Dec; 47(6):564-569.AI

Abstract

INTRODUCTION

Sickle cell disease (SCD) children are at increased risk of invasive pneumococcal disease and rely on penicillin prophylaxis and vaccination for infection prevention. Post-vaccination antibody levels in SCD may wane overtime. HbSC are believed to have better immunological response than HbSS.

OBJECTIVE

To compare antibody response to 23-valent pneumococcal polysaccharide vaccine (PPSV-23) between HbSS and HbSC.

METHODS

Patients with HbSS (n=33) and HbSC (n=11), aged 7-18 years, were prospectively recruited. Luminex pneumococcal antibody levels were measured for 23-serotypes, after two PPSV-23 doses.

RESULTS

Absolute median titer for 20 of the 23 serotypes was higher in HbSC than HbSS and significantly higher for serotypes 22 (3.9 vs. 1.6mcg/ml; p=0.039) and 43 (2.9 vs. 0.8mcg/ml; p=0.007). HbSC mounted a better immune anti-pneumococcal response compared to HbSS (≥1.3mcg/ml) for 18 of 23 serotypes, albeit not significant for any of the serotypes. More HbSC (64%) than HbSS (42%) were good vaccine responders (p=0.303). Two of 21 (10%) good vaccine responders and nine of 23 (39%) poor vaccine responders SCD participants subsequently developed acute chest syndrome or pneumonia (p=0.036). None of the HbSC patients developed ACS after receiving PPSV-23. HbSS poor vaccine responders were at increased future recurrence risk for ACS (p=0.003), pneumonia (p=0.036) or both (p=0.011), compared to good vaccine responders.

CONCLUSION

HbSC possess better pneumococcal vaccine response than HbSS. Poor vaccine response is concerning for future acute pulmonary events. Current vaccination strategy for SCD sub-types are lacking, therefore further study to evaluate utility of vaccine boosters is necessary.

Authors+Show Affiliations

Department of Pediatrics, McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA.Department of Pediatrics, McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA.Department of Pediatrics, McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA.Department of Pediatrics, McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA.Department of Pediatrics, McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA.Department of Pediatrics, McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA.Department of Pediatrics, McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA.Department of Pediatrics, McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA.Department of Pediatrics, McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA. Electronic address: aravind.yadav@uth.tmc.edu.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

31164233

Citation

Le Ng, X, et al. "Comparison of Pneumococcal Vaccination Response in Children With Sickle Cell Disease: HbSS and HbSC." Allergologia Et Immunopathologia, vol. 47, no. 6, 2019, pp. 564-569.
Le Ng X, Alikhan M, Stark JM, et al. Comparison of pneumococcal vaccination response in children with sickle cell disease: HbSS and HbSC. Allergol Immunopathol (Madr). 2019;47(6):564-569.
Le Ng, X., Alikhan, M., Stark, J. M., Mosquera, R. A., Shahrukh Hashmi, S., Gonzales, T., Brown, D. L., Nguyen, T. T., & Yadav, A. (2019). Comparison of pneumococcal vaccination response in children with sickle cell disease: HbSS and HbSC. Allergologia Et Immunopathologia, 47(6), 564-569. https://doi.org/10.1016/j.aller.2019.04.003
Le Ng X, et al. Comparison of Pneumococcal Vaccination Response in Children With Sickle Cell Disease: HbSS and HbSC. Allergol Immunopathol (Madr). 2019 Nov - Dec;47(6):564-569. PubMed PMID: 31164233.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of pneumococcal vaccination response in children with sickle cell disease: HbSS and HbSC. AU - Le Ng,X, AU - Alikhan,M, AU - Stark,J M, AU - Mosquera,R A, AU - Shahrukh Hashmi,S, AU - Gonzales,T, AU - Brown,D L, AU - Nguyen,T T, AU - Yadav,A, Y1 - 2019/06/01/ PY - 2018/11/27/received PY - 2019/04/01/revised PY - 2019/04/05/accepted PY - 2019/6/6/pubmed PY - 2020/4/4/medline PY - 2019/6/6/entrez KW - HbSC KW - HbSS KW - Immunity KW - Pneumococcus KW - Sickle cell disease KW - Vaccine SP - 564 EP - 569 JF - Allergologia et immunopathologia JO - Allergol Immunopathol (Madr) VL - 47 IS - 6 N2 - INTRODUCTION: Sickle cell disease (SCD) children are at increased risk of invasive pneumococcal disease and rely on penicillin prophylaxis and vaccination for infection prevention. Post-vaccination antibody levels in SCD may wane overtime. HbSC are believed to have better immunological response than HbSS. OBJECTIVE: To compare antibody response to 23-valent pneumococcal polysaccharide vaccine (PPSV-23) between HbSS and HbSC. METHODS: Patients with HbSS (n=33) and HbSC (n=11), aged 7-18 years, were prospectively recruited. Luminex pneumococcal antibody levels were measured for 23-serotypes, after two PPSV-23 doses. RESULTS: Absolute median titer for 20 of the 23 serotypes was higher in HbSC than HbSS and significantly higher for serotypes 22 (3.9 vs. 1.6mcg/ml; p=0.039) and 43 (2.9 vs. 0.8mcg/ml; p=0.007). HbSC mounted a better immune anti-pneumococcal response compared to HbSS (≥1.3mcg/ml) for 18 of 23 serotypes, albeit not significant for any of the serotypes. More HbSC (64%) than HbSS (42%) were good vaccine responders (p=0.303). Two of 21 (10%) good vaccine responders and nine of 23 (39%) poor vaccine responders SCD participants subsequently developed acute chest syndrome or pneumonia (p=0.036). None of the HbSC patients developed ACS after receiving PPSV-23. HbSS poor vaccine responders were at increased future recurrence risk for ACS (p=0.003), pneumonia (p=0.036) or both (p=0.011), compared to good vaccine responders. CONCLUSION: HbSC possess better pneumococcal vaccine response than HbSS. Poor vaccine response is concerning for future acute pulmonary events. Current vaccination strategy for SCD sub-types are lacking, therefore further study to evaluate utility of vaccine boosters is necessary. SN - 1578-1267 UR - https://www.unboundmedicine.com/medline/citation/31164233/Comparison_of_pneumococcal_vaccination_response_in_children_with_sickle_cell_disease:_HbSS_and_HbSC_ L2 - http://www.elsevier.es/en/linksolver/ft/pii/S0301-0546(19)30051-5 DB - PRIME DP - Unbound Medicine ER -