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Low baseline antibody level to diphtheria is associated with poor response to conjugated pneumococcal vaccine in

M A Shelly1, M E Pichichero, J J Treanor

  • 1Department of Medicine, Highland Hospital Rochester, New York, USA.

Scandinavian Journal of Infectious Diseases
|August 23, 2001
PubMed

Insights

Low immunity to carrier proteins like diphtheria may explain why some older adults do not respond well to conjugated pneumococcal vaccines. This impacts the effectiveness of these important immunizations in the elderly population.

Area of Science:

  • Immunology
  • Vaccinology
  • Geriatric Medicine

Background:

  • Conjugating polysaccharide antigens to protein carriers enhances immunogenicity in infants.
  • However, conjugated pneumococcal vaccines have shown disappointing results in older adults.
  • Low pre-existing immunity to carrier proteins in the elderly may hinder T-cell-dependent responses.

Purpose of the Study:

  • To investigate the impact of pre-existing immunity to carrier proteins on the immune response to pneumococcal vaccines in older adults.
  • To compare immune responses between younger and older adults vaccinated with pneumococcal polysaccharide or conjugate vaccines.

Main Methods:

  • Immunization of 49 older adults (60-78 years) and 50 younger adults (18-45 years) with pneumococcal polysaccharide vaccine or CRM197-conjugated pneumococcal oligosaccharide vaccine.
  • Analysis of pre- and post-vaccination sera for antibodies to pneumococcal serotypes 14 and 6B, and diphtheria toxin using ELISA.
  • Correlation of baseline diphtheria toxin antibody levels with post-vaccination antibody levels to pneumococcal antigens.

Main Results:

  • Older adults had significantly lower baseline antibody levels to diphtheria toxin compared to younger adults.
  • Higher baseline diphtheria toxin antibody levels correlated with increased post-vaccination antibody levels to pneumococcal serotype 6B.
  • Antibody levels to pneumococcal serotype 14 showed a similar trend, particularly in the older adult group.

Conclusions:

  • Low pre-existing immunity to diphtheria protein may contribute to diminished responses to conjugate pneumococcal vaccines in older adults.
  • This finding suggests a potential mechanism for vaccine failure in the elderly and highlights the importance of carrier protein immunogenicity.

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