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Pneumococcal revaccination of splenectomized children.
H B Konradsen1, F K Pedersen, J Henrichsen
1World Health Organization Collaborating Centre for Reference and Research on Pneumococci, Statens Seruminstitut, Copenhagen S, Denmark.
The Pediatric Infectious Disease Journal
|April 1, 1990
Summary
Splenectomized children receiving pneumococcal vaccines showed antibody levels that correlated with initial levels. Revaccination was safe and effective for those with low antibody concentrations after five years.
Area of Science:
- Immunology
- Pediatrics
- Vaccinology
Background:
- Children who have had their spleen removed (splenectomized) are at increased risk of infections.
- Pneumococcal vaccination is crucial for preventing serious infections in these children.
- Long-term antibody responses after pneumococcal vaccination in asplenic children require further investigation.
Purpose of the Study:
- To assess the long-term antibody concentrations in splenectomized children following pneumococcal vaccination.
- To evaluate the safety and immunogenicity of revaccination in children with suboptimal antibody levels after five years.
Main Methods:
- A cohort of 43 Danish splenectomized children received a 14-valent pneumococcal vaccine.
- Antibody concentrations were measured before, 4 weeks after, and 5 years after the initial vaccination using enzyme-linked immunosorbent assay (ELISA).
- Children were stratified for revaccination based on antibody status at the 5-year mark.
Main Results:
- Antibody concentrations 5 years post-vaccination strongly correlated with pre-vaccination levels.
- Revaccination in children with low antibody levels at 5 years was found to be safe.
- Revaccination elicited a satisfactory antibody response without significant side effects.
Conclusions:
- Pre-vaccination antibody levels are a strong predictor of long-term antibody concentrations in splenectomized children.
- Revaccination with a 23-valent pneumococcal vaccine is a safe and effective strategy for maintaining protective immunity in asplenic children with inadequate antibody levels.
- This study supports individualized revaccination schedules based on antibody monitoring in high-risk pediatric populations.