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Published on: February 15, 2013
Dynamics and Determinants of Pneumococcal Antibodies Specific against 13 Vaccine Serotypes in the Pre-Vaccination Era
Annemarijn C Prins-van Ginkel1, Guy A M Berbers1, Lucienne H Grundeken1
1Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
Insights
Serotype-specific antibody levels in the pre-vaccine era showed some variation, indicating shifts in pneumococcal exposure. Understanding these dynamics is crucial for evaluating vaccine impact on invasive pneumococcal disease (IPD).
Area of Science:
- Immunology
- Epidemiology
- Public Health
Background:
- Pneumococcal conjugate vaccines (PCVs) reduced invasive pneumococcal disease (IPD) but led to increased non-vaccine serotype IPD.
- Understanding pre-vaccine serotype dynamics is essential for assessing serotype replacement.
- Serosurveillance studies offer insights into serotype dynamics alongside IPD surveillance and carriage studies.
Purpose of the Study:
- To compare pneumococcal serotype antibody levels between two Dutch serosurveillance studies conducted before widespread PCV use (PIENTER1: 1995-1996 and PIENTER2: 2006-2007).
- To investigate changes in serotype-specific antibody concentrations and identify associated determinants during the pre-vaccine era.
Main Methods:
- Blood samples and questionnaire data were collected from participants in two Dutch serosurveillance studies.
- Pneumococcal antibodies for PCV13 serotypes were quantified using a multiplex immunoassay.
- Geometric mean antibody concentrations (GMCs) and their determinants were analyzed.
Main Results:
- GMCs for several serotypes (1, 6A, 6B, 9V, 18C, 19F, 23F) were higher in PIENTER2 compared to PIENTER1, while levels for serotypes 3 and 5 were lower.
- Factors like age, daycare attendance, household size, vaccination coverage, and urbanization rate were associated with antibody levels in children.
- In the elderly, associations included education level, ethnicity, age, low vaccination coverage, urbanization rate, and asthma/COPD.
- Determinants of pneumococcal IgG differed slightly between the two study periods in the elderly population.
Conclusions:
- While most serotype antibody levels remained stable, specific serotype antibody levels showed variation during the pre-vaccine era.
- These observed variations suggest changes in exposure to certain pneumococcal serotypes independent of PCV interference.
- The findings highlight the importance of pre-vaccine serotype dynamics for understanding serotype replacement patterns.
Introduction:
Introduction of pneumococcal conjugate vaccines (PCVs) for infants decreased overall invasive pneumococcal disease (IPD), while non-vaccine serotype IPD increased. To fully understand this serotype replacement, knowledge about serotype dynamics in the pre-vaccine era is needed. In addition to IPD surveillance and carriage studies, the serotype replacement can be investigated by serosurveillance studies. The current study compared the results of two Dutch serosurveillance studies conducted in 1995-1996 (PIENTER1) and 2006-2007 (PIENTER2).
Methods:
Participants in these studies donated a blood sample and completed a questionnaire. Pneumococcal antibodies of serotypes included in PCV13 were measured with a fluorescent-bead based multiplex immunoassay. Geometric mean antibody concentrations (GMCs) and determinants of pneumococcal antibody levels were investigated.
Results:
GMCs were higher in PIENTER2 for serotypes 1, 6A, 6B, 9V, 18C, 19F and 23F and lower for 3 and 5. Age, day care attendance, household size, vaccination coverage, and urbanisation rate were associated with pneumococcal antibodies in children. Education level, ethnicity, age, low vaccination coverage sample, urbanisation rate, and asthma/COPD were associated with pneumococcal antibodies in elderly. The determinants significantly associated with pneumococcal IgG were slightly different for the elderly in PIENTER1 compared to the elderly in PIENTER2.
Conclusion:
Although most of the serotype antibody levels remained stable, some of the serotype-specific antibody levels varied during the pre-vaccine era, indicating that exposure of certain serotypes changes without interference of PCVs.
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