Related Experiment Video
Updated: Nov 4, 2025
Experimental Human Pneumococcal Carriage
Published on: February 15, 2013
Pneumococcal immunity and PCV13 vaccine response in SOT-candidates and recipients
G Blanchard-Rohner1, N Enriquez2, B Lemaître3
1Center for Vaccinology and Neonatal Immunology, Department of Pediatrics and Pathology-Immunology, Medical Faculty and University Hospitals of Geneva, Switzerland; Department of Woman, Child and Adolescent Medicine, Unit of Immunology and Vaccinology, University Hospitals of Geneva and Faculty of Medicine, Geneva, Switzerland.
Insights
Solid organ transplantation patients need pneumococcal vaccines. A single dose of pneumococcal-13-valent-conjugate-vaccine (PCV13) before transplant improves protection against invasive pneumococcal disease (IPD).
Area of Science:
- Immunology
- Transplantation Medicine
- Infectious Diseases
Background:
- Solid organ transplantation (SOT) candidates and recipients face high risks of invasive pneumococcal diseases (IPD).
- Limited data exists to guide optimal immunization strategies for this vulnerable population.
- Swiss Health Authorities recommended a single dose of pneumococcal-13-valent-conjugate-vaccine (PCV13) in 2014, omitting the 23-valent-polysaccharide-pneumococcal-vaccine (PPV23).
Purpose of the Study:
- To evaluate pneumococcal immunity and seroprotection rates in SOT candidates and recipients.
- To assess the effectiveness of a single PCV13 dose in this population.
- To inform immunization recommendations for SOT candidates and recipients.
Main Methods:
- Retrospective analysis of pneumococcal immunity using a multiplex binding assay.
- Assessment of seroprotection rates against seven PCV13 and seven PPV23 serotypes.
- Evaluation of sera from SOT candidates and recipients before and at the time of transplant.
Main Results:
- At listing, 49% of SOT candidates were seroprotected against PCV13 serotypes and 60% against PPV23 serotypes.
- Following a single PCV13 dose, 81% of SOT recipients achieved seroprotection against PCV13 serotypes and 79% against PPV23 serotypes at transplant.
- This represents a significant improvement compared to controls transplanted before the PCV13 vaccination strategy.
Conclusions:
- Systematic vaccination with PCV13 for SOT candidates is an effective strategy for broad pneumococcal serotype protection.
- Despite PCV13 vaccination, some SOT candidates remain unprotected, highlighting potential immune competence issues.
- Additional pneumococcal vaccine doses may be necessary before transplantation to ensure adequate protection.
Background:
Solid organ transplantation (SOT) candidates and recipients are highly vulnerable to invasive pneumococcal diseases (IPD). Data on which to base optimal immunization recommendations for this population is scant. The national distribution of IPD serotypes led the Swiss Health Authorities to recommend in 2014 one dose of pneumococcal-13-valent-conjugate-vaccine (PCV13), without any subsequent dose of the 23-valent-polysaccharide-pneumococcal-vaccine (PPV23).
Methods:
This is a retrospective analysis of pneumococcal immunity using a multiplex binding assay, to assess seroprotection rates against a selection of seven PCV13- and seven PPV23-serotypes in SOT-candidates and recipients evaluated and/or transplanted in 2014/2015 in the University Hospitals of Geneva. Seroprotection was defined as serotype-specific antibody concentration greater than 0.5 mg/l and overall seroprotection when this was achieved for ≥ 6/7 serotypes.
Results:
Pre-vaccination and at time of transplant sera were available for 35/43 (81%), and 43/43 (100%) SOT-candidates respectively. At listing, 17/35 (49%) SOT-candidates were seroprotected against PCV13 and 21/35 (60%) against PPV23 serotypes. Following one systematic dose of PCV13 at listing, 35/43 (81%) SOT-recipients were seroprotected at day of transplant against PCV13-serotypes and 34/43 (79%) against PPV23 serotypes, compared to 21/41 (51%) and 28/41 (68%) respectively in the controls transplanted in 2013, before the systematic PCV13-vaccination.
Conclusions:
The systematic vaccination with PCV13 of all SOT candidates without additional PPV23 is a good strategy as it confers seroprotection against a wide range of pneumococcal serotypes. Indeed, one of five PCV13-vaccinated SOT-candidates was nevertheless not seroprotected at time of transplant, reflecting their partial immune competence, and indicating the need for additional dose of pneumococcal vaccines before transplant.
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