Abstract
Asplenic children are at increased risk of life-threatening pneumococcal sepsis. These children show a nearly normal increase in type-specific antibody activity after polyvalent pneumococcal vaccination (PPV), but the duration of elevated antibody levels and, presumably, increased protection is not known. To obtain this information, serum was obtained from 33 asplenic children before and at intervals up to 4½ yrs. after PPV. Using a summarized analysis of 12 antibody types, the postvaccination antibody decline was significant (P=.03) in 23 children splenectomized for trauma (TR) but was not significant (P=.29) in 10 children splenectomized for hereditary spherocytosis (HS). The rate of antibody decline did not depend on the prevaccination antibody level. There was a highly significant difference in rates of antibody decline among the 12 pneumococcal serotypes; the rates of decline were significant (P<.05) in the TR group for types 1, 4, 6A, 7F, 8, 18C, 19F and 23F and in the HS group for types 4, 8 and 23F. Extrapolation of these rates of decline indicate that protective antibody levels (≥ 300 ng AbN/ml) would be expected to persist for 1.3 - 3.8 years after vaccination for the 8 types that showed a significant decline. These results suggest that asplenic children might benefit from re-vaccination with PPV 1 - 3 yrs. after initial vaccination.
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Giebink, G., Le, C. & Schiffman, G. ANTIBODY DECLINE IN SPLENECTOMIZED CHILDREN AFTER PNEUMOCOCCAL VACCINATION. Pediatr Res 18 (Suppl 4), 275 (1984). https://doi.org/10.1203/00006450-198404001-01092
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DOI: https://doi.org/10.1203/00006450-198404001-01092