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Open Access Highly Accessed Research article

The effect of age on the response to the pneumococcal polysaccharide vaccine

Hyunju Lee12, Moon H Nahm3 and Kyung-Hyo Kim12*

Author Affiliations

1 Department of Pediatrics, School of Medicine, Ewha Womans University, Seoul, Republic of Korea

2 Center for Vaccine Evaluation and Study, Ewha Medical Research Institute, Ewha Womans University, Seoul, Republic of Korea

3 Departments of Pathology and Microbiology, University of Alabama at Birmingham, Birmingham, Alabama, USA

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BMC Infectious Diseases 2010, 10:60  doi:10.1186/1471-2334-10-60

Published: 10 March 2010

Abstract

Background

Streptococcus pneumoniae is a leading cause of morbidity and mortality in the elderly. To prevent invasive pneumococcal diseases, the 23-valent pneumococcal polysaccharide vaccine (PPV) is recommended in subjects over 65 years of age. Although it has been reported to provide approximately 50-80% protection against invasive disease in the general elderly population, there is still controversy as to the effectiveness of the PPV in the elderly.

Methods

To evaluate the immune response to the pneumococcal polysaccharide vaccine in the elderly, samples from young adults and elderly were obtained before and one month after vaccination. The quantitative and qualitative response to the vaccine were measured by the ELISA and opsonophagocytic killing assay for eight vaccine type serotypes (4, 6B, 9V, 14, 18C, 19A, 19F, 23F) and one vaccine-related serotype (6A).

Results

The response to the pneumococcal polysaccharide vaccine showed a similar response between adults and elderly when evaluated by the ELISA, however the functional activity of the antibodies elicited after vaccination were lower in the elderly group for more than half of the serotypes evaluated. In comparison of the antibody needed for 1:8 opsonic titer, more antibodies were needed in the elderly for serotypes Pn 4, 19F, 23F and 6A, suggesting the functional activity of antibody detected by the ELISA was lower in the elderly compared with the adult group for these serotypes. As for subjects with an opsonic titer <8 after vaccination, only one subject each for serotypes Pn 4, 9V and 6A were found in the adult group. However, up to 10 (30.3%) of the subjects did not show opsonic activity after vaccination in the elderly group for serotypes Pn 4, 9V, 14, 19A and 6A.

Conclusions

Although the amount of antibodies elicited were similar between the two age groups, distinct differences in function were noted. This report highlights the importance of a quantitative and qualitative evaluation of the immunogenic response to the PPV in the elderly age group.

Trial registration

This trial is registered with Clinical trials.gov. Registration number NCT00964769