Comparison of pneumococcal vaccination response in children with sickle cell disease: HbSS and HbSC

X. Le Ng, M. Alikhan, J. M. Stark, R. A. Mosquera, S. Shahrukh Hashmi, T. Gonzales, D. L. Brown, T. T. Nguyen, A. Yadav

Research output: Contribution to journalArticle

Abstract

Introduction: Sickle cell disease (SCD) children are at increased risk of invasive pneumococcal disease and rely on penicillin prophylaxis and vaccination for infection prevention. Post-vaccination antibody levels in SCD may wane overtime. HbSC are believed to have better immunological response than HbSS. Objective: To compare antibody response to 23-valent pneumococcal polysaccharide vaccine (PPSV-23) between HbSS and HbSC. Methods: Patients with HbSS (n = 33) and HbSC (n = 11), aged 7–18 years, were prospectively recruited. Luminex pneumococcal antibody levels were measured for 23-serotypes, after two PPSV-23 doses. Results: Absolute median titer for 20 of the 23 serotypes was higher in HbSC than HbSS and significantly higher for serotypes 22 (3.9 vs. 1.6 mcg/ml; p = 0.039) and 43 (2.9 vs. 0.8 mcg/ml; p = 0.007). HbSC mounted a better immune anti-pneumococcal response compared to HbSS (≥1.3 mcg/ml) for 18 of 23 serotypes, albeit not significant for any of the serotypes. More HbSC (64%) than HbSS (42%) were good vaccine responders (p = 0.303). Two of 21 (10%) good vaccine responders and nine of 23 (39%) poor vaccine responders SCD participants subsequently developed acute chest syndrome or pneumonia (p = 0.036). None of the HbSC patients developed ACS after receiving PPSV-23. HbSS poor vaccine responders were at increased future recurrence risk for ACS (p = 0.003), pneumonia (p = 0.036) or both (p = 0.011), compared to good vaccine responders. Conclusion: HbSC possess better pneumococcal vaccine response than HbSS. Poor vaccine response is concerning for future acute pulmonary events. Current vaccination strategy for SCD sub-types are lacking, therefore further study to evaluate utility of vaccine boosters is necessary.

Original languageEnglish (US)
Pages (from-to)564-569
Number of pages6
JournalAllergologia et Immunopathologia
Volume47
Issue number6
DOIs
StatePublished - Nov 1 2019
Externally publishedYes

Fingerprint

Sickle Cell Anemia
Vaccination
Vaccines
Pneumococcal Vaccines
Pneumonia
Acute Chest Syndrome
Antibodies
Penicillins
Antibody Formation
Serogroup
Recurrence
Lung
Infection

Keywords

  • HbSC
  • HbSS
  • Immunity
  • Pneumococcus
  • Sickle cell disease
  • Vaccine

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Pulmonary and Respiratory Medicine

Cite this

Comparison of pneumococcal vaccination response in children with sickle cell disease : HbSS and HbSC. / Le Ng, X.; Alikhan, M.; Stark, J. M.; Mosquera, R. A.; Shahrukh Hashmi, S.; Gonzales, T.; Brown, D. L.; Nguyen, T. T.; Yadav, A.

In: Allergologia et Immunopathologia, Vol. 47, No. 6, 01.11.2019, p. 564-569.

Research output: Contribution to journalArticle

Le Ng, X, Alikhan, M, Stark, JM, Mosquera, RA, Shahrukh Hashmi, S, Gonzales, T, Brown, DL, Nguyen, TT & Yadav, A 2019, 'Comparison of pneumococcal vaccination response in children with sickle cell disease: HbSS and HbSC', Allergologia et Immunopathologia, vol. 47, no. 6, pp. 564-569. https://doi.org/10.1016/j.aller.2019.04.003
Le Ng, X. ; Alikhan, M. ; Stark, J. M. ; Mosquera, R. A. ; Shahrukh Hashmi, S. ; Gonzales, T. ; Brown, D. L. ; Nguyen, T. T. ; Yadav, A. / Comparison of pneumococcal vaccination response in children with sickle cell disease : HbSS and HbSC. In: Allergologia et Immunopathologia. 2019 ; Vol. 47, No. 6. pp. 564-569.
@article{50e1d887e58a451da8d0cee4bf9d7e56,
title = "Comparison of pneumococcal vaccination response in children with sickle cell disease: HbSS and HbSC",
abstract = "Introduction: Sickle cell disease (SCD) children are at increased risk of invasive pneumococcal disease and rely on penicillin prophylaxis and vaccination for infection prevention. Post-vaccination antibody levels in SCD may wane overtime. HbSC are believed to have better immunological response than HbSS. Objective: To compare antibody response to 23-valent pneumococcal polysaccharide vaccine (PPSV-23) between HbSS and HbSC. Methods: Patients with HbSS (n = 33) and HbSC (n = 11), aged 7–18 years, were prospectively recruited. Luminex pneumococcal antibody levels were measured for 23-serotypes, after two PPSV-23 doses. Results: Absolute median titer for 20 of the 23 serotypes was higher in HbSC than HbSS and significantly higher for serotypes 22 (3.9 vs. 1.6 mcg/ml; p = 0.039) and 43 (2.9 vs. 0.8 mcg/ml; p = 0.007). HbSC mounted a better immune anti-pneumococcal response compared to HbSS (≥1.3 mcg/ml) for 18 of 23 serotypes, albeit not significant for any of the serotypes. More HbSC (64{\%}) than HbSS (42{\%}) were good vaccine responders (p = 0.303). Two of 21 (10{\%}) good vaccine responders and nine of 23 (39{\%}) poor vaccine responders SCD participants subsequently developed acute chest syndrome or pneumonia (p = 0.036). None of the HbSC patients developed ACS after receiving PPSV-23. HbSS poor vaccine responders were at increased future recurrence risk for ACS (p = 0.003), pneumonia (p = 0.036) or both (p = 0.011), compared to good vaccine responders. Conclusion: HbSC possess better pneumococcal vaccine response than HbSS. Poor vaccine response is concerning for future acute pulmonary events. Current vaccination strategy for SCD sub-types are lacking, therefore further study to evaluate utility of vaccine boosters is necessary.",
keywords = "HbSC, HbSS, Immunity, Pneumococcus, Sickle cell disease, Vaccine",
author = "{Le Ng}, X. and M. Alikhan and Stark, {J. M.} and Mosquera, {R. A.} and {Shahrukh Hashmi}, S. and T. Gonzales and Brown, {D. L.} and Nguyen, {T. T.} and A. Yadav",
year = "2019",
month = "11",
day = "1",
doi = "10.1016/j.aller.2019.04.003",
language = "English (US)",
volume = "47",
pages = "564--569",
journal = "Allergologia et Immunopathologia",
issn = "0301-0546",
publisher = "Ediciones Doyma, S.L.",
number = "6",

}

TY - JOUR

T1 - Comparison of pneumococcal vaccination response in children with sickle cell disease

T2 - HbSS and HbSC

AU - Le Ng, X.

AU - Alikhan, M.

AU - Stark, J. M.

AU - Mosquera, R. A.

AU - Shahrukh Hashmi, S.

AU - Gonzales, T.

AU - Brown, D. L.

AU - Nguyen, T. T.

AU - Yadav, A.

PY - 2019/11/1

Y1 - 2019/11/1

N2 - Introduction: Sickle cell disease (SCD) children are at increased risk of invasive pneumococcal disease and rely on penicillin prophylaxis and vaccination for infection prevention. Post-vaccination antibody levels in SCD may wane overtime. HbSC are believed to have better immunological response than HbSS. Objective: To compare antibody response to 23-valent pneumococcal polysaccharide vaccine (PPSV-23) between HbSS and HbSC. Methods: Patients with HbSS (n = 33) and HbSC (n = 11), aged 7–18 years, were prospectively recruited. Luminex pneumococcal antibody levels were measured for 23-serotypes, after two PPSV-23 doses. Results: Absolute median titer for 20 of the 23 serotypes was higher in HbSC than HbSS and significantly higher for serotypes 22 (3.9 vs. 1.6 mcg/ml; p = 0.039) and 43 (2.9 vs. 0.8 mcg/ml; p = 0.007). HbSC mounted a better immune anti-pneumococcal response compared to HbSS (≥1.3 mcg/ml) for 18 of 23 serotypes, albeit not significant for any of the serotypes. More HbSC (64%) than HbSS (42%) were good vaccine responders (p = 0.303). Two of 21 (10%) good vaccine responders and nine of 23 (39%) poor vaccine responders SCD participants subsequently developed acute chest syndrome or pneumonia (p = 0.036). None of the HbSC patients developed ACS after receiving PPSV-23. HbSS poor vaccine responders were at increased future recurrence risk for ACS (p = 0.003), pneumonia (p = 0.036) or both (p = 0.011), compared to good vaccine responders. Conclusion: HbSC possess better pneumococcal vaccine response than HbSS. Poor vaccine response is concerning for future acute pulmonary events. Current vaccination strategy for SCD sub-types are lacking, therefore further study to evaluate utility of vaccine boosters is necessary.

AB - Introduction: Sickle cell disease (SCD) children are at increased risk of invasive pneumococcal disease and rely on penicillin prophylaxis and vaccination for infection prevention. Post-vaccination antibody levels in SCD may wane overtime. HbSC are believed to have better immunological response than HbSS. Objective: To compare antibody response to 23-valent pneumococcal polysaccharide vaccine (PPSV-23) between HbSS and HbSC. Methods: Patients with HbSS (n = 33) and HbSC (n = 11), aged 7–18 years, were prospectively recruited. Luminex pneumococcal antibody levels were measured for 23-serotypes, after two PPSV-23 doses. Results: Absolute median titer for 20 of the 23 serotypes was higher in HbSC than HbSS and significantly higher for serotypes 22 (3.9 vs. 1.6 mcg/ml; p = 0.039) and 43 (2.9 vs. 0.8 mcg/ml; p = 0.007). HbSC mounted a better immune anti-pneumococcal response compared to HbSS (≥1.3 mcg/ml) for 18 of 23 serotypes, albeit not significant for any of the serotypes. More HbSC (64%) than HbSS (42%) were good vaccine responders (p = 0.303). Two of 21 (10%) good vaccine responders and nine of 23 (39%) poor vaccine responders SCD participants subsequently developed acute chest syndrome or pneumonia (p = 0.036). None of the HbSC patients developed ACS after receiving PPSV-23. HbSS poor vaccine responders were at increased future recurrence risk for ACS (p = 0.003), pneumonia (p = 0.036) or both (p = 0.011), compared to good vaccine responders. Conclusion: HbSC possess better pneumococcal vaccine response than HbSS. Poor vaccine response is concerning for future acute pulmonary events. Current vaccination strategy for SCD sub-types are lacking, therefore further study to evaluate utility of vaccine boosters is necessary.

KW - HbSC

KW - HbSS

KW - Immunity

KW - Pneumococcus

KW - Sickle cell disease

KW - Vaccine

UR - http://www.scopus.com/inward/record.url?scp=85066299894&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85066299894&partnerID=8YFLogxK

U2 - 10.1016/j.aller.2019.04.003

DO - 10.1016/j.aller.2019.04.003

M3 - Article

C2 - 31164233

AN - SCOPUS:85066299894

VL - 47

SP - 564

EP - 569

JO - Allergologia et Immunopathologia

JF - Allergologia et Immunopathologia

SN - 0301-0546

IS - 6

ER -