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  • Title: Pneumococcal vaccine in children and young adults with chronic renal disease.
    Author: Fuchshuber A, Kühnemund O, Keuth B, Lütticken R, Michalk D, Querfeld U.
    Journal: Nephrol Dial Transplant; 1996 Mar; 11(3):468-73. PubMed ID: 8671817.
    Abstract:
    BACKGROUND: Pneumococcal vaccination has been recommended for immunocompromised children over 2 years including patients with chronic renal disease. However, the effect of vaccination and revaccination is variable and the indication for immunization is a subject of controversy. METHODS: Forty children and young adults with chronic renal diseases (including the idiopathic nephrotic syndrome, chronic renal failure, patients undergoing dialysis and after transplantation) were vaccinated with a 23-valent pneumococcal vaccine. The efficacy of the vaccine was evaluated by measuring antibody titres before and 4 weeks, 6 months, and 12 months after vaccination. Twenty-two patients were submitted to a revaccination 1 year after the first vaccination. RESULTS: A sufficient immune response, defined as an at least fourfold increase of postvaccinal antibody titres and an antibody titre > 200, was observed in 83% of the patients 4 weeks after vaccination, but only in 68% after 6 months, and in 48% after 1 year. Revaccination produced a significant immune response in 11/22 patients (50%) followed by a rapid decline of antibody levels within 6 months. Both vaccinations were well tolerated. CONCLUSIONS: The currently available vaccine is without major side-effects and effective in producing a significant immune response. Antibody levels should be monitored in vaccinated patients with chronic renal diseases considering the rapid decline as early as 6 months after vaccination. Evaluation of the efficacy of revaccination in these patients requires further investigations.
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