Simultaneous
vaccination against influenza and invasive pneumococcal disease in chronic
dialysis patients
Trmal J.1, Havlíčková M.2, Bícová R.2, Bitterová Z.3, Kelerová J.1
1Krajská hygienická stanice Ústeckého kraje se sídlem v Ústí n/L 2Státní zdravotní ústav, Praha 3Masarykova nemocnice v Ústí n/L, příspěvková organizace |
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Summary:
Study objective: To evaluate the antibody response to simultaneous vaccination against influeza
and pneumococcal disease in chronic dialysis patients.
Methods: Fifty-four chronic dialysis patients were vaccinated with subunit influenza vaccine
Influvac. Thirty-five of these patients were vaccinated with both influenza vaccine and
Pneumo 23 vaccine while 19 patients received influenza vaccine alone. Antibodies against
influenza vaccine antigens were determined in paired sera by the hemagglutination inhibition
test. The geometric mean titre (GMT) of antibodies, protection level (PR), seroconversion (SC)
and conversion factor (CF) were calculated. The levels of antibodies against pneumococcal
vaccine antigens were detected by the EIA and the geometric mean concentrations of
antibodies were calculated from the results.
Results: Simultaneous vaccination did not induce adequate PR for antigens A H1N1 and A H3N2,
SC and CF for A H3N2 and B. Influenza vaccination alone resulted in inadequate PR and SC for
A H3N2, with CF being adequate for all of the antigens. The geometric mean titres of antibodies
were higher in the patients vaccinated with influenza vaccine alone, the difference not being
statistically significant. Good responsiveness to the pneumococcal vaccine was observed, with the
geometric mean concentrations of antibodies increasing 4.8 times after vaccination but
decreasing to 1/3 a year later.
Conclusion: The antibody response to influenza vaccine was negatively influenced by
immunodeficiency due to underlying diseases in dialysis patients. Although poorer results were achieved in patients vaccinated with influenza vaccine alone compared to those vaccinated with
the two vaccines, the difference was not significant. An adjuvant influenza vaccine is expected to
be more promising.
Key words:
influenza vaccine – pneumococcal vaccine – simultaneous vaccination.
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