Immunogenicity of pneumococcal vaccine in persons with spinal cord injury.

Abstract:

OBJECTIVE:To determine immunogenicity and optimum timing for administering the 23-valent pneumococcal vaccine after spinal cord injury (SCI). DESIGN:Double-blind, randomized, placebo control study. SETTING:SCI unit in a tertiary care medical center and community. PARTICIPANTS:Eighty-seven persons with recent SCI. INTERVENTION:Participants were randomized to receive either placebo or pneumococcal vaccine at 16 to 18 days versus 4 to 6 months postinjury. MAIN OUTCOME MEASURES:Antibody concentrations were measured prior to intervention and 1, 2, and 12 months afterward to evaluate the immune response to five serotypes of Streptococcus pneumoniae. Effects of demographic and injury-related variables on immune response were also evaluated. RESULTS:Timing of vaccination did not influence mean antibody concentrations for any serotype (p > .05). Ninety-five percent of vaccinated persons had twofold or greater increases in antibody concentration for at least one serotype when measured 1 month after vaccination versus 35% of placebo groups (p < .01). After 12 months, 93% of vaccinated persons in both groups maintained antibody concentrations twofold or greater than baseline values. CONCLUSIONS:Most participants developed an immune response to at least one serotype that was maintained for at least 12 months. Immune response varied according to serotype. Given the favorable immune response and no effect of timing, persons with SCI should receive pneumococcal vaccine during initial hospitalization.

journal_name

Arch Phys Med Rehabil

authors

Waites KB,Canupp KC,Edwards K,Palmer P,Gray BM,DeVivo MJ

doi

10.1016/s0003-9993(98)90410-5

subject

Has Abstract

pub_date

1998-12-01 00:00:00

pages

1504-9

issue

12

eissn

0003-9993

issn

1532-821X

pii

S0003-9993(98)90410-5

journal_volume

79

pub_type

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