Simultaneous vaccination against influenza and invasive pneumococcal disease in chronic dialysis patients

Overview

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.