Chest
Volume 84, Issue 4, October 1983, Pages 433-435
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Pneumococcal Vaccine In Elderly Patients With Copd

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Antibody levels to 12 serotypes of the 14 valent pneumococcal vaccine were measured in 12 patients (mean age of 70) with chronic obstructive pulmonary disease (COPD), approximately one year postvaccination and in 17 additional patients with COPD (mean age 70) who were not vaccinated. In the vaccinated group, the geometric mean antibody concentration (GMAC) 13 months postvaccination was above the presumed postvaccination minimally protective level (250 to 300 ng of antibody nitrogen per milliliter) for all serotypes except 6A and 19F. Antibody levels exceeded 700 ng for nine of 12 types. The GMAC for all 12 types was 927. In the nonvaccinated group, GMAC were slightly higher than seen with healthy younger persons (395 vs 217). It is concluded that elderly persons with COPD have adequate antibody titers for at least one year after vaccination.

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Patients

All patients were diagnosed as having either chronic bronchitis or emphysema and were followed on a regular basis at the Kings County Hospital Chest Clinic. Diagnosis was based on a compatible clinical picture, roentgenographic findings, and pulmonary function tests. Persons with asthma were not included in the study. There were 29 patients who were divided in two groups. Group 1 consisted of 17 patients (mean age 70) who did not receive the vaccine and served as control subjects. Group 2

RESULTS

The geometric mean antibody levels for the group 1 and group 2 patients are presented in Table 1. Prevaccination antibody levels derived from normal healthy young adults (age range 20 to 28) are included for comparison purposes (sera supplied by the Bureau of Biologics).

Group 1 patients had geometric mean antibody levels that were slightly but not significantly higher than were seen in healthy nonvaccinated adults (395 ng Ab N/ml vs 217 ng Ab N/ml). Group 2 patients had a total geometric mean

DISCUSSION

Numerous studies have shown that the pneumococcal polyvalent vaccine is capable of inducing antibodies that protect an individual against pneumococcal infection. Most of these studies have been done in relatively healthy young to middle-aged persons.4, 5, 6 There are few data available on antibody responses in the elderly, particularly the elderly with underlying pulmonary disease. Because elderly patients with COPD are a recommended target population for the vaccine, data on the magnitude and

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  • Pneumococcal vaccination for patients with COPD: Current practice and future directions

    2008, Chest
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    This is an important issue because it is possible that COPD patients may respond differently than the general population, given their ongoing systemic inflammation, chronic colonization of the lower respiratory tract, repeated exacerbations, and frequent use of inhaled and systemic steroids. Studies of biological response have shown that COPD patients can mount antibodies when challenged with pneumococcal vaccine,343536 even when patients are receiving systemic corticosteroids3738 or when the vaccine is given via inhalation.39 Unfortunately, these studies were performed using the earlier generation of ELISAs, limiting the interpretation of their results.

  • Cost benefits of targeting the Pneumococcal Vaccination Program to the elderly population in Taiwan

    2006, American Journal of Infection Control
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Assistant Professor of Medicine.

Professor of Microbiology and Immunology.

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