Impaired response to 13-valent pneumococcal conjugate vaccine (PCV13) in children with recurrent respiratory infections and chronic cough

Abstract

<b>Background:</b> Functional antibodies (FAB) test refers to the measurement of specific IgG antibodies against vaccines to exclude clinically significant antibody deficiency. Most healthy infants and children (&gt;90%) develop antibodies to the majority of serotypes included in PCV13 (1). <b>Aim:</b> To examine the incidence of impaired PCV13 response in children referred to a tertiary paediatric respiratory centre with recurrent respiratory infections (RRI) and/or chronic cough (CC). <b>Methods:</b> Retrospective review of case notes. <b>Results:</b> 137 patients, between age 2 and 15 years old who had FAB test were identified with history of RRI and/or CC, within a two year period. Mean&nbsp;age was 5.9 years (2-14), 46.7% of children were female. 73% had a history of RRI, 76.6% had a history of CC and 49.6% had a history of both RRI and CC. Diagnosis of asthma (36.5%) and preschool wheeze (41.6%) were common.&nbsp; 32.8% of patients with RRI and/or CC and 37% of patients with history of RRI only, had impaired response to PCV13, with specific antibody concentration of 0.35 ug/ml or higher to less than seven&nbsp;PCV13 serotypes. Those on prophylactic Azithromycin or on moderate to high dose of inhaled corticosteroids&nbsp;were more likely to have&nbsp;impaired response to PCV13 (OR 1.51, 95%CI 1.51 0.53-4.27 and OR 2.7 95%CI 0.94-7.77 respectively). <b>Conclusion:</b> Paediatric patients referred to tertiary centre with RRI and/or CC have high incidence of impaired response to PCV13 compared to general population and may benefit from booster vaccination against pneumococcus. 1.&nbsp;Doffinger et al. Age specific responses to Pneumovax in healthy children.&nbsp; Clinical &amp; Experimental Immunology (2008) 154: 72-72.