Immune response of 23-valent pneumococcal polysaccharide vaccinated elderly and its relation to frailty indices, nutritional status, and serum zinc levels

• Published in: Geriatrics & gerontology international Vol. 12; no. 2; pp. 223 - 229
• Main Authors: Hamza, Sarah A, Mousa, Shereen M, Taha, Shereen E, Adel, Lamiaa A, Samaha, Hanan E, Hussein, Dalia A
• Format: Journal Article
• Language: English
• Published: Melbourne, Australia Blackwell Publishing Asia 01.04.2012; Blackwell Publishing Ltd
• Subjects: Aged; B-Lymphocytes - immunology; Bacterial infections; Check lists; Cognitive ability; Cross-Sectional Studies; elderly; Female; Frailty; Geriatric Assessment; Geriatrics; Hospitals; Humans; Immune response; Immunization; Immunoglobulin M; Immunoglobulin M - immunology; Immunologic Memory - immunology; Immunological memory; Immunosuppressive agents; Lymphocytes B; Male; Memory cells; Mouth; Nutrition; Nutritional status; Nutritional Status - immunology; Older people; Pneumococcal Vaccines - immunology; Polysaccharides; Streptococcus pneumoniae; Teeth; Vaccination; Vaccines; Zinc; Zinc - blood
• ISSN: 1444-1586; 1447-0594
• DOI: 10.1111/j.1447-0594.2011.00749.x

Aim:  To detect the immunoglobulin M memory B cell population response following vaccination with the 23‐valent pneumococcal polysaccharide vaccine and determine its relation to frailty indices, nutritional status, and serum zinc levels. Methods:  A cross‐sectional study was carried out in the outpatient geriatric clinic, Ain Shams University Hospital. It included 80 community‐dwelling elderly, 32 male and 48 female. Each participant underwent vaccination with the 23‐valent pneumococcal polysaccharide vaccine, comprehensive geriatric assessment, nutritional assessment with the DETERMINE check list, frailty indices assessment, and serum zinc level measurement. The percentage of immunoglobulin M memory B cells was evaluated before and 4 weeks after vaccination. Immune response was calculated as the difference between cell percentage before and after vaccination. Results:  Before the vaccination, the immunoglobulin M memory B cell percentage was significantly lower among those eating fewer than two meals a day and taking three or more drugs a day; after vaccination significance was observed among those with tooth or mouth problems that make eating difficult. Immune response was significantly lower among those with tooth or mouth problems (P < 0.001), weight loss (P < 0.001), shrinking (P = 0.001), poor endurance (P = 0.04), multiple comorbidities (P = 0.013), and cognitive impairment (P = 0.001). Participants with immune response ≥10% showed significantly higher serum zinc levels compared to those with immune response <10% of increase in cell percentage. Conclusion:  Poor nutritional status, frailty and a lower zinc level impair the immunological response of elderly individuals. Geriatr Gerontol Int 2012; 12: 223–229.