Pneumococcal serotype-specific cut-offs based on antibody responses to pneumococcal polysaccharide vaccination in healthy adults

• Published in: Vaccine Vol. 39; no. 21; pp. 2850 - 2856
• Main Authors: Park, Miguel A., Jenkins, Sarah M., Smith, Carin Y., Pyle, Regan C., Sacco, Keith A., Ryu, Euijung, Hagan, John B., Joshi, Avni Y., Snyder, Melissa R., Abraham, Roshini S.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 18.05.2021; Elsevier Limited
• Subjects: Adults; Allergy and Immunology; Antibodies; antibody formation; Antibody response; Antigens; diagnostic techniques; Humoral immunodeficiency; IgG antibody; Immunoglobulin G; Immunology; immunosuppression; Multiplex bead analysis; Pneumococcal; Pneumococcal conjugate vaccine; Pneumococcal polysaccharide vaccine; Pneumovax; Polysaccharides; Prevnar; Primary immunodeficiency; Serotype; Serotypes; Streptococcus infections; Streptococcus pneumoniae; Testing laboratories; Vaccination; Vaccines; United States > US; Pneumococcal conjugate vaccine; PCV; Multiplex bead analysis; Pneumovax; PID; IEI; Prevnar; Antibody response; Primary immunodeficiency; Pneumococcal; Pneumococcal polysaccharide vaccine; PPV; Humoral immunodeficiency; Serotype; primary immunodeficiencies; inborn errors of immunity
• DOI: 10.1016/j.vaccine.2021.04.015
• ISSN: 0264-410X; 1873-2518

•IgG pneumococcal antibodies assessed in healthy pneumococcal-naïve adults.•Serotype-specific thresholds defined to pneumococcal polysaccharide vaccination.•The serotype-cutoffs is used for interpretation of pneumococcal antibody responses.•It may be useful in patients with humoral immunodeficiencies or other contexts. Antibody responses to pneumococcal polysaccharide vaccination are frequently used as a diagnostic tool for humoral immunodeficiencies, part of the larger collection of inborn errors of immunity. Currently, arbitrary criteria, such as a serotype specific titer of >/= 1.3 µg/mL is most often used as a cut-off for interpretation of pneumococcal antibody responses. The magnitude of the antibody response to each of the 23 serotypes in Pneumovax®, and serotype-specific cut-offs in healthy pneumococcal vaccine-naïve adults has not been previously characterized. IgG antibody concentrations were measured prospectively for 23 pneumococcal serotypes pre and 4–6 weeks post-Pneumovax® vaccination in 100 healthy adults, using a multiplex bead-based assay. Antibodies to 19 of 23 serotypes were informative for distinguishing subjects who responded to vaccination, and the serotype threshold was determined to be 9 of 19 serotypes, which characterized an antibody response to pneumococcal vaccination. While this study may facilitate classification of IgG serotype-specific antibody responses post-pneumococcal vaccination in adult patients undergoing diagnostic immunological evaluation for antibody immunodeficiencies or other relevant contexts, additional studies in healthy children and S. pneumoniae protein-conjugate-vaccinated healthy adults will need to be undertaken in the future.