Immunization of renal transplant recipients with pneumococcal polysaccharide vaccine

Background: Streptococcus pneumoniae, a common pathogen leading to pneumoni a, is a cause of morbidity and mortality in immunosuppressed patients. Vacc ination against this agent can be recommended for immunosuppressed patients , including those with chronic renal failure, nephrotic syndrome and renal transplant recipients; however, a diminished immune response and loss of pr otective antibodies have been observed. Patients and methods: In our prospective study, the efficacy and side effec ts of polyvalent pneumococcal vaccination were investigated in renal transp lant recipients. A total of 21 patients (6 female, 15 male) with well-funct ioning renal allografts, who had transplant surgery at least 2 months befor e, were included in the study. The patients were stratified according to th e immunosuppressive protocol and 8 received double, while 13 received tripl e, immunosuppresive agents. After obtaining basal serum samples, all cases were vaccinated with the 0.5 mt intramuscular administration of polyvalent polysaccharide pneumococcal Vaccine (Pneumo 23 Pasteur-Merieux, lot No: K 1 131). Results: Following a mean of 6 wk in all patients and also a mean of 12 wk in 12 patients, serum samples were again obtained to measure pneumococcal a ntibodies. Antibody titers following 6 and 12 wk of vaccination were signif icantly higher, as compared with basal values in all patients, except one. These titers did not show any statistically significant difference between double and triple therapies. There was no significant difference between th e 12th and 6th wk postvaccination antibody titers. No systemic or local adv erse effects were observed. Conclusion: Pneumococcal vaccination is safe and effective in patients with well-functioning renal allografts, at least in the short term. This vaccin ation policy may be useful for preventing invasive pneumococcal disease in immunosuppressed patients.