TABLE 1

Summary of trials demonstrating PPV23-related immune hyporesponsiveness

Study(ies)CountryVaccination schedulePopulationNo. of patientsSummary of findings
Sigurdardottir et al. (2014) (59)IcelandPCV9/PCV9/PCV13Children 7.5 yrs old39PPV23 vaccination of toddlers attenuated the subsequent response to PCV13
PCV9/PPV23/PCV1350
Papadatou et al. (2014) (60)GreecePCV13Asplenic adults with β-thalassemia39Prior history of PPV23 vaccination attenuated the response to PCV13 in a dose- and time-dependent manner
1–4 PPV23 doses given prior to the study
Clutterbuck et al. (2012) (62); Lazarus et al. (2011) (61)United KingdomPPV23-PCV7-PCV7Adults 50–70 yrs old116Prior vaccination with PPV23 attenuated the response to subsequent vaccination with PCV7
PCV7-PPV23-PCV7116
PCV7-PCV7-PPV23116
Russell et al. (2010) (63)Fiji1–3 PCV7 doses/mPPV23aInfants276The response to an mPPV23 challenge was lower in children who had received PPV23 at 12 mo of age
1–3 PCV7 doses/PPV23/mPPV23276
Dransfield et al. (2009) (64)United StatesPCV7Adults with COPD57Prior vaccination with PPV23 reduced vaccine responsiveness to either PPV23 or PCV7
PPV2363
1–4 PPV23 doses given prior to the study
Orthopoulos et al. (2009) (65)GreecePCV7/PPV23/PPV23Asplenic adults with β-thalassemia17Multiple PPV23 doses induced hyporesponsiveness for some serotypes
PCV7/PCV7/PPV2318
0–3 PPV23 doses given before the study
Musher et al. (2008) (66)United StatesPCV7/PPV23Adults who recovered from pneumococcal pneumonia37Prior recent (>1 yr) vaccination with PPV23 attenuated the response to PPV23 and PCV7; the PPV23/PCV7 schedule resulted in lower antibody responses that the PCV7/PPV23 schedule
PPV23/PCV744
PPV23 doses given prior to the study
de Roux et al. (2008) (67)GermanyPCV7/PCV7Adults >70 yrs old43PPV23 used as the primary dose induced hyporesponsiveness
PCV7/PPV2338
PPV23/PCV778
Mufson et al. (1991) (68)United StatesPPV14/PPV23Adults 56–79 yrs old15Antibody levels after revaccination were lower than after primary vaccination
  • a mPPV23, small dose of PPV23.