ABSTRACT
Smoldering multiple myeloma (SMM) is an asymptomatic clonal plasma cell disorder that frequently progress to multiple myeloma (MM), a disease at high risk of pneumococcal infections. Moreover, if the polysaccharide vaccine is poorly immunogenic in MM, the 13-valent conjugated vaccine has never been tested in clonal plasma cell disorders. We evaluated its immunogenicity for 7 serotypes in 20 patients ≥ 50 years of age with smoldering multiple myeloma (SMM) pre and post routine-vaccination with PCV13. Concentrations of IgG specific for 7 serotypes were measured at baseline, 1, 6, and 12 months after vaccination by standardized ELISA and an Opsonophagocytic Assay (OPA). The primary endpoint was the proportion of patients responding to at least 5 of the 7 serotypes by ELISA at one month. At 1 month post vaccination, 12 patients (60%) were responders by ELISA, among whom 8 were also responders by OPA. At 6 months, 6 (30% of total) of the 12 responders had persistent immunity, and only 2 (10% of total) at 12 months. These results suggested a partial response in this population and a rapid decrease in antibody levels in the first months of vaccination. Although one injection of the 13-valent pneumococcal conjugate vaccine is immunogenic in some patients with SMM, the response is transient. Repeated injections are likely to be needed for effective and sustained protection.
ABSTRACT
Meningococcal vaccines in france. In France in 2015, several vaccines against invasive meningococcal disease (IMD) are available: non-conjugated polysaccharide vaccines (bivalent AC and tetravalent ACYW135) conjugate vaccines (monovalent A monovalent C and quadrivalent ACYW135) and a novel multicomponent meningococcal B vaccine. These vaccines have a very satisfactory safety profile. Currently in France, universal vaccination against serogroup C meningococcal disease is recommended for all infants at the age of 12 months with catch up till the age of 24 years. Vaccination against IMD B and C are also recommended to persons with specific individual risk factors (mainly asplenia, complement deficiency, hematopoietic stem cells) or travel in endemic areas. Despite recommendations, vaccination coverage remains below recommended levels in most of the targeted populations.
Vaccination antiméningococcique en france. En France en 2015, plusieurs vaccins contre les infections invasives à méningocoques (IIM) sont disponibles : des vaccins polyosidiques non conjugués (bivalent AC et tétravalent ACYW135), des vaccins conjugués (monovalent C et tétravalent ACYW135) et le vaccin protéique contre le méningocoques de sérogroupe B. Tous ces vaccins ont un profil de tolérance très satisfaisant. À l'heure actuelle, en France, une vaccination universelle contre les infections à méningocoque de sérogroupe C est recommandée pour tous les nourrissons à 12 mois avec rattrapage jusqu'à l'âge de 24 ans. Il existe également des recommandations de vaccination contre les infections à méningocoques C et B en fonction de facteurs de risque particuliers (principalement asplénie, déficit en complément, greffe de cellules souches hématopoïétiques) ou de voyage en zone d'endémie. Malgré ces recommandations, la couverture vaccinale reste cependant inférieure aux préconisations dans la plupart des populations ciblées.
Subject(s)
Meningococcal Infections , Meningococcal Vaccines , Neisseria meningitidis, Serogroup C , France , Humans , Infant , Meningococcal Infections/prevention & control , Meningococcal Vaccines/therapeutic use , Vaccines, ConjugateABSTRACT
Bordetella pertussis isolates that do not express pertactin (PRN) are increasing in regions where acellular pertussis vaccines have been used for >7 years. We analyzed data from France and compared clinical symptoms among infants <6 months old infected by PRN-positive or PRN-negative isolates. No major clinical differences were found between the 2 groups.
