TY - JOUR
T1 - Clinical Effectiveness of Conjugate Pneumococcal Vaccination in Hematopoietic Stem Cell Transplantation Recipients
AU - Roberts, Matthew B.
AU - Bak, Narin
AU - Wee, Li Yan A.
AU - Chhetri, Rakchha
AU - Yeung, David T.
AU - Lewis, Ian
AU - Hiwase, Devendra K.
N1 - Funding Information:
The authors thank Emma Pontifex, Clinical Nurse, Cancer Outpatients, Royal Adelaide Hospital. Financial disclosure: Supported by the Royal Adelaide Hospital Research Fund. Conflict of interest statement: There are no conflicts of interest to report. Authorship statement: M.R. designed the study, collected and analyzed data, and wrote the manuscript; A.W. analyzed data and edited the manuscript; R.C. collected data; D.Y. designed the study and edited the manuscript; I.L. designed the study and edited the manuscript; N.B. designed the study and edited the manuscript; and D.H. designed the study, analyzed data, and edited the manuscript. Financial disclosure: See Acknowledgments on page 426.
Funding Information:
The authors thank Emma Pontifex, Clinical Nurse, Cancer Outpatients, Royal Adelaide Hospital. Financial disclosure: Supported by the Royal Adelaide Hospital Research Fund. Conflict of interest statement: There are no conflicts of interest to report. Authorship statement: M.R. designed the study, collected and analyzed data, and wrote the manuscript; A.W. analyzed data and edited the manuscript; R.C. collected data; D.Y. designed the study and edited the manuscript; I.L. designed the study and edited the manuscript; N.B. designed the study and edited the manuscript; and D.H. designed the study, analyzed data, and edited the manuscript.
PY - 2020/2
Y1 - 2020/2
N2 - Hematopoietic stem cell transplantation (HSCT) recipients are vulnerable to invasive pneumococcal disease (IPD), with reported IPD rates ranging from 3.81 to 22.5/1000 HSCT. This IPD risk could relate to immunodeficiency, low vaccination uptake, and poor immunogenicity of pneumococcal polysaccharide vaccine (PPV). Literature comparing the clinical effectiveness of pneumococcal conjugate vaccination (PCV) and PPV after HSCT is limited. In this retrospective analysis of HSCT recipients at our center from 2004 to 2015, we evaluated vaccination uptake and compared IPD rates in patients receiving PPV (pre-2010 group) and PCV (post-2010 group). IPD was determined from microbiological results for all HSCT recipients from January 2004 to June 30, 2019. Eight hundred patients had a total of 842 HSCT events, including autologous HSCT (auto-HSCT; n = 562) and allogeneic HSCT (allo-HSCT; n = 280). More than 90% of the HSCT recipients were enrolled, and >93% of surviving HSCT recipients completed the vaccination protocol. Fifteen IPD episodes occurred in 13 patients between 2004 and June 30, 2019. Thirteen episodes occurred in the pre-2010 group, even though 9 of 13 (69%) serotyped isolates were covered by PPV. Two episodes occurred in the post-2010 group; neither serotype was covered by PCV. Thus, with PCV introduction, IPD rate was significantly reduced from 38.5/1000 unique HSCTs pre-2010 to 4.0/1000 unique HSCTs post-2010 (P <. 001). A significant reduction was seen in both auto-HSCTs (from 29.4 to 3.1 /1000 unique auto-HSCTs; P =. 011) and allo-HSCTs (from 58.3 to 5.6/1000 unique allo-HSCTs; P =. 011). PCV demonstrated superior clinical effectiveness over PPV, highlighting its importance in preventing infectious complications after HSCT. Robust vaccination programs at transplantation centers are needed to optimize vaccination uptake and completion.
AB - Hematopoietic stem cell transplantation (HSCT) recipients are vulnerable to invasive pneumococcal disease (IPD), with reported IPD rates ranging from 3.81 to 22.5/1000 HSCT. This IPD risk could relate to immunodeficiency, low vaccination uptake, and poor immunogenicity of pneumococcal polysaccharide vaccine (PPV). Literature comparing the clinical effectiveness of pneumococcal conjugate vaccination (PCV) and PPV after HSCT is limited. In this retrospective analysis of HSCT recipients at our center from 2004 to 2015, we evaluated vaccination uptake and compared IPD rates in patients receiving PPV (pre-2010 group) and PCV (post-2010 group). IPD was determined from microbiological results for all HSCT recipients from January 2004 to June 30, 2019. Eight hundred patients had a total of 842 HSCT events, including autologous HSCT (auto-HSCT; n = 562) and allogeneic HSCT (allo-HSCT; n = 280). More than 90% of the HSCT recipients were enrolled, and >93% of surviving HSCT recipients completed the vaccination protocol. Fifteen IPD episodes occurred in 13 patients between 2004 and June 30, 2019. Thirteen episodes occurred in the pre-2010 group, even though 9 of 13 (69%) serotyped isolates were covered by PPV. Two episodes occurred in the post-2010 group; neither serotype was covered by PCV. Thus, with PCV introduction, IPD rate was significantly reduced from 38.5/1000 unique HSCTs pre-2010 to 4.0/1000 unique HSCTs post-2010 (P <. 001). A significant reduction was seen in both auto-HSCTs (from 29.4 to 3.1 /1000 unique auto-HSCTs; P =. 011) and allo-HSCTs (from 58.3 to 5.6/1000 unique allo-HSCTs; P =. 011). PCV demonstrated superior clinical effectiveness over PPV, highlighting its importance in preventing infectious complications after HSCT. Robust vaccination programs at transplantation centers are needed to optimize vaccination uptake and completion.
KW - Hematopoietic stem cell transplantation
KW - Invasive pneumococcal disease
KW - Pneumococcal vaccines
UR - https://www.scopus.com/pages/publications/85076545874
U2 - 10.1016/j.bbmt.2019.10.006
DO - 10.1016/j.bbmt.2019.10.006
M3 - Article
C2 - 31627016
AN - SCOPUS:85076545874
SN - 1083-8791
VL - 26
SP - 421
EP - 427
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
IS - 2
ER -