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SUPPORT FOR PNEUMOCOCCAL REVACCINATION AFTER SIX YEARS.

Pneumococcal vaccine is recommended for all people over age 65 and for anyone over age 2 with immunodeficiency or chronic conditions that increase the risk for infection. Antibody levels wane significantly within six years after vaccination, necessitating revaccination of high-risk patients. This interesting study evaluated immunogenicity associated with revaccination.

The subjects were from rural Northwest Alaska, where the rate of pneumococcal disease is higher than elsewhere in the U.S. Twenty-six adults who had received pneumococcal vaccine 5.5 to 9 years before (mean, 7.4 years) were matched with 26 previously unvaccinated adults by age, number of chronic diseases, sex, and ethnicity. The previously vaccinated subjects had low serotype-specific antibody levels as compared with unvaccinated subjects. All subjects received intramuscular pneumococcal vaccine and had their antibody levels retested 20 to 84 days later. Antibody levels increased at least 1.4-fold in about 55 percent of both groups.

Comment: Although small, this study provides immunologic evidence to support recent recommendations for revaccination with pneumococcal vaccine after six years in people with high-risk chronic conditions.

— CD Mulrow

Published in Journal Watch General Medicine October 18, 1994

Citation(s):

Davidson M et al. Immunogenicity of pneumococcal revaccination in patients with chronic disease. Arch Intern Med 1994 Oct 10 154 2209-2214.

• Medline abstract (Free)