Medical University of Vienna, Austria
Title: Effectiveness and immunogenicity of pneumococcal vaccination in splenectomized and functionally asplenic patients
Stephanie Plefkagraduated from Medical University of Vienna in 2011 at the age of 25 years. Her research project focused on pneumococcal vaccination in splenectomized patients and was operated at the Department of Internal Medicine I, Division of Infectious Diseases and Tropical Medicine at the Medical University of Vienna. Since 2012 she works as a doctor in training to become a General Practitioner at the Hospital Wilhelminenspital in Vienna.
The purposeofthisstudy was toinvestigate the effectiveness of pneumococcal vaccination, using the 23-valent pneumococcalpolysaccaride vaccine(PPV23) and/orthe 7-valent pneumococcalconjugate vaccine (PCV7), in preventing over whelming post-splenectomyinfection (OPSI) among adult asplenicpatients and patients after splenectomy. Between 1996 and 2009 145 splenectomizedand 2 functionallyasplenicpatientsreceivedeitheroneorbothvaccinations. The maincause of death in 68% oft the 53 patientswhodied was theunderlyinghaemato-oncologicaldisease, followedbysepticshock in 13.2%. In the 94 patientswhowere still aliveafter thisperiod, twelvesufferedfrom post-vaccinecomplications: pneumonia in 9 patients, otitismedia in 2, pneumococcalsepsis in 4. Splenectomizedpatientsvaccinated in thepreviousfiveyears (n=15) showedsignificantlyhigher GMCs (P<0.05) againstserotypes 4,6B,9V,14,18C,19Fand 23F thanthe non-splenectomized non-vaccinatedcontrolgroup (n=34). Patientsvaccinated in thefirst 5 years after splenectomyby PCV7 had strong serologicalresponses. Postvaccinal complications occurred in less than 10% after immunisation, but post-vaccine pneumococcal sepsis was still diagnosed in 3.3% of the splenectomised patients still alive in 2009.
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