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A judicious analysis and comparison of studies on the immunogenicity of pneumococcal vaccine in patients with systemic lupus erythematosus (SLE)1–9 is hampered by wide heterogeneity in several factors, including differences in the immunoassays performed, cut-off levels used as serological correlates of protection, number of individual serotypes as well as types of capsular antigens analysed, response criteria, and SLE-related immunosuppressive treatment. In addition, how to interpret vaccine response when preimmunisation antipneumococcal antibody titres (anti-PnAbs) are already high (or protective) is not yet clear, which is of relevance given that non-immunised adults often have high antibody levels for some serotypes as a result of prior pneumococcal infections. Moreover, only a minority of individuals with high prevaccination anti-PnAbs are reportedly capable of mounting a ≥4-fold rise in …
Handling editor Josef S Smolen
Contributors RPR and EMK conceived and designed the study, analysed the data and drafted the manuscript. LECA reviewed the manuscript and contributed to the intellectual content of the article.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent for publication Not required.
Ethics approval Hospital Universitário Pedro Ernesto.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement No additional data available.
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