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Impaired long-term immune protection following pneumococcal 13-valent/23-valent polysaccharide vaccine in systemic lupus erythematosus (SLE)
  1. Karim Sacre1,2,3,
  2. Tiphaine Goulenok1,
  3. Mathilde Bahuaud4,
  4. Chrystel Francois1,
  5. Marie Claude Van der Haegen1,
  6. Jean-François Alexandra1,
  7. Pierre Aucouturier5,
  8. Maria Hurtado-Nedelec1,6,
  9. Helene Moins-Teisserenc7,
  10. Frédéric Batteux4,
  11. Thomas Papo1,2,3
  1. 1Département de Médecine Interne, Université Paris Diderot, PRES Sorbonne Paris Cité, Assistance Publique Hôpitaux de Paris, Paris, France
  2. 2Centre de Recherche sur l’Inflammation, INSERM U1149, Paris, France
  3. 3Département Hospitalo-Universitaire FIRE (Fibrosis, Inflammation and Remodelling in Renal and Respiratory Diseases), Assistance Publique Hôpitaux de Paris, Paris, France
  4. 4Plateforme d’Immunomonitoring Vaccinal, Laboratoire d’Immunologie, Groupe hospitalier Cochin-Broca-Hotel Dieu, Assistance Publique Hôpitaux de Paris, Paris, France
  5. 5Centre de Recherche Saint-Antoine, INSERM/UMR S938, Université Pierre et Marie Curie, Paris, France
  6. 6Département d’Hématologie et d’Immunologie, Hôpital Bichat, Université Paris Diderot, PRES Sorbonne Paris Cité, Assistance Publique Hôpitaux de Paris, Paris, France
  7. 7Laboratoire d’Immunologie-Histocompatibilité et, INSERM UMR-1160, Institut Universitaire d’Hématologie, Hôpital Saint-Louis, Université Paris Diderot, PRES Sorbonne Paris Cité, Assistance Publique Hôpitaux de Paris, Paris, France
  1. Correspondence to Professor Karim Sacre, Department of Internal Medicine, Bichat Hospital, APHP, Paris 75018, France; karim.sacre{at}bch.aphp.fr

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Although patients with systemic lupus erythematosus (SLE) are at increased risk for Streptococcus pneumoniae infection,1 2 vaccination coverage remains dramatically low in SLE,3 and efficacy of the now recommended prime-and-boost strategy using 13-valent pneumococcal conjugate vaccine (PCV13) and 23-valent pneumococcal polysaccharide vaccine (PPSV23) is not known.

Consecutive patients with SLE admitted in our daycare hospital unit were prospectively enrolled to receive PCV13 followed by PPSV23 8 weeks later. Immune protection, defined by an antigen-specific IgG concentration ≥1.3 µg/mL for at least 70% of seven pneumococcal serotypes (4, 6B, 9V, 14, 18C, 19F and 23F), was assessed at baseline, 2 and 12 months. Patients were defined as ‘long-term protected (LTP)’ when seroconversion was observed 2 months and 12 months after PCV13 shot. Patients were considered ‘short-term protected (STP)’ when seroconversion was observed 2 months but no more at 12 months after PCV13 shot. Patients were ‘not protected (NP)’ when seroconversion occurred neither 2 months nor 12 months after PCV13 shot. Laboratory tests included the analysis of blood …

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