Streptococcal Pneumonia Vaccine Administration Safe, Effective in Patients With HIV

The 23-valent pneumococcal polysaccharide vaccine (PPV23) offered significant protection against pneumococcal pneumonia in patients with human immunodeficiency virus (HIV) in a patient cohort in China, according to study findings published online ahead of print in the journal Vaccine.

“Due to the lack of understanding of the protective effects and safety of PPV23 in immune-deficient populations, the vaccination rate of PPV23 among HIV-infected patients is still very low in China,” researchers wrote. “Our study results showed that PPV23 can be safely and effectively administered to HIV-1 infected individuals, effectively preventing Streptococcal pneumonia.”

The study included 60 adults with HIV without any pneumococcal vaccination who volunteered for vaccination with PPV23. Researchers compared patients over 1 year of follow-up with an unvaccinated control group of 120 adults with HIV.

Twelve months after vaccination, 76.67% of patients in the vaccination cohort achieved serologic response to PPV23, according to the study. The odds of having antibody responses were 20.77 times higher for patients with CD4 counts above 500 cells per cubic millimeter of blood compared with patients with lower CD4 cell counts. Patients who received antiviral therapy within 1 month of diagnosis were 11.92 times more likely to have serological antibody response compared with those who received antiviral therapy later.

Just a single patient in the vaccination group had a confirmed case of pneumococcal pneumonia within 12 months of vaccination compared with 11 patients in the unvaccinated group, the study found. The vaccine effectiveness was 81.79%.

PPV23 vaccination reduced pneumonia-related outpatient costs, treatment costs, and indirect costs. Researchers reported a per-capita benefit of $39.32 and a benefit-cost ratio of 1.19.

“Considering the cost-benefit of vaccination among HIV-infected persons, as it has been reported in our study, it is necessary to promote the widespread use of the vaccine among HIV-infected persons in the future,” researchers advised.

Reference:
Zou X, He J, Zheng J, et al. Evaluation of effectiveness, safety and cost-benefit of the 23-valent pneumococcal capsular polysaccharide vaccine for HIV-infected patients [published online ahead of print November 29, 2021]. Vaccine. 2021;S0264-410X(21)01532-2. doi:10.1016/j.vaccine.2021.11.058