Long-term Immunogenicity and Boostability of the 13-valent Pneumococcal Conjugate Vaccine Followed by the 23-valent Pneumococcal Polysaccharide Vaccine in Adults Receiving Immunosuppressive Therapy and Adults With HIV—3-year Follow-up of a Prospective Cohort Study
Bibliographic record
Abstract
BACKGROUND: The long-term immunogenicity of the 13-valent pneumococcal conjugate vaccine (PCV13) followed by the 23-valent pneumococcal polysaccharide vaccine (PPSV23) remains unclear among immunocompromised patients (ICPs). METHODS: This 3-year follow-up of a previously reported prospective cohort study included people with human immunodeficiency virus (HIV) (PWH), patients on immunosuppressive therapy, and immunocompetent controls who received PCV13 followed by PPSV23 2 months later. IgG levels for all 24 vaccine serotypes were measured 3 years after PCV13 (M36). The primary outcome was the seroprotection rate (SPR) at M36, defined as IgG concentrations ≥1.3 μg/mL for 17/24 vaccine serotypes. To assess immunological memory, we measured rapid recall responses 7 days after a PCV20 booster vaccination among initial responders 2 months after the priming schedule (M4) who had sero-reverted at M36. RESULTS: Between M4 to M36, SPRs dropped from 44% (22/50) to 9% (5/55) in PWH, from 55% (59/108) to 17% (22/131) in patients on immunosuppressive therapy and from 82% (14/17) to 42% (8/19) in controls. Rapid recall responses were observed in 40% (4/10) of PWH, 14% (2/14) of patients on immunosuppressive monotherapy, 22% (2/9) of patients on combination therapy, and 67% (2/3) of controls. Antibody levels increased significantly for 7/13 PCV20/PCV13-shared serotypes, but for none (0/7) of the PCV20/PPSV23-shared serotypes. CONCLUSIONS: Only a minority of PWH and patients on immunosuppressive therapy and under half of controls remained seroprotected 3 years after vaccination. As rapid recall responses were limited to PCV serotypes, future research in ICPs should focus on expanded priming schedule with higher-valent PCVs such as PCV20.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".