Immunogenicity of the 23-Valent Polysaccharide Pneumococcal Vaccine in Children with Idiopathic Nephrotic Syndrome

Background Due to secondary immunodeficiency, idiopathic nephrotic syndrome in children increases the risk of invasive pneumococcal disease. This study compares pneumococcal vaccine antibody responses in children with idiopathic nephrotic syndrome to healthy controls. We also investigated the effects of relapse frequency and corticosteroid dose on antibody levels in children with idiopathic nephrotic syndrome. Methods The study included 30 children with corticosteroid-responsive minimal change nephrotic syndrome and 24 healthy children. All children participating in the study were vaccinated with the 23-valent pneumococcal polysaccharide vaccine. Results Positive vaccine response (at least a 2-fold increase in polysaccharide anti-pneumococcal IgG titers) rates and the titer change rates were similar between patients and healthy subjects. Moreover, the rates of a four-fold increase were comparable between the two groups. Additionally, relapse rate and corticosteroid doses in patients did not impact pre- and post-vaccination antibody titers. No adverse events were observed during the study. Conclusions The 23-valent pneumococcal polysaccharide vaccine is safe and elicits a robust immune response in children with idiopathic nephrotic syndrome, comparable to that of healthy children. The response also was unaffected by disease relapses or cumulative corticosteroid dose. Larger cohorts and antibody protection duration are needed for the vaccine response investigation.