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http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12558722&dopt=Abstract

 

J Am Geriatr Soc 2003 Feb;51(2):240-5

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Pneumococcal polysaccharide revaccination: immunoglobulin g seroconversion, persistence, and safety in frail, chronically ill older subjects.

Lackner TE, G Hamilton R, J Hill J, Davey C, Guay DR.

Institute for the Study of Geriatric Pharmacotherapy, College of Pharmacy, University of Minnesota, Minneapolis, Minnesota 55455, USA. lackn001@umn.edu

OBJECTIVES: To determine the 1-month postpneumococcal polysaccharide-revaccination immunoglobulin G (IgG) antibody response, its persistence at 1 year, and tolerability of revaccination in frail, chronically ill older nursing facility residents. DESIGN: Prospective study conducted between December 1998 and July 2000. SETTING: Six skilled nursing facilities in the Minneapolis-St. Paul, Minnesota, metropolitan area. PARTICIPANTS: Sixty-seven subjects aged 65 and older having received primary vaccination with pneumococcal polysaccharide vaccine (PPV) at least 5 years before enrollment. INTERVENTION: Revaccination with one dose of 23-valent PPV. MEASUREMENTS: Adverse events and concentrations of seven individual pneumococcal polysaccharide type-specific IgG antibodies (against serotypes 4, 6B, 9V, 14, 18C, 19F, 23F) and their aggregate before and 1 and 12 months after revaccination. RESULTS: A significant increase in all individual and aggregate median antibody concentrations over baseline was observed 1 month after revaccination. However, after 1 year, the increase remained significant only for serotypes 6B and 18C and the aggregate parameter. One month after revaccination, the mean increase in antibody concentration over baseline was significantly greater than 1.4-fold for six of the seven serotypes and the aggregate. However, the increase was not significantly greater than 1.4 at 1 year for any of the serotypes or the aggregate. Minor, self-limited localized adverse reactions and systemic reactions occurred in 11.3% of the subjects. CONCLUSIONS: In frail, chronically ill older nursing facility residents, revaccination with 23-valent PPV at least 5 years after primary vaccination (whether primary vaccination occurred before or after age 65) is associated with a significant, albeit brief, immunological response for most of the serotypes tested. Revaccination was well tolerated.

PMID: 12558722 [PubMed - in process]

http://www.mercola.com/2003/feb/26/pneumonia_vaccine.htm

COMMENT By Dr. Sherri Tenpenny:

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(Sherri J. Tenpenny, D.O. is a nationally renowned and respected vaccine expert. In August 2002, I hosted a timely and important teleconference featuring Dr. Tenpenny to discuss the real dangers of vaccines and how you can legally avoid them. "The Danger of Vaccines, and How You Can Legally Avoid Them" audiotape, a professionally recorded 90-minute cassette available in my "Recommended Products" section, presents that full conference.)

The first pneumococcal polysaccharide vaccine for adults was released in the 1940s but was withdrawn from the market on the assumption that penicillin and sulfonamide drugs would eradicate pneumococcal disease. When this proved to be untrue, the 23-valent (antigen) vaccines were re-licensed, and widespread use began in 1980. The two vaccines administered to adults in the United States today are Pneumovax 23 (produced by Merck) and Pnu-Immune 23 (produced by Wyeth-Lederle).

Pneumococcal disease is caused by a type of bacteria called Streptococcus pneumoniae and more than 90 different serotypes, or “cousins,” to this bacteria exist. The bacteria can cause pneumonia, can invade the bloodstream (bacteremia) and, rarely, can cause meningitis. The 23 strains that most frequently cause disease have been isolated and a tiny portion of cell wall from each bacterium is extracted to form the vaccine. This cell wall “piece” is called an antigen. Each antigen constitutes a single vaccine because it stimulates a unique antibody response.

Therefore, a single injection of Pnuemovax or Pnu-Immune is the equivalent of receiving 23 different vaccines at one time. This antigen load is delivered directly into the blood stream and causes quite a jolt to the immune system since the “normal” way that this type of bacteria enters the body is through the nasal passages and lungs.

Since their initial release, the 23-valent “pneumonia” vaccines have been given to persons aged 50 years and older, and until recently a single dose was considered to provide “lifetime coverage.” Ongoing research has determined that the vaccine’s antigens stimulate mature B lymphocytes to produce antibodies, but the antigens have no effect on the T lymphocytes, the work-horses of the TH-1 pathways.

Without the TH-1 portion of the immune system being involved, the effect of the vaccine will not be long lasting.[1] This is a serious problem with all vaccines and the reason why none of them provide lifetime immunity.

In the last three years, “pneumonia vaccine booster” protocols have been developed to encourage revaccination of the elderly. It now appears that the vaccine will be recommended for annual use. Why is this being suggested? Is there any evidence that the incidence in pneumococcal disease has increased over the last 10 years?

We gave a vaccine that at one time supposedly provided lengthy protection. If it really wasn’t working, wouldn’t there have been an increased incidence in pneumonia and meningitis in the elderly, suggesting that we needed more vaccinations? I can find no evidence of this in the medical literature. Therefore, is it really necessary to give this vaccine at all?

The nation's Healthy People 2000 goals for pneumococcal vaccine state that 60 percent of persons aged 65 years and older should receive the vaccine. [2] According to the 2000 Census Bureau statistics, there were 56 million people aged 55 and older living in the United States at that time, and that number is anticipated to grow to nearly 80 million by the year 2030.[3]

Let’s do the math: 56 million x 60 percent x $14 (AWP/dose[4])--and that doesn’t include European sales. That’s a lot of money, especially for something that is ineffective at best and at worst unnecessary.

References

[1] Richard Kent Zimmerman, MD, MPH. et.al. Routine Vaccines Across the Life Span, 2001. J of Fam. Pr. Oct. 2001,Vol. 50, No. 10.

[2] 138. US Department of Health and Human Services, Public Health Service: Healthy People 2000. Washington, DC, Government Printing Office, 1990

[3] http://www.census.gov/ population/ www/socdemo/ age/ppl-147.html

[4] AWP=Average Wholesale Price. List of Immunizing Agents and Average Wholesale Prices for 2002. PA Bulletin Doc. No. 02-1897. http:// www.medscape.com/ content/ 2002/00/44/19/ 441921/441921_tab.html

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ALL INFORMATION, DATA, AND MATERIAL CONTAINED, PRESENTED, OR PROVIDED HERE IS FOR GENERAL INFORMATION PURPOSES ONLY AND IS NOT TO BE CONSTRUED AS REFLECTING THE KNOWLEDGE OR OPINIONS OF THE PUBLISHER, AND IS NOT TO BE CONSTRUED OR INTENDED AS PROVIDING MEDICAL OR LEGAL ADVICE.  THE DECISION WHETHER OR NOT TO VACCINATE IS AN IMPORTANT AND COMPLEX ISSUE AND SHOULD BE MADE BY YOU, AND YOU ALONE, IN CONSULTATION WITH YOUR HEALTH CARE PROVIDER.