Evaluation of effectiveness, safety and cost-benefit of the 23- valent pneumococcal capsular polysaccharide vaccine for HIV-Infected patients

Xiaobai Zou; Jianmei He; Jun Zheng; Mengran Liang; Jinjin Gao; Jianwen Huang; Yang Jiang; Yonglin Jiang; Xi Chen

doi:10.1016/j.vaccine.2021.11.058

Evaluation of effectiveness, safety and cost-benefit of the 23- valent pneumococcal capsular polysaccharide vaccine for HIV-Infected patients

Vaccine. 2022 Jan 3;40(1):37-42. doi: 10.1016/j.vaccine.2021.11.058. Epub 2021 Nov 29.

Authors

Xiaobai Zou¹, Jianmei He¹, Jun Zheng¹, Mengran Liang², Jinjin Gao³, Jianwen Huang⁴, Yang Jiang¹, Yonglin Jiang⁵, Xi Chen⁶

Affiliations

¹ Hunan Provincial Center for Disease Control and Prevention, No.450 Section 1 Furongzhong middle Road, Kaifu District, Changsha, Hunan 410005, China.
² University of South China, No. 28, Changsheng West Road, Hengyang City, Hunan 421001, China.
³ Hengyang City Center for Disease Control and Prevention, No.138 Hengchang Road, Chengnan District, Hengyang, Hunan 421001, China.
⁴ Lanshan County Center for Disease Control and prevention, No.50 Xinmin Road, Lanshan County, Hunan 425800, China.
⁵ Yongzhou City Center for Disease Control and Prevention, No. 159 Chezhan Road, Lengshuitan District, Yongzhou, Hunan 425000, China.
⁶ Hunan Provincial Center for Disease Control and Prevention, No.450 Section 1 Furongzhong middle Road, Kaifu District, Changsha, Hunan 410005, China. Electronic address: Chenxi@hncdc.com.

PMID: 34857419
DOI: 10.1016/j.vaccine.2021.11.058

Abstract

Introduction: Due to the lack of understanding of the protective effects and safety of 23-valent pneumococcal polysaccharide vaccine (PPV23) in immune-deficient populations, the vaccination rate of PPV23 among HIV-infected patients is still very low in China. The main objectives of this study were to determine whether the efforts to assess measures for the prevention of pneumococcal pneumonia are still worthwhile, and provide designated vaccination program of HIV-infected persons for government policy based on.

Methods: 60 HIV-infected adults in Lanshan county who had never been vaccinated with any pneumococcal vaccine were enrolled in this study, voluntary vaccination of PPV23 and One-year follow-up after vaccination can be completed.

Result: 76.67% patients (46/60) had serologic response at 12 months after vaccine, CD4 count(≤500 cells/ul or > 500 cells/ul) and Month from diagnosis to first antiviral therapy (≤1 month or > 1 month) were related to antibody responses (p < 0.05).In this study, PPV23 was well tolerated, no adversereaction was reported.11 Streptococcus pneumoniae pneumonia (9.17%,11/120) occurred in the Unvaccinated group and 1 case(1.67%,1/60)in the vaccination group within one year after vaccination(Fisher's exact probability, P = 0.225). The VE was 81.79%. The per capita benefit was 39.32 dollars, thebenefit-costratio = 1.19. There are significant statistical differences between the vaccinated group and the non-vaccinated group in outpatient costs (p < 0.05, 95 %CI: 9.29-32.11), Medicine costs (p = 0.017, 95 %CI: 2.47-24.44), and disease related indirect costs (p = 0.038, 95 %CI: 0.93-33.63) within one year of vaccination.

Conclusion: Our study results showed that PPV23 can be safely and effectively administered to HIV-1 infected individuals and effectively preventing Streptococcal pneumonia. 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.

Keywords: 23-valent pneumococcal polysaccharide vaccine; HIV; Pneumococcal pneumonia; Streptococcus pneumoniae.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

CD4 Lymphocyte Count
HIV Infections* / complications
Humans
Pneumococcal Infections* / prevention & control
Pneumococcal Vaccines / adverse effects
Pneumonia, Pneumococcal*
Polysaccharides
Vaccination

Substances

Pneumococcal Vaccines
Polysaccharides