2002/12/01 by David V. Shatz, Sandra Romero‐Steiner, Sandra Romero-Steiner +4 · 75 citations
Medicine · Veterinary · #Abdominal Trauma and Injuries #Animal health and immunology #Antibiotics #Antibody #Antibody response #Antibody titer #Biology #Gastroenterology #Immunization #Immunoglobulin G #Immunology #Medicine #Microbiology #Pneumococcal polysaccharide vaccine #Pneumococcal vaccine #Pneumonia and Respiratory Infections #Serotype #Spleen #Splenectomy #Streptococcus pneumoniae #Titer #Vaccination
paper · doi:10.1097/00005373-200212000-00001
published in The Journal of Trauma: Injury, Infection, and Critical Care 53(6), 1037-1042 (Lippincott Williams & Wilkins)
openalex publication_date 2002/12/01 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/30
BACKGROUND: We have previously demonstrated, using functional antibody assays, that patients undergoing splenectomy for trauma exhibit a better response to pneumococcal immunization when vaccinated at 14 days postoperatively versus 1 or 7 days. However, patients immunized at 14 days failed to reach the response of normal controls. This study was conducted to determine whether even later immunization would improve the antibody response. METHODS: Forty surviving patients undergoing emergent splenectomy were randomized to receive Pneumovax at 14 or 28 days after splenectomy. Blood samples were drawn at the time of vaccination (prevaccination) and 4 weeks later (postvaccination). A control group of 24 healthy adults was used for comparison. Antibody titers to four of the most common serotypes were determined by enzyme-linked immunosorbent assay and opsonophagocytic assay (OPA). RESULTS: Samples from 38 patient were analyzed. Each serotype and each group tested demonstrated a statistically significant increase in geometric mean enzyme-linked immunosorbent assay immunoglobulin G antibody concentration (microg/mL) and OPA titer (1/dilution) after vaccination. There were no statistically significant differences (p >or= 0.07) in the immunoglobulin G antibody concentrations and OPA titers between the 14-day or the 28-day study groups when compared with normal healthy adults regardless of the serotype tested. In addition, there were no differences in the antibody responses between the 14-day and the 28-day study groups. CONCLUSION: Despite our previous study suggesting that delay in vaccination after emergent splenectomy resulted in improved antibody response, antibody response was not improved any further by delaying vaccination to 28 days.