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Down Syndrome Abstract
of the Month: May 2007

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Antibody response to pneumococcal capsular polysaccharide vaccine in Down syndrome

Costa-Carvalho BT, Martinez RM, et al.
Braz J Med Biol Res. 2006 Dec;39(12):1587-92.

Disciplina de Alergia, Imunologia Clinica e Reumatologia, Departamento de Pediatria, Escola Paulista de Medicina, Universidade Federal de Sao Paulo, Brazil.

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The majority of children with Down syndrome (DS) tend to have frequent bacterial infections including recurrent respiratory infections. Our objective was to evaluate the production of antibodies to pneumococcal polysaccharide antigens after active immunization in DS subjects. IgG antibodies to pneumococcal serotypes were measured before and 6 weeks after immunization with a 23-valent pneumococcal vaccine (Pneumo23, Pasteur-Merrieux) in 6- to 13-year-old DS children (N = 17) and in aged-matched normal controls (N = 30). An adequate response was defined as a 4-fold increase over baseline or a post-immunization level of specific pneumococcal serotype antibody > or = 1.3 microg/mL. After immunization, all DS children had an increase in post-immunization levels against all serotypes analyzed. A 4-fold or more increase was observed in all DS children concerning serotypes 1 and 14, in 90% of subjects for serotypes 3 and 9V, and in 65% for serotype 6B. Regarding this increase, 8 of the 17 DS children had an adequate response to all serotypes analyzed, 8/17 patients to 4 serotypes and 1/17 to 3 serotypes. However, when we compared post-immunization levels between DS children and controls, we observed lower levels in the former group (P < 0.05) for all serotypes except serotype 3. We conclude that pneumococcal polysaccharide immunization could be beneficial for these DS children.

My comments:

This isn't earth-shattering research, but I included this study since it covered immunity and DS, which is a topic I don't see very often anymore. This study used the old pneumococcal vaccine which has been replaced by the newer PrevnarTM, which covers more of the serotypes that cause significant disease in children. Since children with DS do have a higher risk of infection, this is a good vaccine for these children.

Previously, the only study done on people with DS and vaccinations was done on hepatitis B, which showed good results. While theoretically all the vaccines should have the same effect on children with DS as in the general population, it's good to see it confirmed by research .
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