Giebink G S, Le C T, Schiffman G
J Pediatr. 1984 Oct;105(4):576-82. doi: 10.1016/s0022-3476(84)80422-9.
Asplenic persons are at increased risk of overwhelming sepsis caused by Streptococcus pneumoniae. Vaccination with polyvalent pneumococcal polysaccharide has been shown to stimulate a nearly normal antibody response in these individuals, indicating that active vaccination might prevent pneumococcal disease in this population. To obtain information on the duration of protective levels of pneumococcal antibody, 33 asplenic children were vaccinated and antibody levels were measured at intervals for up to 4 1/2 years after vaccination. Significant antibody decline was observed in children who had undergone splenectomy because of trauma, but antibody decline was not observed in children whose spleens had been removed because of hereditary spherocytosis. There was a highly significant difference in rates of antibody decline among the 12 antibody serotypes measured: types 1, 4, 6A, 7F, 8, 19F, and 23F showed the greatest decline. Based on measured rates of antibody decline, subprotective antibody levels (antibody nitrogen less than 300 ng/ml) for types 7F, 8, and 19F would be reached 1 to 2 years after vaccination; type 6A never reached the protective level; and antibodies against the remaining eight types either were within the protective range initially or did not show significant decline. Asplenic children may benefit from revaccination with certain antigen types (7F, 8, and 19F) 1 to 2 years after initial vaccination.
无脾者感染肺炎链球菌导致暴发性败血症的风险增加。已证明接种多价肺炎球菌多糖疫苗能在这些个体中刺激产生近乎正常的抗体反应，这表明主动接种疫苗可能预防该人群中的肺炎球菌疾病。为了获取有关肺炎球菌抗体保护水平持续时间的信息，对33名无脾儿童进行了疫苗接种，并在接种后长达4年半的时间里定期测量抗体水平。因创伤而接受脾切除术的儿童中观察到抗体显著下降，但因遗传性球形红细胞增多症而切除脾脏的儿童中未观察到抗体下降。在所测量的12种抗体血清型中，抗体下降率存在极显著差异：1型、4型、6A 型、7F型、8型、19F型和23F型下降最为明显。根据所测量的抗体下降率，7F型、8型和19F型疫苗接种后1至2年将达到亚保护抗体水平（抗体氮低于300 ng/ml）；6A型从未达到保护水平；针对其余8种类型的抗体要么最初处于保护范围内，要么未显示出显著下降。无脾儿童在初次接种疫苗后1至2年再次接种某些抗原类型（7F型、8型和19F型）可能会受益。
