Ensuring Pneumococcal Immunity in Sickle Cell Disease Children

This publication was approved and written in close collaboration with Dr. Seethal Jacob.

Dr. Seethal Jacob is a Hematologist and Director of the Comprehensive Pediatric Sickle Cell Program at Riley Hospital for Children at IU Health. Dr. Jacob is a featured expert in our health equity-focused Pro Hub that lists inclusive global healthcare professionals committed to advancing inclusive research and providing the highest quality care to all patients.

These articles are written by Diverse Health Hub to summarize complex medical research in order to facilitate deeper understanding. Diverse Health Hub publications are not intended to persuade its readers. We present information to create in-depth conversations that encourage patients to critically think and decide for themselves.

The genetic condition of sickle cell disease (SCD) results when sickle cell genes are inherited from each parent. We connected with Dr. Seethal Jacob about a study on maintaining an immune response against pneumococcal bacteria in children with SCD. This is new research that has yet to be evaluated by other clinical researchers and should not be used to guide clinical practice.

Who Does SCD and SCT Impact the Most?

Sickle cell disease primarily impacts those with African ancestry. Sickle cell trait (SCT) provides protection against malaria and is also more common in Latina/Latino/Lantinx people from Central America, the Caribbean, and South America; people of Southeast Asian descent; people of Mediterranean descent, and people of Middle Eastern descent.

Symptoms of sickle cell disease can start as early as a baby’s first 6 months of age. Complications of SCD can range from mild to severe conditions and vary by patient. Some complications of SCD may include:

·   Anemia

·   Pain

·   Acute chest syndrome

·   Hand-foot syndrome

·   Splenic sequestration (sudden-onset spleen enlargement)

·   Leg ulcers

·   Loss of vision

·   Pulmonary embolism

·   Deep vein thrombosis

·   Infection

·   Organ damage 

Preventing Severe Pneumococcal Disease in Children With SCD

Along with the previously mentioned complications, increased susceptibility to certain bacterial infections can also impact those with SCD. Children with SCD are at particularly high risk due to these infections.  A bacteria type named pneumococcal is among those bacteria and has been linked to cases of severe blood infections and pneumonia. Pneumococcal vaccines are recommended for children, adults ages 65 and older, and for people with medical conditions, including SCD, that put them at higher risk of infection and hospitalization.

Pneumococcal Vaccine Immunity Study Results and Recommendations

Of the 41 SCD patients who were included in the study, the average age was 12 years, and the gender percentage was balanced between male and female patients. The patients’ pneumococcal vaccinations and immunity were tracked, and the study results found that an adequate immune response occurred in 68 percent of the patients 5 years (plus or minus 1 year) following completion of a two-dose series of the 23-valent pneumococcal vaccine.

 For the study participants who fell into the inadequate pneumococcal immune response, the average time was 5.42 years after their last pneumococcal dose. The study found that even among those who were vaccinated yet did not show an adequate level of pneumococcal immunity, they did not demonstrate a higher level of severe pneumococcal disease. The researchers were also curious if there might be a link between specific disease characteristics and pneumococcal immune response. But when they examined the study data, no evidence to correlate a link between the two was found. 

Study researchers concluded that the initial two doses of the 23-valent pneumococcal vaccine are important to protect against severe bacterial infections, but additional doses after that may not be necessary right away.

What Happens Next With the Pneumococcal Vaccine in Children With SCD Study? 

After the conclusion of the study and examination of study results, the SCD researchers concluded that potential future studies should look at levels of immunity over a longer period of time. By examining results over a longer period of time, studies could help find the rate of loss of immunity, likelihood of severe pneumococcal infection, and to help determine the ideal times for revaccination of children with SCD. If you have concerns about your pneumococcal immunity and whether you need additional vaccination, make sure to talk to your doctor about your concerns or contact one of the experts featured in our Sickle Cell Provider Directory who are committed to working toward optimal health outcomes.

In retaining editorial control, the information produced by Diverse Health Hub does not encapsulate the views of our sponsors, contributors, or collaborators.

Importantly, this information is not a substitute for, nor does it replace professional medical advice, diagnosis, or treatment. If you have any concerns or questions about your health, you should always consult with a healthcare professional.

Sources

Mahvish Q. Rahim, MD; Alexandria M. Arends, PharmD, BCPPS; and Seethal A. Jacob, MD, MS. Maintenance of an Immunogenic Response to Pneumococcal Vaccination in Children With Sickle Cell Disease. Accessed August 2, 2021. https://journals.lww.com/jpho-online/Abstract/9000/Maintenance_of_an_Immunogenic_Response_to.96897.aspx

Pneumococcal Vaccination. Centers for Disease Control and Prevention website. Accessed August 2, 2021. https://www.cdc.gov/vaccines/vpd/pneumo/index.html