Home Publications Research Grants Inventions & Patents Awards Additional Research Activities Faculties & Institutions Research Areas

A randomized trial of simultaneous versus sequential pneumococcal vaccination in elderly

Bahrs C, Andreas N, Lehmann T, Baumgart S, Jørgensen CS, Makarewicz O, Röll D, Moeser A, Hagel S, Watzl C, Bogdan C, Kamradt T, Pletz MW (2025)

---

Publication Type: Journal article

Publication year: 2025

Journal

DOI: 10.1016/j.cmi.2025.08.014

Abstract

Objectives: To evaluate whether simultaneous vaccination of the 13-valent pneumococcal conjugate vaccine (PCV13) and the 23-valent polysaccharide vaccine (PPSV23) elicits higher antigen-specific memory B cell responses compared to sequential (PCV13 followed by PPSV23 after 6 months) or single PPSV23 vaccination in elderly. Methods: In this monocentric, randomized trial, vaccine-naïve adults aged ≥60 years were assigned 1:1:1 to a simultaneous, sequential or single vaccination group. The primary outcome was the change in memory B cells specific for four vaccine-serotypes (ST3, ST14, ST19A, and ST23F) at 27 to 28 weeks after first vaccine dose compared to baseline. Secondary outcomes assessed safety, serotype-specific immunoglobuin G geometric mean fold rise (GMFR) and memory B cells over a 24-month period. Results: Total of 123 persons (41 per group, 65.2 ± 4.4 years, 61.8% females) were randomized. Among 118 evaluable persons, median changes (95% CI) in memory B cells relative to total B cells from baseline to week 27 to 28 were most pronounced for ST19A with 0.022% (0.002%–0.045%) in the simultaneous, 0.022% (−0.006% to 0.068%) in the sequential, and 0.005% (−0.004% to 0.054%) in the single group. There was no evidence of a significant difference in memory B cell responses across all four vaccine-serotypes induced by simultaneous when compared with sequential or single vaccination (e.g. Hodges-Lehmann [HL-] estimator for ST19A, −0.007% [95% CI, −0.038% to 0.021%] for simultaneous vs. sequential; 0.009% [95% CI, −0.017% to 0.036%] for simultaneous versus single), at primary endpoint. Six months after completing the full vaccination schedule, memory B cell response for ST19A was lower in simultaneous than sequential group (HL-estimator, −0.039%; 95% CI, −0.071% to −0.010%). At 24 months, sequential vaccination achieved higher immunoglobulin G against ST3 (GMFR 5.17) than simultaneous (GMFR 2.82) or single vaccination (GMFR 1.94). No serious adverse events occurred. Conclusion: Simultaneous vaccination did not elicit higher memory B cell responses compared to sequential or single vaccination. All approaches were safe.

Authors with CRIS profile

Involved external institutions

How to cite

APA:

Bahrs, C., Andreas, N., Lehmann, T., Baumgart, S., Jørgensen, C.S., Makarewicz, O.,... Pletz, M.W. (2025). A randomized trial of simultaneous versus sequential pneumococcal vaccination in elderly. Clinical Microbiology and Infection. https://doi.org/10.1016/j.cmi.2025.08.014

MLA:

Bahrs, Christina, et al. "A randomized trial of simultaneous versus sequential pneumococcal vaccination in elderly." Clinical Microbiology and Infection (2025).

BibTeX: Download