Table 8

Immunogenicity and safety of 7-valent and 13-valent pneumococcal conjugate vaccine (PCV7 and PCV13), including prime boosting with 23-valent pneumococcal polysaccharide vaccine (PPSV23), in patients with AIIRD (October 2009–August 2018)

First author +ref.YearStudy designNo. casesStrategyNo. STImmunogenicitySafetyLoE
Imm. Saf.
 Grabar128 2017RCT46 SLE:
27 placebo +PPSV23
19 PCV7 +PPSV23
NA7Adequate immunogenicity
No differences between groups
No safety issue1b4
 David Morgan105 2016Cohort92 AAVNA7Preserved immunogenicity in patients on remission2b
 Nagel123 2015Cohort248 RA
249 SpA
NA2Good correlation between levels of immunogenicity and incidence of pneumonia2b
 Kapetanovic108 2013Cohort173 RA
86 SpA controls
NA2Reduced response in patients treated with ABA and RTXNo safety issue2b4
 Kapetanovic127 2013Cohort163 RA
139 SpA
NA2Reduced immunogenicity after 1.5 y2b
 Kapetanovic110 2011Cohort253 RA
252 SpA
(MTX, anti-TNF)
NA2Reduced response in pts treated with MTXNo safety issue2b4
 Kapetanovic111 2011Cohort201 RA (PCV7)
201 RA (PPSV23)
NA2Similar immunogenicity for PCV7 and PPSV23No safety issue2b4
PCV13, including prime boosting with PPSV23
 Nguyen106 2017RCT98 RA
12Adequate and similar response in the three armsNo safety issue2b4
 Bahuaud133 2018Cohort23 RAPCV13 +PPSV2310Adequate short-term response
Functional antibodies decreased after 2 years
 Kapetanovic118 2017Cohort10 RA-MTX
10 RA-DC
PCV132Reduced response in MTX-treated patients4
 Nived117 2017Cohort49 vasculitis
49 HC
PCV132Adequate response, similar in both groupsNo safety issue2b4
 Nagel114 2017Cohort47 SLE
21 HC
PCV1312Decreased response in IS-treated patients with SLE, preserved under HCQ and belimumabNo safety issue2b4
 Rakoczi129 2016Cohort22 RA
24 OA
PCV13NRAdequate immunogenicity, but lower in RANo safety issue2b4
 Groh132 2017Case series19 AAV
  • 9 induction

  • 10 maintenance

PCV13/PCV 7±PPSV237Decreased response on induction, preserved on maintenance therapy4
  • AAV, ANCA-associated vasculitis; ABA, abatacept; ANCA, antineutrophil cytoplasmic antibodies; bDMARD, biological disease-modifying antirheumatic drug; (cs)DMARD, (conventional synthetic) DMARD; DC, disease control; HC, healthy controls; HCQ, hydroxychloroquine; imm., immunogenicity; IS, immunosuppressives; LoE, level of evidence; MTX, methotrexate; No., number; NR, not reported; OA, osteoarthritis; pts, patients; RA, rheumatoid arthritis; RCT, randomised controlled trial; ref., reference; RTX, rituximab; saf., safety; SLE, systemic lupus erythematosus; SpA, spondyloarthropathy; ST, serotypes; TCZ, tocilizumab; TNF, tumor necrosis factor; y, years.