Kidney Week

Abstract: SA-PO1105

PCV13 and PPSV23 Effectiveness in Individuals with and Without Reduced Kidney Function

Session Information

• CKD Epidemiology, Risk Factors, Prevention - III
  November 04, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

• Le, Dustin, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States

Dustin Le,

• Chang, Alexander R., Geisinger Health, Danville, Pennsylvania, United States

Alexander R. Chang,

• Grams, Morgan, New York University Grossman School of Medicine, New York, New York, United States

Morgan Grams,

• Coresh, Josef, Johns Hopkins University Welch Center for Prevention Epidemiology and Clinical Research, Baltimore, Maryland, United States

Josef Coresh,

• Ishigami, Junichi, Johns Hopkins University Welch Center for Prevention Epidemiology and Clinical Research, Baltimore, Maryland, United States

Junichi Ishigami,

Background

Individuals with chronic kidney disease have increased risk of infection and decreased serologic response to pneumococcal vaccination. The comparative effectiveness of pneumococcal vaccination in individuals with and without CKD is unknown.

Methods

Test negative design of all hospitalized adults at Geisinger Health System with a pneumococcal urine antigen test from 2016 – 2021. Cases were defined by a composite of positive urine test, body fluid culture, or diagnostic code for pneumococcal disease. Controls were those who tested negative. We used doubly robust estimation by controlling for the probability of receiving a pneumococcal vaccine using inverse probability of treatment weighting as well as multivariable logistic regression to estimate the odds ratios (ORs) of receiving vaccination between cases and controls. VE was calculated as 1-OR*100.

Results

We identified a total of 180 cases and 3,889 controls (mean age 69 years, female 48%, White 97%, mean eGFR 71 mL/min/1.73 m²). The receipt of PCV13, PPSV23, and both was seen in 42%, 76%, and 39% among cases, and 51%, 78%, and 48% among controls. In the overall population, the adjusted PCV13 VE was 36% (95% CI 2.6 – 58%), and combination PCV13 & PPSV23 was 40% (13 - 59%); but not evident for PPSV23 (VE -16% [95% CI -93 – 31%]). When stratified by eGFR, the adjusted PCV13 VE was consistent in eGFR ≥60 (VE 38% [95% CI -5.2 - 64%]) and 30-59 ml/min/1.73m² (VE 57% [95% CI 11 – 79%]) without significant interaction; but not calculable for eGFR <30 due to small sample size.

Conclusion

Receipt of PCV13 was associated with reduced risk of pneumococcal diseases in individuals with reduced kidney function.

Abbreviations: VE, vaccine effectiveness; PCV13, Pneumococcal conjugate vaccine 13; PPSV23, Pneumococcal polysaccharide vaccine 23; eGFR, estimated glomerular function; ICD10, International Classification of Disease; IPTW, inverse probability of treatment weighting