PPV-233 vaccination significantly increases antibody of elderly hajj pilgrims

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Illustration by Feri Fenoria

UNAIR NEWS – The emergence of several health problems faced by Indonesian hajj pilgrims, especially the elderly inspired researcher to find a solution. One of the research is from Department of Internal Medicine, Faculty of Medicine, Dr. Soetomo, Universitas Airlangga which published in one of the leading international journals, New Armenian.

Gatot Soegiarto MD., PhD, his research results confirm that PPV-23 vaccination significantly increases antibody levels and is quite protective. Besides, an important conclusion is PPV-23 vaccination significantly promotes an increase in serum pneumococcal-specific IgG levels in elderly pilgrims and prevents pneumococcal infection.

“There is still limited data on the effect of pneumococcal polysaccharide vaccination (PPV-23) on specific levels of serum pneumococcal IgG in the elderly,” he said.

Gatot said the current population in Indonesia is 225,000,000 and 7.6% or 17,100,000 people are elderly. In 2025, it is estimated that Indonesia’s elderly population will increase by around 13.1 % of the population.

“In the elderly, decreased immune response causes more severe infections. That is why vaccination to prevent infections, especially pneumonia, is significant, ” he said.

Gatot said pneumonia risk factors that are often found in the elderly, namely a decrease in immune function. Many aspects of the body’s defense decline in the elderly: reduced ability to produce antibodies, decreased mucociliary cleansing function, and changes in respiratory ability.

Bacteria colonization of the upper respiratory tract by gram-positive and gram-negative bacteria is often found in the elderly and associated with the severity of the systemic disease. Smoking, heart failure, diabetes mellitus, malignancy, and a previous history of pneumonia are risk factors for pneumonia. Nevertheless, the increase in serum levels of pneumococcal-specific IgG after PPV-23 vaccination in this study is evidence that this vaccine is no less effective for the elderly.

“Unfortunately, the effectiveness of pneumonia vaccination in older people is still being debated. The meta-analysis failed to provide strong evidence about the benefits of vaccines against Invasive Pneumococcus Disease (IPD) or pneumonia, “he said.

According to Gatot, the signs and symptoms of pneumonia in the elderly are often not known by people so it often causes delays in diagnosis. This situation has very significant impacts such as more extended treatment periods, higher treatment costs, and frequent complications.

The immune response to pneumococcal vaccination can be measured by various parameters such as an increase in specific levels of serum pneumococcal IgG or the protective effect of vaccination in the event of pneumonia infection. The effectiveness of vaccination can be evaluated by conducting clinical trials, which are not easy to do. ELISA can measure evaluation of serum pneumococcal specific antibody levels after vaccination.

Gatot said the elderly have a high risk of pneumonia infection due to high transmission factors and extreme weather. Pneumonia is the most common infection for elderly hajj pilgrims.

“This study focuses on determining the effect of PPV-23 vaccination on specific levels of serum pneumococcal IgG in elderly pilgrims who will perform the pilgrimage and evaluate the incidence of pneumonia infection during hajj,” he said. (*)

Author: Feri Fenoria

Editor: Khefti Al Mawalia

Detail  information from this study can be seen at New Armenian Medical Journal:

https://ysmu.am/website/documentation/files/b11f70f8.pdf

Merlyna Savitri, Jusri Ichwani, Ari Baskoro, Gatot Soegiarto. 2019. Polysaccharides Pneumonia Vaccination (Ppv-23) and Serum Pneumonia-specific IgG Levels in the Elderly. The New Armenian Medical Journal Vol.13, Nо 1, p. 85-90

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