Kidney Week

Abstract: SA-PO0837

Seroprotection Following Pneumococcal Vaccination in Patients with Glomerular Diseases

Session Information

• Glomerular Management: Real-World Lessons and Emerging Therapies
  November 08, 2025 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Glomerular Diseases

• 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics

Authors

• Glenn, Dorey A., The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States

Dorey A. Glenn, MD, MPH

• Liu, Qian, The Children's Hospital of Philadelphia Research Institute, Philadelphia, Pennsylvania, United States

Qian Liu, MPH

• Greenbaum, Larry A., Emory University, Atlanta, Georgia, United States

Larry A. Greenbaum, MD, PhD

• Bomback, Andrew S., Columbia University, New York, New York, United States

Andrew S. Bomback, MD, MPH

• Mariani, Laura H., University of Michigan, Ann Arbor, Michigan, United States

Laura H. Mariani, MD, MS, FASN

• Zee, Jarcy, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States

Jarcy Zee, PhD

• Hogan, Susan L., The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States

Susan L. Hogan, PhD, MPH

• Falk, Ronald, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States

Ronald Falk, MD, FASN

• Denburg, Michelle, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States

Michelle Denburg, MD

• Mottl, Amy K., The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States

Amy K. Mottl, MD, MPH, FASN

Background

Pneumococcal infections contribute to excess healthcare utilization and morbidity in individuals with glomerular disease (GD). Immunogenicity of pneumococcal vaccines in individuals with GD may be attenuated by immune dysregulation and immunosuppressant use.

Methods

We retrospectively evaluated immunogenicity of conjugate (PCV13) and polysaccharide (PPSV23) pneumococcal vaccines among patients with GD enrolled in the CureGN observational cohort study. Antibody titers to 23 pneumococcal serotypes were measured by quantitative multiplex bead assay from samples obtained within 6 months prior to (V0), and 1-4 months (V1) and 10-18 months (V2) following vaccination. Seroprotection was defined as a ≥2-fold increase in serotype titer with a post-vaccination titer ≥1.3 ng/mL for >50% of serotypes if aged 2-5 years or >70% of serotypes if aged 6-65 years. A lower threshold of 0.35 ng/mL was used to estimate seroprotection from invasive pneumococcal infections. Logistic GEE models were developed to examine the univariate associations between age, sex, race, disease activity markers, and immunosuppressants with seroprotection.

Results

A total of 77 individuals received 58 PCV13 and 26 PPSV23 vaccinations (34% female, median age 50 years [IQR 34, 60], median eGFR 72 ml/min/1.73m²). 48% were receiving immunosuppressants +/- 2 weeks of vaccination. Seroprotection rates at V1 and V2 timepoints were 36% and 27% following PCV13 vaccination and 27% and 21% following PPSV23 vaccination, respectively. Seroprotection rates against invasive pneumococcal infections (threshold >0.35 ng/mL) at V1 and V2 were 90% and 90% following PCV13 and 96% and 79% following PPSV23. Individuals exposed to anti-CD20 therapy at time of vaccination had greater odds of poor seroprotection (p=0.0521).

Conclusion

Seroprotection following pneumococcal vaccination may be poor in patients with GD receiving anti-CD20 therapy, leading to excess infection-related morbidity in this vulnerable population.

Funding

• NIDDK Support

Digital Object Identifier (DOI)

• doi: 10.1681/ASN.2025yx29hwd0