Kidney Week

Abstract: SA-PO0535

Serum Antibody Responses to the 20-Valent Pneumococcal Conjugate Vaccine Across CKD Stages and Dialysis

Session Information

• CKD: Clinical - Therapies, CKM Health, Special Populations, and More
  October 24, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2202 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

• Jain, Swati, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States

Swati Jain, PhD

• Wills, Kelly M., VA Eastern Colorado Health Care System, Aurora, Colorado, United States

Kelly M. Wills, RN

• Silveira, Lori, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States

Lori Silveira, PhD

• Nicholson, Lindsay K., VA Eastern Colorado Health Care System, Aurora, Colorado, United States

Lindsay K. Nicholson, MD

• Janoff, Edward N., University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States

Edward N. Janoff, MD

• Jani, Alkesh, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States

Alkesh Jani, MD

Background

Patients with chronic kidney disease (CKD) are at increased risk of pneumococcal disease, with pneumonia contributing substantially to morbidity and mortality. Immune responses to pneumococcal conjugate vaccines across CKD stages and dialysis remain incompletely defined, particularly with newer formulations such as the 20-valent pneumococcal protein-polysaccharide conjugate vaccine (PCV-20).

Methods

Adults >50 years with CKD stage III/IV (n=37), CKD V and on dialysis (n=10), and control subjects without CKD (n=34) (95% of whom had previously received other pneumococcal vaccines) were immunized with PCV-20. Sera were collected at baseline, week 4, and week 26. IgG to pneumococcal capsular polysaccharide (PPS) serotypes and the CRM-197 carrier protein were quantified by ELISA. Values at each time were compared across groups.

Results

PCV-20 induced significant increases in serum PPS-specific IgG to >90% of serotypes across all groups. Overall serotype-specific responses in CKD stage III/IV were comparable to non-CKD controls, with no consistent attenuation (Figure 1). Peak IgG levels at week 4 were similar between CKD and controls for nearly all serotypes, except for higher levels to serotype 18C in CKD. Responses in CKD V/dialysis were largely comparable to both CKD III/IV and controls, but with greater variability. Fold rises in PPS-specific IgG from baseline to week 4 were similar across groups, with no consistent relationship between CKD stage and response magnitude. In contrast, while polysaccharide-specific (PPS) responses were preserved, dialysis patients exhibited reduced IgG responses to the CRM-197 carrier protein compared with CKD and controls.

Conclusion

PCV-20 elicits broadly preserved serum antibody responses to PPS serotypes in CKD stage III/IV and CKD V/dialysis, indicating maintained systemic immunogenicity despite comorbidity burden. In contrast, CKD V/dialysis is associated with a selective attenuation of protein-specific responses, suggesting differential responses to polysaccharides and proteins with advanced renal failure.

Funding

• Veterans Affairs Support