Pharmacists Provide Tailored Pneumococcal Vaccines to Patients With Down Syndrome

Researchers uncovered a low occurrence of adequate immune responses to pneumococcal vaccination among children with Down syndrome (DS), according to a study published in Vaccine: X.¹ Because patients with DS are more at risk for pneumococcal and other vaccine-preventable diseases when compared with otherwise healthy patients, researchers suggested tailored vaccine strategies and approaches specifically within the DS population.

“DS is the most common chromosomal anomaly at birth, accounting for approximately 8% of all recorded congenital anomalies in Europe,” wrote authors of the study. “[Multiple factors] contribute to an increased susceptibility to recurrent respiratory infections, resulting in high rates of hospitalization and illness-related school absenteeism. Individuals with DS show increased prevalence and severity of pneumonia, which remain a major cause of morbidity and mortality in this group of individuals and is often associated with infections by Streptococcus pneumoniae.”

Topics surrounding vaccine efficacy, their safety among children, and their potential risks have flooded recent discourse. While some experts and researchers are correcting misinformation on vaccines for children with autism and their parents, others are exploring the heightened need for vaccination among children with DS.

READ MORE: Pneumococcal Conjugate Vaccines Reduces Incidence of Pneumonia for Children 2 Years and Under

According to the International Journal of Contemporary Pediatrics, children with DS are highly susceptible to severe, potentially prolonged, and often recurring infectious diseases. With upper respiratory tract infection (URTI) and otitis media being the most common diseases among this population, people with DS are also suggested to receive all regular vaccine schedules as well as influenza, pneumococcal, rotavirus, human papillomavirus, meningococcal, and hepatitis B vaccines.²

“Pneumococcal conjugate vaccines (PCVs) have significantly reduced the burden of invasive pneumococcal disease in the general population; however, the specific immune response in children with DS has not been fully elucidated, and the available data are limited to small sample sizes and methodological limitations,” continued authors of the current study.¹

With immune system deficiency common among people with DS, as well as the condition being a risk factor for pneumococcal diseases, previous research and recommendations suggest all adults with DS should receive pneumococcal vaccination.³ However, with uncertainties in the immune responses for children and adolescents with DS, researchers of the current study wanted to further explore pneumococcal vaccine efficacy in this population.¹

Their main goals were to examine rates of adequate immune responses to pneumococcal vaccination, such as antibody coverage, as well as identify the predictors of these responses. To do this, researchers conducted a monocentric cross-sectional study consisting of a significantly large group of patients 1 to 19 years old with DS between September 2021 and April 2022. Children were only included in the final analysis if they’d received a confirmed DS diagnosis and PCV from the Italian vaccine schedule.

Using the VaccZyme Anti-PCP IgG Enzyme Immunoassay Kit, researchers measured patients’ anti-pneumococcal immunoglobulin G (IgG) titers, which helped them determine the number of antibodies protecting patients against pneumococcal capsular polysaccharides and their serotypes.¹

The final analysis concluded with a total of 406 participants (mean age, 8.4 years; 56.2% boys) with DS.

Among the patient population, recurrent respiratory infections, as the researchers previously noted, were common and occurred in 57.4% of participants. URTIs were the most common autoimmune disorders (39.9%) among the cohort, and 84.55% of the population received at least 1 dose of PCV13.

“Most of the subjects (84.5%) received the PCV13, but despite this high rate of vaccination, only about half of the population (50.5%) achieved a satisfactory immune response, defined as anti-pneumococcal IgG levels ≥0.35 μg/mL; these data are lower than the responses typically seen in non-DS population and can reflect the already mentioned compromised sustained vaccine responses in DS,” they wrote.¹

Indeed, only about half of the study population achieved a significant immune response following PCV administration. For those under the 0.35 μg/mL threshold, participants were more likely to be younger and less likely to have autoimmune disorders or hypothyroidism.

Based on these study results, researchers believe a significantly more tailored approach—with the help of vaccine experts such as pharmacists—in vaccinating children with DS against pneumococcal diseases is crucial. Along with more personalized approaches to immunization in this population, researchers also suggested future research to better improve outcomes for at-risk groups like patients with DS.

“Our findings highlight the suboptimal specific immune response to pneumococcal vaccination in children with DS and underscore the need for tailored immunization schedules in this high-risk population,” concluded the authors.¹ “By ‘tailored,’ we refer to vaccination strategies adapted specifically to the DS population as a whole, such as adjusted booster schedules or timing modifications, to enhance immunological protection against pneumococcal disease and other vaccine-preventable infections. Future research should focus on defining the optimal vaccination protocols to improve outcomes in this vulnerable group.”

READ MORE: Pneumococcal Resource Center

Don’t get left behind: Sign up today for our free Drug Topics newsletter and get the latest drug information, industry trends, and patient care tips delivered straight to your inbox.

REFERENCES

1. Musolino A, Roversi M, Romaniello M, et al. Antibody response after pneumococcal vaccination in a large cohort of Italian children and adolescents with Down syndrome. Vaccine: X. 2025;27:100744. https://doi.org/10.1016/j.jvacx.2025.100744

2. Alrahili M, Binyamen A, Al Otaibi F, et al. View of importance of vaccines in children with Down syndrome. IJCP. 2018;5(5). https://doi.org/10.18203/2349-3291.ijcp20183503

3. Chicoine B, Dominiak E, Graham H. Pneumococcal vaccines. Advocate Medical Group. October 2024. Accessed November 6, 2025. https://adscresources.advocatehealth.com/pneumonia-vaccine/