Background: While the 23-valent pneumococcal polysaccharide vaccine (PPV23) is routinely used in Canada and\nsome other countries to prevent pneumococcal infection in adults with chronic kidney disease (CKD), patients\ndevelop a suboptimal antibody response to PPV23 due to their immune dysfunction. The 13-valent pneumococcal\nconjugate vaccine (PCV13) has superior immunogenicity in some categories of immunocompromised adults;\nhowever, its effect on the immune response in CKD patients has only been addressed by two recent studies with\nconflicting results. The effect of PPV23 or PCV13 on B cells in these patients has not been previously studied. We\nstudied the absolute numbers and proportions of B cells and subpopulations in two groups of adult patients with\nsevere CKD pre- and 7 days post-immunization with PCV13: pneumococcal vaccine naive and previously immunized\nwith PPV23 (over one year ago)....................
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