The Efficacy of Pneumococcal and Influenza Vaccination in Prevention of Relapse of Steroid-Sensitive Nephrotic Syndrome in Children

Abstract Background: Nephrotic syndrome (NS) is a common disorder in the pediatric age group. The majority of them developed relapse due to infection. About 50%–70% relapses occur due to respiratory tract infection. Therefore, pneumococcal and influenza vaccination may prevent the number of relapses. Materials and Methods: This prospective, case–control study was carried out in the department of Pediatric Nephrology, Bangabandhu Sheikh Mujib Medical University, Dhaka, from November 2016 to February 2018. A total of 120 patients aged 2–18 years old with an initial episode of idiopathic NS (INS) were included in this study. They were divided in two groups according to age and administration of the Haemophilus influenzae vaccine: Group A and Group B. Group A included 60 children of younger age group (2–8 years). All of them received Haemophilus influenzae vaccine through the Expanded Program on Immunization (EPI) schedule. They were further subdivided into two subgroups: Group A1 and Group A2. Group A1 included 30 children who received pneumococcal and influenza vaccines. Group A2 also included 30 children who refused vaccination. Similarly, Group B included 60 children, and they belonged to the older age group (>8–18 years). They did not receive Haemophilus influenzae vaccine through the EPI schedule. They were further subdivided into two subgroups: Group B1 and Group B2. Group B1 included 30 children who received pneumococcal and influenza vaccine. Group B2 also included 30 children who refused vaccination. All of them were followed up for 1 year to compare the clinical effects. Results: A total of 120 patients were studied. Among them, the number of patients without relapses was high in the younger age vaccinated group than non-vaccinated group (36.7% vs. 10%; P = 0.003). In addition to this, older age vaccinated group developed less relapses compared to the non-vaccinated group ( P < 0.05). This indicates that vaccination has a beneficial role in preventing relapse in children with INS. Conclusion: Vaccination against pneumococcus and influenza lowers relapses in children with INS.