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Impaired responses to pneumococcal polysaccharide vaccination*

Impaired responses to pneumococcal polysaccharide vaccination*
Phenotype* PPSV23 response
6 years and older Younger than 6 years
Severe ≤2 protective titers (≥1.3 mcg/mL) ≤2 protective titers (≥1.3 mcg/mL)
Moderate <70% of serotypes are protective (≥1.3 mcg/mL) <50% of serotypes are protective (≥1.3 mcg/mL)
Memory Loss of response within 6 to 12 months Loss of response within 6 to 12 months
Notes:
  1. Antibody response phenotypes are not always consistent with or predictive of infection severity.
  2. If initial responses are not adequate, patients might respond to a second dose of PPSV23, administered one year after the first dose.
  3. If antibodies in previously unimmunized individuals or in subjects who previously received conjugate vaccine(s) are <1.3 mcg/mL, response to the polysaccharide vaccine given subsequently can be evaluated based on the results of all tested serotypes. In patients who already have protective antibodies in response to conjugate vaccines, the response to PPSV23 can only be evaluated based on antibodies to serotypes that are not in the conjugate vaccine.
  4. Responses to conjugate vaccines do not rule out unresponsiveness to pure polysaccharides.
PPSV23: 23-valent pneumococcal polysaccharide vaccine.
* Diagnosis requires that the patient have a history of recurrent, severe, or refractory sinopulmonary infections.
Original table modified for this publication. From: Orange JS, Ballow M, Stiehm ER, et al. Use and interpretation of diagnostic vaccination in primary immunodeficiency: A working group report of the basic and clinical immunology interest section of the American Academy of Allergy, Asthma & Immunology. J Allergy Clin Immunol 2012; 130:S1. Table used with the permission of Elsevier Inc. All rights reserved.
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